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Incorporating Interprofessional Evidenced-Based Sepsis Simulation Education for Certified Nursing Assistants (CNAs) and Licensed Care Providers Within Long-term Care Settings for Process and Quality Improvement

Mihaljevic, Susan E. DNP, CRNP-PC, CCRN; Howard, Valerie M. EdD, MSN, RN

doi: 10.1097/CNQ.0000000000000092
Original Articles

Improving resident safety and quality of care by maximizing interdisciplinary communication among long-term care providers is essential in meeting the goals of the United States' Federal Health care reform. The new Triple Aim goals focus on improved patient outcomes, increasing patient satisfaction, and decreased health care costs, thus providing consumers with quality, efficient patient-focused care. Within the United States, sepsis is the 10th leading cause of death with a 28.6% mortality rate in the elderly, increasing to 40% to 60% in septic shock. As a result of the Affordable Care Act, the Centers for Medicare & Medicaid services supported the Interventions to Reduce Acute Care Transfers 3.0 program to improve health care quality and prevent avoidable rehospitalization by improving assessment, documentation, and communication among health care providers. The Interventions to Reduce Acute Care Transfers 3.0 tools were incorporated in interprofessional sepsis simulations throughout 19 long-term care facilities to encourage the early recognition of sepsis symptoms and prompt communication of sepsis symptoms among interdisciplinary teams. As a result of this simulation training, many long-term care organizations have adopted the STOP and WATCH and SBAR tools as a venue to communicate resident condition changes.

Robert Morris University, RISE Center, Moon Township, Pennsylvania (Dr Mihaljevic); and Robert Morris University, School of Nursing and Health Sciences, Moon Township, Pennsylvania (Dr Howard).

Correspondence: Susan E. Mihaljevic DNP, CRNP-PC, CCRN, Carlow University, 3333 Fifth Avenue, Pittsburgh, PA 15213 (

Sepsis simulation sessions were supported by a cooperative agreement (CMS-1E1-12-002 & CFDA: 93.621) from Centers for Medicare & Medicaid Services (CMS) known as Reduce Avoidable hospitalizations using Evidenced-based interventions for Nursing facilities in Western Pennsylvania (RAVEN).

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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