Digital Repository Masters Projects Spring 2025 Decreasing Sepsis Rates Through Increased Community Awareness and Education Kellie Bennion Weber State University Follow this and additional works at: https://dc.weber.edu/collection/ATDSON Bennion, K. 2025. Decreasing Sepsis Rates Through Increased Community Awareness and Education Weber State University Masters Projects. https://dc.weber.edu/collection/ATDSON This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact scua@weber.edu. WSU REPOSITORY MSN/DNP Decreasing Sepsis Rates Through Increased Community Awareness and Education Project Title by Kellie Bennion Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY Ogden, UT April 20, 2025 Date Kellie Bennion 4/20/2025 Student Name, Credentials (electronic signature) Date MSN Project Faculty (electronic signature) Date Anne Kendrick (electronic signature) Date DNP, RN, CNE MSN Program Director Note: The program director must submit this form and paper. 1 Decreasing Sepsis Rates Through Increased Community Awareness and Education Kellie Bennion, BSN, RN, MSN Student Annie Taylor Dee School of Nursing Weber State University MSN Project 2 Abstract Purposes/Aims: This project aims to raise awareness of sepsis in the local community by educating the public about its early warning signs, the significance of seeking timely medical care, and the enhancement of outcomes through increased awareness. Rationale/Background: There is a need for sepsis awareness and education in community settings. Much of the public lacks- knowledge about sepsis. Many cases start outside hospitals, delaying treatment and resulting in complications or death. This MSN project provides community sepsis education, and research indicates that implementing public education increases individuals' confidence in recognizing sepsis. Methods: Educational materials, including posters, infographics, and social media posts, will be distributed within the community. An in-person presentation and a dedicated sepsis website will offer additional resources. Analyzing pre- and post-survey responses will measure the campaign's effectiveness, and themes and patterns will be identified. The team will use qualitative data from open-ended questions and quantitative data from closed-ended questions to analyze confidence levels and knowledge changes. Results: The project aims to enhance the ability of Weber County community members to identify sepsis symptoms and take timely action. Increased awareness and education foster early intervention, improving outcomes and saving lives. The project will utilize the Iowa Model for continuous evaluation and feedback. Conclusions: Educating the community helps individuals gain the knowledge and confidence to seek prompt treatment for sepsis. Evidence suggests that such educational efforts can reduce mortality rates by enabling earlier detection and intervention. Keywords: sepsis education, community awareness, early intervention, mortality rates 3 Decreasing Sepsis Rates Through Increased Community Awareness and Education Sepsis is a life-threatening condition that occurs when the body's immune system overreacts to an infection. This condition can lead to tissue and organ damage, shock, multiple organ failure, and, in severe cases, death. It can affect anyone, regardless of age. Some common symptoms of sepsis include fever, rapid heart rate, rapid breathing, confusion, and low blood pressure (World Health Organization, 2024). Over 1.7 million Americans develop sepsis each year and of those, 270,000 die (Gaddis & Gaddis, 2021). Yearly, close to 50 million people worldwide are affected by sepsis, and about 40% of those are children younger than five (Schlapbach et al., 2020). Globally, sepsis is responsible for millions of deaths and is declared a health priority by the World Health Organization (WHO) (Cavaillon et al., 2020). Nationally, public awareness and knowledge about sepsis is limited. Many people do not know what sepsis is, and they are unaware that it is a medical emergency that may result in death. People need to become more familiar with the signs and symptoms of sepsis and when it is appropriate to seek treatment (Fiest et al., 2022). Internationally, 88% of people reported not hearing the word sepsis before being educated (Jabaley et al., 2018). Sepsis can be categorized into three stages: sepsis, severe sepsis, and septic shock. All three stages can be life-threatening and require prompt treatment. The first stage is sepsis, which begins when the immune system overreacts to an infection in the body. If it is not treated, it can lead to severe sepsis, resulting in organ dysfunction and potentially involving multiple organs. This stage is typically caused by low blood pressure and widespread inflammation. The last stage is septic shock, which results from extremely low blood pressure despite significant IV (intravenous) resuscitation or medications (Cleveland Clinic, 2022). 4 Community education and awareness programs play a crucial role in helping the public better understand sepsis and the need for prompt medical treatment (Srzić et al., 2022). Eightyseven percent of sepsis cases start outside the hospital, and many go unrecognized without treatment, demonstrating a need for further sepsis education (Gaddis & Gaddis, 2021). Lastly, educating the public on the dangers of sepsis helps motivate them to learn more and instills hope that awareness and early intervention can save lives (Peters et al., 2023). Statement of Problem Recent data and research show a national need for sepsis awareness and education in the community setting. Due to the public's lack of knowledge and understanding, treatment is often delayed, resulting in organ failure and death (Srzić et al., 2022). This lack of awareness and understanding about sepsis in the community leads to poor outcomes. It is crucial to remember that sepsis is preventable; yet patients, the public, and some healthcare professionals do not widely recognize it. Leigh et al. (2022) found that most sepsis cases start in the community, making public awareness of sepsis essential to early diagnosis and treatment. Therefore, this MSN project aims to raise awareness about sepsis and educate the public about its early warning signs and symptoms. It will search current literature to determine the extent of the problem and identify best practices for developing and implementing sepsis awareness and education programs for community members. Significance of the Project Many members of the community are unaware of what sepsis is, its signs or symptoms, or that it is a medical emergency that can result in death (Fiest et al., 2022). For every hour that treatment is delayed, there is an eight percent increase in mortality (Sepsis Alliance, 2024). The longer a person waits for treatment, the poorer their outcome will be. Research