Evaluation of the (qSOFA) Tool in the Emergency Department Setting: Nurse Perception and the Impact on Patient Care.

Abstract

In the emergency department (ED) setting, nurses perform the initial evaluation of patients, thereby placing ED nurses in a prime position to recognize sepsis and greatly influence prompt implementation of treatment. The quick Sequential Organ Failure Assessment (qSOFA) tool was first introduced as part of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) as a predictor of both increased mortality and longer intensive care unit (ICU) stays. Designed for use outside the ICU, the qSOFA tool functions as a simple bedside tool to quickly identify patients at risk for developing sepsis. As a method to improve detection of sepsis in the ED, an evidence-based screening tool based on the qSOFA criteria was developed. The project implemented over a 14-day period resulted in 106 surveys. Average time from patients entering the ED to actual triage evaluation was 13 min, and the median time from the completion of triage evaluation to the completion of the qSOFA screening tool was 4 min. To determine acceptance of the qSOFA tool for use in detecting sepsis in the ED, a second aim was to evaluate ED nurses' perceptions of the effectiveness, timeliness, and ease of use of the qSOFA evaluation tool. Anonymous postsurvey results revealed that participants were moderately familiar with the qSOFA tool and found it overall easy to complete. The majority of participants stated only a slight likelihood of using the qSOFA tool if it were implemented into clinical practice.