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  1. Hatozaki, Chie RN
  2. Sakuramoto, Hideaki PhD, RN
  3. Okamoto, Mayu RN
  4. Nakajima, Hisao RN
  5. Shimojo, Nobutake MD, PhD
  6. Inoue, Yoshiaki MD, PhD


Background: Previous studies have demonstrated that delayed antibiotic administration increases the risk of mortality in patients with sepsis.


Local Problem: In the emergency department, the antibiotic administration rate within 1 and 3 hours for patients with suspected sepsis was low.


Methods/Interventions: We implemented an educational intervention with the nursing staff, which included training sessions and feedback, to ensure early detection and management of patients with suspected sepsis. Antibiotic administration rates were compared before and after education.


Results: A total of 503 patients were included. The antibiotic administration rate improved as the phases continued (1 hour: from 5.2% to 15.6%, P = .004; 3 hours: from 35.6% to 49.7%, P = .04; 6 hours: from 74.1% to 89.1%, P = .002). The time to initial antibiotic administration also improved from 229 to 185 minutes (P < .001).


Conclusions: Nurse-initiated quality improvement improved the early administration of antibiotics for patients with suspected sepsis.