suggests that up 5 to 80% of sepsis deaths are preventable with more prompt diagnosis and treatment (Gaddis & Gaddis, 2021). Creating sepsis awareness and education campaigns in the community can help increase survival rates (Leigh et al., 2022). Additionally, the financial burden of treating sepsis is vast for both the patient and the healthcare system, costing billions per year (Gyawali et al., 2019). Since most cases originate outside the hospital, public awareness of sepsis is vital in helping decrease sepsis cases (Leigh et al., 2022). For people diagnosed with severe sepsis, there is only a 60% chance of surviving five years. Survivors often have a decreased quality of life and lifelong problems. A prompt diagnosis and rapid treatment positively impact sepsis outcomes (Amland et al., 2019). Furthermore, cases of sepsis are rising at an alarming rate, and prompt medical interventions and awareness can save lives (Cavaillon et al., 2020). Thus, educating the community and increasing its knowledge about sepsis based on evidence-based research helps ensure people recognize sepsis and take proactive steps for a better chance of survival. Review of the Literature This literature review explores current literature and examines how best to educate the public and raise awareness of sepsis in the community. Helping the public recognize early warning signs and know when to seek prompt treatment influences sepsis outcomes. This project utilizes the Iowa Model as a guide for the framework and synthesizes literature to identify three themes throughout the research to guide the approach. Strengths and limitations are identified, the literature is analyzed, and findings are applied. Framework The Iowa Model of evidence-based practice (EBP) is among the most widely used in the United States. It aims to guide nurses and clinicians in finding, evaluating, and implementing 6 EBP research changes for direct patient care. The framework consists of seven steps: identifying triggering issues and opportunities, stating the purpose, forming a team, appraising and synthesizing evidence, developing/piloting a practice change, integrating the change, and disseminating information (Cullen et al., 2022; Brown, 2014). This MSN project will utilize the steps in the Iowa model, guiding a change in educating and creating sepsis awareness among community members. Sepsis awareness has been identified as a priority population health issue that needs attention (Sepsis Alliance, 2024). The team will consist of the registered nurse driving the change and staff at the local health department, including staff, nurses, directors, and content experts in existing leadership roles (Gaddis & Gaddis, 2021). After a thorough literature review examining the most current, up-to-date, evidence-based research and information about the topic, the team will integrate the change. The information gained during the appraisal and the synthesis of the current research will be applied to the project, guiding the implementation of the EBP pilot change (Brown, 2014; Buckwalter, 2017). Working with staff and stakeholders, the team will educate the public, promoting sepsis awareness with the goal of increasing the public’s confidence regarding recognizing the early signs of sepsis and increasing understanding regarding when to seek treatment, helping to improve patient outcomes (Brown, 2014; Peters et al., 2023). Lastly, the team will record community members’ responses and evaluate their responses to the education. The project results will be shared and disseminated to other agencies (Jabaley et al., 2018; Buckwalter, 2017). 7 Strengths and Limitations A significant strength of the Iowa Model is its focus on frontline practice issues. Frontline workers often choose issues that are important to staff and patients, resulting in improved outcomes (Chiwaula & Jere, 2022). Additionally, the model aligns with evidencebased practice (EBP) and organizational priorities, which are crucial to gaining organizational support and creating sustainable change. The solution or change should be practical and longlasting (Duff et al., 2020). Lastly, the model’s framework is flexible and adaptive, can be used in different settings, applies to various populations, and can be used concurrently with other EBP models and frameworks (Cullen et al., 2022). The model's limitations include requiring the researcher to have a certain degree of knowledge and skill base. Without advanced knowledge, the researcher is unable to assess the evidence thoroughly. Next, the model is for use at an organizational level, limiting its use (Dusin et al., 2023). Lastly, the model often lacks a patient’s view or perspective (Cullen et al., 2022). The strengths of this model will ensure that the issue of sepsis education for the public is thoroughly addressed and examined, leading to positive community outcomes. Analysis of Literature This literature review explores current literature regarding sepsis education and the recognition of early warning signs in the community. Through this literature review, this project examines whether educating the public about the early signs and symptoms of sepsis, as opposed to no education, increases awareness of sepsis in the community within 6 months. Three themes have been identified and included in this literature review. The themes examine how educating the public about sepsis is necessary and that time matters when seeking care for sepsis. Search Strategies 8 A literature search was conducted to identify current evidence using Google Scholar, Weber State University’s Stewart Library’s OneSearch and Advanced Search (which span multiple databases), and CINAHL to direct initial exploration. Only articles from 2019 through 2024 were included in this literature review to keep information current. The search included keywords of sepsis, education, early warning, signs, symptoms, educating, the general public, sepsis awareness, campaigns, define sepsis, infection, mortality rates, community education, time, qualitative, quantitative, protocols, patient perception, managing symptoms, sepsis mortality globally, and within the United States. Various Boolean combinations were created with the abovementioned keywords to create a broad search. Synthesis of the Literature Three themes identified in the literature are 1) the lack of public knowledge regarding sepsis, 2) many sepsis cases begin outside of a hospital setting, and 3) the importance of public awareness campaigns in saving lives. Lack of the Public Knowledge Regarding Sepsis Current literature shows a lack of public knowledge regarding sepsis in the community (Fiest et al., 2022; Leigh et al., 2022). Sepsis is preventable, yet globally, knowledge gaps exist among patients, the public, and some healthcare professionals (Fiest et al., 2022). For example, in North America and Europe, 80−90% of people did not know what the term ‘sepsis’ was and were unaware that it was a leading cause of death (Dugani & Kissoon, 2017). Globally, there were an estimated 30 million cases of sepsis and over 6 million sepsis-related deaths. Despite these staggering numbers, communities commonly lack awareness regarding sepsis (Moller et al., 2019; Al-Orainan et al., 2020). 9 Additionally, in the United States and Canada, sepsis was the number one reason for hospital deaths in 2017, and globally, it accounted for almost 20% of all deaths (Leigh et al., 2022). Multiple international researchers found that a primary reason people delay getting help for sepsis is that they lack an understanding and awareness of what sepsis is, do not recognize sepsis as dangerous, and do not know the signs and symptoms (Ruffin et al., 2023; Al-Orainan et al., 2020). Further, in 2021, a Sepsis Alliance survey found that 65% of American adults had heard of the term sepsis but lacked a more general knowledge of the topic (Peters et al., 2023). Awareness is slowly increasing (Fiest et al., 2022), as evidenced by the 2024 Sepsis Alliance’s annual awareness survey, which showed that 69% of U.S. adults were familiar with the term "sepsis"; however, only 15% could identify the four most common symptoms of sepsis. There were also many misconceptions about infections and sepsis. For example, 77% did not believe or realize that the flu can progress to sepsis, and 82% indicated that they did not know vaccines can prevent someone from getting sepsis (Sepsis Alliance, 2024). Demographics may also impact sepsis awareness. Kule et al. (2024) found that knowledge and understanding of sepsis differed significantly among healthcare professionals, patients, and the public and depended on a person’s location. A Canadian cross-sectional survey showed significant regional variation in self-reported awareness (p<0.001), and a correlation of knowledge could be attributed to a person’s education, ethnicity, sex, and age (Kule et al., 2024). Fiest et al. (2022) noted that the definition of sepsis was not the same across the literature, and few studies reported on patient, public, or healthcare professional knowledge of sepsis risk factors. Further, many patients and the public seek sepsis information online, whereas healthcare professionals get it from their jobs, training, and education. 10 Sepsis Cases Often Begin Outside of a Hospital Setting According to the Centers for Disease Control and Prevention (CDC, 2022), most cases of sepsis start before a patient goes to the hospital. In specific geographical locations and many rural communities, there is a lack of access to equitable care, which makes it harder to get prompt treatment for sepsis (Dugani & Niranjan, 2017). When people in these communities are not seen early, there is an increased risk of complications and death. People seeking care for infectious symptoms in these areas are lower than in larger cities (Peters et al., 2023). Research suggests that traditional beliefs and practices are more likely to occur in rural areas, limiting a person’s desire to seek medical care (Dugani & Niranjan, 2017; Peters et al., 2023). Sepsis does not discriminate and can affect anyone of any age (CDC, 2022). Symptoms in children usually start at home and are sometimes not evident. Presenting signs may not be obvious, such as not tolerating feedings, vomiting, or simply feeling miserable (Lim, 2024). Less than half of surveyed parents believe they understand what sepsis is and would consider having their child seen at an urgent care clinic or hospital; however, only 37.3% of parents surveyed said they would call an ambulance if their child were sick. Parents can help improve sepsis outcomes by seeking prompt medical care early when they suspect a febrile illness may be due to sepsis in their child (Peters et al., 2022). Upon arrival at the hospital, septic patients often receive treatment via bundles developed from evidence-based research. The 3-hour and 6-hour bundles are part of the Surviving Sepsis Campaign. Patient outcomes improve when these bundles are implemented as a group treatment. These bundles should be initiated quickly (Gyawali et al., 2019). They include obtaining blood cultures before antibiotics are administered, careful monitoring of blood pressure, and blood draws to measure the lactate level. Next, broad-spectrum antibiotics are utilized, followed by 11 fluid resuscitation with crystalloid fluid to treat hypotension. Some patients may need additional medications, such as vasopressors, to increase their blood pressure (Pruinelli et al., 2019). Conversely, sepsis may be more challenging to recognize in the older population because many of the ‘classic’ symptoms are nonexistent or different. In the home setting, home healthcare staff who have developed therapeutic relationships with their patients are vital to sepsis recognition and prompt treatment (Conner et al., 2021). People often report a fever, shivering, feeling cold, clammy, nausea, vomiting, and pain (CDC, 2022). When finally seeking care because of their worsening symptoms, some sepsis patients reported that medical providers had advised them to remain at home and wait to see how things progressed. To help reduce complications, healthcare professionals must assess, recognize, and treat patients early in prehospital settings (Olander et al., 2023). The research further demonstrated that sepsis can affect anyone with an infection regardless of age or health (CDC, 2022; Gaddis & Gaddis, 2021). Sepsis is a problem not only in hospitals; it often occurs in our communities and begins in our own homes with our loved ones. Finally, it is essential that people get early medical care and that providers are aware and observant when diagnosing and treating sepsis (Olander et al., 2023). Public Awareness Campaigns Save Lives The research demonstrated that addressing and educating people about sepsis saves countless lives (Ackerman et al., 2022), improves a survivor's outcome, and reduces healthcare costs (Schlapbach et al., 2023; Fiest et al., 2022). In 2013, the State of New York introduced a mandate for evidence-based sepsis protocols for all healthcare services; it showed a reduction in mortality rates of 3.2% (95%-confidence interval 1.0% to 5.4%, p = 0.004) as compared to states that did not have a sepsis mandate (Schlapbach et al., 2023). 12 Many hospitals use protocols and bundles to help them treat septic patients. However, these guidelines vary across institutions. The use of these protocols helps guide clinicians in providing appropriate care to their patients. Patients with sepsis may manifest clinical signs or symptoms many hours before their condition worsens. Many protocols use early warning scores (Modified Early Warning Score (MEWS), Early Warning Scoring System (EWSS), or National Early Warning Score (NEWS) to help screen patients who may deteriorate quickly (Kim & Park, 2019). Additional research found that best practices include creating awareness and providing “intervention campaigns” to educate the public, thus ensuring quicker recognition of symptoms and promoting survival (Abels et al., 2024; Ackerman et al., 2022). Public awareness campaigns should emphasize that sepsis is preventable. Topics to teach included education emphasizing the danger signs of sepsis, the risks of not seeking treatment, recognition of early signs/symptoms, and why prompt medical treatment is essential (Ruffin et al., 2023; Leigh et al., 2022). Early warning signs and symptoms may vary and often mimic other conditions, including fever, nausea, unwellness, and body aches and pains. The acronym T.I.M.E. can help people decide when to seek treatment based on their symptoms and learn danger signs. “T” stands for temperature (higher or lower than designated parameters). The “I” stands for Infection (signs and symptoms of an infection). “M” stands for mental decline (sleepy, difficult to rouse, confused). “E” stands for extremely ill (severe pain, discomfort, shortness of breath) (Meyers, 2024). Other danger signs may include urinating less, severe nausea and vomiting, cold, clammy, pale or mottled skin, a gray (ashen) appearance, and loss of consciousness (NiDirect, 2024). The World Health Organization (WHO) recommended educating the public about ways to avoid infection and prevent sepsis. Their recommendations include teaching the public about 13 good personal hygiene, washing your hands thoroughly, safe food preparation, avoiding unclean water or unsanitary toilets, getting recommended vaccinations, eating healthy, and breastfeeding newborns (WHO, 2024). Finally, the timing of care matters for people with sepsis, and their knowledge of when to seek care directly impacts their outcome. Treatment is recommended if symptoms worsen or do not improve after 24 hours (Fiest et al., 2022). Earlier access to healthcare promotes the use of sepsis protocols that guide treatment and ensure consistency and reliability in treatment (Schlapbach et al., 2020; Leigh et al., 2022). One study found that for every hour antibiotic treatment is delayed, a person’s chance of dying increases by eight percent (Ruffin et al., 2023). Educating people about preventive measures, early recognition of symptoms like fever, dehydration, confusion, hypotension, and when to seek prompt medical treatment is vital (Leigh et al., 2022). When people arrive at the hospital, sepsis protocols, including antibiotics and fluids, are promptly administered, leading to better outcomes and survival (Amland et al., 2019; Abels et al., 2024). Patients who experience delays in treatment are at a higher risk of complications and death (Ruffin et al., 2023; Amland et al., 2019). Educating the public about sepsis is crucial, and effective education promotes positive outcomes and decreases the chances of dying (Leigh et al., 2022). When people are educated, they recognize that sepsis is a medical emergency and that they should seek prompt medical care. Further data shows that the sooner a person begins treatment, the better their chances of survival (Gaddis & Gaddis, 2021). The effectiveness of sepsis awareness campaigns in helping people identify sepsis requires more research to determine if any type of campaign is more effective than another (Kule et al., 2024). Lastly, limitations of public healthcare campaigns include an incomplete understanding of the literature on sepsis awareness and knowledge. There 14 is a lack of current evidence on how people seek and access sepsis information (Fiest et al., 2022). Summary of Literature Review Findings and Application to the Project A detailed review of current literature shows a need for education regarding sepsis in community members. A lack of knowledge about sepsis, early warning signs, and when to seek medical care often exists. Much of the public is unaware of what sepsis is and that it constitutes a medical emergency. Time matters when diagnosing and treating sepsis, and prompt medical care saves lives. The literature shows that more than 87% of sepsis cases occur outside of a hospital and that delaying treatment for sepsis can result in mortality (Sepsis Alliance, 2024; Association of American Medical Colleges (AAMC), 2024). The literature also suggested that one solution to this problem is to educate the public and increase public awareness by educating them about the dangers of sepsis, when they should seek care, recognition of early warning signs, and that early medical care helps to save lives, resulting in better patient outcomes. The public can be educated through media platforms, social media messages, in-person presentations, and education courses about sepsis (Leigh et al., 2022; AAMC, 2024). This information has helped substantiate this project's potential to improve public health and safety by providing education. Finally, this project will impact the community by using evidence-based research to increase the community’s understanding and perception of sepsis, ultimately helping to decrease rates of sepsis. Project Plan and Implementation Recent literature has shown that a gap in public education concerning awareness and understanding of sepsis exists (Kule et al., 2024). Evidence suggests that educational programs are essential for helping community members learn more about sepsis, including its causes, 15 symptoms to recognize, and when to seek medical care (Leigh et al., 2022). This project will design and implement a plan to educate the general public on this topic to improve outcomes and potentially save lives. This initiative will inform community members through signage, social media messages, and an in-person presentation and will employ pre- and post-assessment surveys to evaluate the public’s response to the education provided (Leigh et al., 2022; AAMC, 2024). A team consisting of the registered nurse leading the MSN project and staff from the local health department, including directors, nurses, staff, and content experts in established leadership roles, will aid in designing, implementing, and delivering education to the public (Gaddis & Gaddis, 2021). Plan and Implementation Process Providing community education and raising awareness about sepsis is essential for enhancing the public’s understanding of the condition (Srzić et al., 2022). This project aims to offer community education and resources to the local Weber County area to increase awareness and improve sepsis outcomes. The Iowa model and its framework will be the guiding framework for this plan. The first step in the model is to identify a subject that is a priority and needs addressing. The team has identified that the lack of sepsis community education is a problem and will seek to address it (Brown, 2014; Buckwalter, 2017). The remaining steps in the model consist of stating the purpose and priority, locating organizational support, synthesizing evidence, piloting the practice change, and evaluating and redesigning the change will be utilized (Cullen et al., 2022). The implementation process will begin with a presentation to stakeholders. This meeting will take place during the first week and will involve the director of the health department, the director of nursing, their support staff, and the registered nurse overseeing the MSN project. It 16 will offer a chance to discuss the project, plan, and review the materials for the education campaign. This meeting will allow for open dialogue and clear lines of communication during the project (Gaddis & Gaddis, 2021). After obtaining approval from the stakeholders, members will form a team. This team will share and discuss ideas for effectively educating the public about sepsis. The meeting will include open discussion and feedback from the various stakeholders. Over the next three weeks, the team will gather for one to two hours weekly to decide what materials they will use and how each member will contribute to the educational design (Cullen et al., 2022). Next, team members will meet weekly for the upcoming month. During these meetings, they will utilize the Iowa framework and focus on developing and planning the project’s implementation and execution. The team will collaborate to create an educational plan for their local community (Brizuela et al., 2020). Relevant literature will be reviewed, after which open dialogue regarding the process will be prioritized. The group will review the deliverables, provide feedback, and revise as necessary. Together, team members will discuss necessary changes and propose ideas about where and when the education should occur. Additionally, decisions will be made regarding the number of classes to offer in the community and using external resources such as clinics, pharmacies, and hospitals to display materials (Fiest et al., 2022). During the third month, team members will meet weekly for two hours. Guided by the nursing director, the team will compile their designs, ideas, handouts, posters, and other educational materials while gathering final input during these meetings. Together, the team will finalize the delivery and evaluation of education at the community level. The prepared materials and established processes will guide the education of the local community over the next two 17 months. Lastly, a plan will be developed and agreed upon to ensure that each member understands their role in the process (Duff et al., 2020). Members will use evidence to support the educational program’s goal of helping community members learn more about sepsis, including its causes, the symptoms to recognize, and when to seek medical care, all aimed at saving lives (Leigh et al., 2022). From months four to six, the team will launch the awareness campaign and provide inperson courses and a website where information is available. During the weekly education sessions, the team will emphasize the critical time-sensitive nature of sepsis recognition and utilize infographics and posters to reinforce this message (Sepsis Alliance, 2024). The team will share stories of local individuals and well-known global celebrities who have had sepsis to make the education relevant to the community. Nurses and staff will instruct on recognizing symptoms, identifying warning signs, and determining when to seek care. These messages can be disseminated online through posters and in-person meetings. According to Fiest et al. (2022), when community members learn about high-profile sepsis-related stories, including celebrity deaths, it presents an opportunity to raise sepsis awareness. The author recommends using this strategy to raise sepsis awareness at the local level. Next, a nurse or team staff member will provide a one-hour presentation on sepsis at the in-person community class. A new class will be held weekly to involve more participants. They will share stories and videos and use a simple presentation or other infographic program to educate about the dangers of sepsis. Before the class begins, the participants will answer a short pre-survey with questions related to sepsis, complications, and symptoms. The one-hour inperson lesson will occur at the health department or a local community center. After the initial lesson, a question-and-answer session will follow, concluding with a post-survey. The team will 18 assess the class's effectiveness by comparing the pre- and post-survey results and evaluating the level of engagement and understanding during the class. At the end of the six months, the team will evaluate community members’ responses to the surveys and assess their comprehension and answers to the pre- and post-surveys. The information will allow the team to gauge community members’ comprehension levels and evaluate their learning. To conclude, the team will share the results and findings with other agencies (Fiest et al., 2022). Interdisciplinary Team A collaborative team with diverse backgrounds and specialties will help ensure efficient teamwork. Forming a strong interdisciplinary team will guide the evidence-based change process and ensure that the public receives the best sepsis education (Cullen et al., 2022). For this MSN project, a team comprised of the nurse leader (the registered nurse leading the change), staff from the local health department, including the director, nursing director, auxiliary staff, and content experts in established leadership roles, will collaborate to create an education plan to inform their local community. The team will work together, sharing their knowledge and skills to help develop and execute this project, leading to increased sepsis awareness. Nurse Leader. The nurse leader will oversee the project from start to finish. First, the nurse responsible for the project will conduct a thorough literature review and examine the most current evidence-based research and information about the topic (Cullen et al., 2022). As the leader, this person will share up-to-date findings, information, and materials with the team. The nurse leader will present the synthesized evidence at meetings and share what they have learned with the team. The leader will create and present the deliverables to the interdisciplinary team to 19 foster buy-in and implementation. Additional roles include facilitating open communication and encouraging collaboration among team members and stakeholders. Furthermore, the leader’s role entails answering questions during the project's planning, implementation, and evaluation stages. The head nurse and other nurses will collaborate with additional staff as needed to create online social media messages, pre- and post-surveys, and design infographics for use (Brown, 2014). The nurse will collaborate in designing a one-hour presentation on sepsis, including offerings for an in-person class at the health department (Brown, 2014; Buckwalter, 2017). Finally, the nurse will lead and analyze pre- and post-survey data to determine the project's effectiveness and help disseminate the findings (Buckwalter, 2017). Health Director. The director is a key stakeholder in the project's success (Duff et al., 2020). Under the director’s guidance, the team will decide which materials and services to use and how to develop the educational content effectively. The director will assist the team in making final decisions about the best ways to implement and deliver community education, aiming to raise awareness about sepsis. Additionally, the director will help facilitate weekly meetings and ensure the necessary funding is secured for the project (Fiest et al., 2022). Nursing Director. Utilizing their nursing expertise, this individual will guide changes to the project and help the team understand its significance and necessity. The nursing director will assist in leading the team and ensure that open lines of communication are maintained. This team member will be responsible for educating the team about sepsis when necessary and clarifying any misconceptions. Finally, they will direct the team regarding policies and procedures to ensure that the classes and materials are published and utilized appropriately. Additional roles include reviewing the synthesized material provided by the nurse leader and determining the best 20 way to apply it in the project's implementation. This leader will guide the evaluation and assessment of community members, assessing their learning and comprehension of sepsis. Additionally, the director will assist in developing the deliverables and their application (Fiest et al., 2022). Nurses/Auxiliary Staff. Nurses and auxiliary staff will collaborate with other team members to provide education that enhances sepsis awareness. Staff and nurses aim to increase the public’s confidence in recognizing the early signs of sepsis and understanding when to seek treatment, contributing to better patient outcomes (Brown, 2014; Peters et al., 2023). Further, this team will assist in creating sepsis awareness and education campaign materials, helping raise awareness in the community and thereby helping to improve survival rates (Leigh et al., 2022). Nurses will work with the leader and directors, assisting in posting on social media platforms, creating posters, and promoting and distributing materials in the community. The nursing staff will teach the content and answer questions and phone calls as necessary. Content Experts. These individuals will use their expertise to guide changes while ensuring the materials presented are accurate and current. The experts will review the synthesized literature and recommend suggestions for improvement and clarity as needed. These content experts will further address what needs to be changed and offer their opinions when necessary to ensure that the awareness campaign and education materials are correct and representative of the community. Lastly, the entire team will assess community members’ responses and observe how they received the education. The team will evaluate the community members’ responses to determine whether the project was successful and measure their comprehension. Then, the team and the 21 director will disseminate and share the results with other agencies (Jabaley et al., 2018; Buckwalter, 2017). Description and Development of Project Deliverables Four deliverables were developed for this MSN project. They will be utilized during the sepsis awareness campaign's planning, implementation, and evaluation phases. This section will give a brief overview of the deliverables and explain how each will contribute to educating local community members. Pre- and Post-Survey. The first deliverable is a pre- and post-survey (Appendix A). The pre-survey establishes a baseline of knowledge and understanding at the beginning of the education course. It helps team members evaluate and assess the learning during the sepsis education campaign. It is used with permission from Sepsis Alliance (2024) and includes a series of questions about a person’s knowledge and comprehension regarding sepsis. After completing the education course, community members will be asked to complete a similar post-survey to assess their understanding and evaluate how comfortable they feel recognizing and seeking care for sepsis. The results of these surveys can provide opportunities for the team to make changes and address things that are not clearly understood (Duff et al., 2020). The pre- and postassessment surveys can help evaluate the public’s response to the education provided (Leigh et al., 2022; AAMC, 2024). Community Poster. The second deliverable (Appendix B) is a community sepsis education poster that can be utilized in various settings and locations. These locations may include doctor’s offices, hospitals, clinics, libraries, grocery stores, community centers, and the health department (Sepsis Alliance, 2024). It is designed with large, bright text that captures the reader’s attention. The poster employs simple phrases and images to ensure that individuals of all 22 backgrounds comprehend the message (Srzić et al., 2022; Leigh et al., 2022). It presents straightforward, easy-to-understand content paired with images that assist in recognizing the warning signs of sepsis. This resource emphasizes how an infection can lead to sepsis, identifies symptoms to watch for, and advises when to seek medical attention. The posters will effectively disseminate information in high-traffic areas, increasing public awareness (CDC, 2022; Brizuela et al., 2020). During the awareness campaign, the poster emphasizes that time matters (CDC, 2022). The poster highlights that time is crucial for sepsis and survival, helping the reader understand that sepsis often starts in the community and can affect anyone (Sepsis Alliance, 2024). Posters and signage containing information about sepsis will be displayed in community centers, pharmacies, and medical clinics. The poster will also encourage people to attend an in-person course at the local health department. Infographic. The third deliverable (Appendix C) is an infographic designed for classroom use as a handout or to enhance learning and for sharing on social media platforms. Like the poster and other deliverables, this infographic focuses on helping the reader recognize sepsis's signs, symptoms, and causes, along with prevention methods (Leigh et al., 2022). The infographic will complement a social media post by providing an engaging visual for the audience. It aims to give a brief understanding of sepsis, increasing motivation to learn more. At the bottom of the infographic, there is a link to the campaign's website. The educational material is easy to understand and free of jargon (Fiest et al., 2022). Brizuela et al. (2020) recommend using social media platforms to connect with community members through community pages by featuring a straightforward online post that includes an infographic with essential information. 23 Community Sepsis Education Website. Finally, the fourth deliverable (Appendix D) is a website created by the team for the local community. The Community Sepsis Education Website was developed using Adobe Express and provides a comprehensive understanding of sepsis. It offers education about the causes, warning signs, prevention techniques, and information to help individuals seek and make informed choices when seeking health information online (Gaddis & Gaddis, 2021; Jabaley et al., 2018). This website can be used independently to provide education and raise awareness or to complement the material presented in the classroom. The website encourages individuals to seek prompt medical care and informs them that sepsis often starts at home and, if left untreated, can lead to death (Fiest et al., 2022). Timeline The project's timeline (Appendix E) is approximately six months for approval, implementation, and evaluation. To begin this project, the nurse leader will meet with the stakeholders during the first week to discuss the change plan. This meeting will help establish clear lines of communication, build trust, and strengthen relationships that will benefit the project. Once the groundwork is laid and approval is granted, the stakeholders and nurse leaders will create a team and define roles for individual members. Under the directors' leadership, materials and deliverables will be produced, course content will be approved, and the campaign will be outlined. The nurse leader will conduct a literature review, synthesize information, and share it with the team throughout the process. Over three months, the team will meet multiple times to solidify the content, approve the material, and use their creative minds to create education for the public. Over months four through six, the team will utilize their deliverables and seek to educate the local community 24 about the importance of sepsis and the necessity of seeking prompt medical care. The team will use social media posts and infographics to reach a greater audience. Brizuela et al. (2020) recommend that teams leverage social media like Twitter, Facebook, and Instagram to create and share campaign messages. They further recommended using hashtags to increase the impact of the message. Using social media platforms to reach community members through community pages can help provide evidence-based information about sepsis. The community social media pages will display a simple online posting with an infographic that contains essential information. The post will include a link asking community members to take the pre- and post-assessment surveys. The message will also include information about the in-person class that will take place at the health department. The team will ensure that the infographic and messages are visually appealing and engaging (Brizuela et al., 2020). During the implementation phase, the team will use posters and signage containing information about sepsis that will be displayed in community centers, pharmacies, and medical clinics. The signs will present straightforward, easy-to-understand messages accompanied by images that guide people to recognize the warning signs of sepsis. They will highlight how an infection can lead to the condition, what symptoms to watch for, and when to seek medical assistance. The signs will help provide information at places frequented by the public, helping to increase exposure (CDC, 2022; Brizuela et al., 2020). After month six, the team will meet and compare the pre- and post-assessment answers, hoping to identify a successful awareness campaign. The evaluation process will be longer because the team needs to measure if a participant’s comprehension regarding sepsis has 25 increased or changed (Fiest et al., 2022). After making any changes and recommendations, the team will disseminate their data and information to other agencies (Cullen et al., 2022). This project aims to raise awareness about sepsis and educate the local community on the importance of seeking care. By developing and utilizing deliverables and other materials, the team aims to create real change by helping to reduce sepsis cases through community education over two months and increasing individuals' knowledge about sepsis. Project Evaluation The evaluation process requires evaluators to collect and analyze essential information for a project. It drives change, identifies patterns within a specific population, and fosters shared insights (Hamilton et al., 2020). To improve the evaluation process, evaluators should clarify their short- and long-term goals. Creating detailed criteria for success during this process is essential. Answering a few simple questions beforehand can enhance the evaluation. These include: What does success look like in reaching the audience? What defines a successful process and its outcomes? How can the team determine whether they conducted sufficient outreach? A clear set of criteria that aligns with the team’s shared vision promotes open discussions about their objectives and goals (Agency for Healthcare Research and Quality [AHRQ], 2023). The success of this project will be measured by comparing and evaluating community responses and results from the pre-survey and post-survey (Appendix A). Correct answers on the post-survey may indicate increased participants’ knowledge and confidence regarding sepsis. Increased knowledge and improved confidence scores suggest that the staff effectively implemented the sepsis campaign. The nurse leader and team members will compare scores and analyze materials for changes and improvements. A score of nine out of eleven correct responses 26 will suggest that the project was successful. The nurse leader and other team members will assess the information gathered during the evaluation process to identify trends and themes from the surveys and questions answered during the educational courses. According to Fiest et al. (2022), evaluating sepsis awareness should include assessing participants' knowledge and information-seeking behaviors. This evaluation process should involve ongoing summative assessment throughout a sepsis awareness campaign, using local data to tailor the public awareness initiative and address specific knowledge gaps in the community. Various educational interventions, such as print materials, posters, digital animations, and websites, can enhance sepsis knowledge as part of a formative evaluation that refines these interventions based on community feedback (Fiest et al., 2022). Using articles and research, the nurse leader has provided a comprehensive review of the existing literature on sepsis awareness and knowledge, which serves as a summative evaluation of the current state of global sepsis awareness. This literature review demonstrates the effectiveness of various sepsis education interventions and public awareness campaigns, showing how they enhance sepsis knowledge among patients, the public, and healthcare professionals. The summative evaluation will occur after the program's implementation, aiming to assess the overall impact and effectiveness. This process allows the team to determine whether the program's goals and objectives were achieved (AHRQ, 2023). Completing the evaluation will involve examining the final report containing the survey results and responses from staff, which will help gauge the participants' confidence levels. The formative evaluation will focus on assessing the initial stages of the sepsis awareness campaign and refining the education provided. In contrast, the summative evaluation will measure the overall success of this campaign in improving public awareness and knowledge of sepsis (Fiest et al., 2022). 27 After the project, a meeting will be held with the team and stakeholders to inform them of its effectiveness and offer suggestions for future improvement. The pre- and post-survey data and feedback from community participants will be shared, and team members and stakeholders will be encouraged to express their thoughts and ideas on how the education was received and how to enhance it. Lastly, the nurse leader and staff will utilize the evaluated data, share it with outside entities, and use it to promote increased awareness on a broader scale (Hamilton et al., 2020). Ethical Considerations Fiest et al. (2022) emphasize that ethical considerations in sepsis awareness campaigns are critical for their success, particularly ensuring the information provided is accurate, understandable, and actionable. The authors recommend using a tool known as the Patient Education Materials Assessment Tool (PEMAT) or the Health on the Net criteria to assess the content quality and ensure that the campaign is based on local data that addresses specific knowledge gaps and preferences related to sepsis information. This approach ensures that the campaigns are customized to meet the target audience's needs and effectively raise awareness and enhance knowledge about sepsis (Fiest et al., 2022). The nurse leader and nursing director will act as the project leaders, ensuring the project adheres to ethical standards and remains free from personal bias. Holding meetings with stakeholders to discuss the project's plans, motivations, goals, and methods of accomplishment will help uphold ethical standards. Utilizing reliable, non-discriminatory evaluation methods will help guarantee accurate and unbiased results. Participants must understand that their involvement is voluntary and that they have the right to refuse education or leave at any time, which will assist the team in maintaining proper ethical standards (Hunt et al., 2021). The sepsis awareness campaign will be available at no cost to everyone in the community and offered in Spanish and 28 English. At the start of the in-person education course, a staff member will explain how participants' information will be collected and used. Participants can include their names and information on the pre- and post-surveys. If this information is provided, it will help the staff follow up and assess their learning and confidence levels later. Finally, for those who prefer not to disclose their names, the forms will be utilized and compared with those of other attendees to assess the overall level of learning. All information will be stored securely and protected by a password, ensuring it is accessible only to team members. The online material containing a link to the survey will include a disclaimer regarding the use of their information and the reasons for its collection. All personal data collected will solely be used for the sepsis campaign and will not be shared. Participants can view the final reports and understand how their information was utilized (Hunt et al., 2021). Discussion Sepsis is a condition that often goes unrecognized by the public. Educating community members to help them recognize and understand sepsis can save lives. Since many cases of sepsis begin outside of a hospital, it is essential that this education teaches them when to seek care and what symptoms to watch for and provides a general understanding of the condition and its causes (Abels et al., 2024; AHRQ, 2023; AAMC, 2024; Fiest et al., 2022; Leigh et al., 2022). This MSN project will be implemented at the local health department, and educational materials will be available online and throughout the community. This MSN project aims to increase local community members’ knowledge and confidence levels by offering an educational course and materials. The hope is to provide education that helps the public better understand sepsis and how seeking prompt medical care can save lives. This section will discuss the dissemination of 29 the project's results, its significance in advancing nursing practice, implications, and additional recommendations. Evidence-based Solutions for Dissemination After implementing the project, data collected during the educational campaign will be analyzed. The post-survey results will be compared to those completed before the course began. The gathered data and information will be compiled and shared with the local health director, the nursing director, and staff members. This collection and processing of information will allow these leaders to evaluate the education delivered, suggest improvements to the project, and recommend necessary changes. After this step, the information can be disseminated to outside agencies and used by other health department directors and nursing directors to enhance sepsis education in their communities. During a team meeting, the nurse leader and nursing director will share the findings with the health director, stakeholders, and other staff members. In the final meeting, the project’s findings will be presented with a presentation that includes a graph depicting the education and confidence levels of community members. This will be followed by an open discussion, allowing attendees to identify the strengths and weaknesses of the project, which will help facilitate improvements and design it for future use. The nurse leader will also present a poster to peers and faculty at the Annie Taylor Dee School of Nursing at Weber State University. This presentation will allow the project's findings to be shared openly with others in the field. Significance to Advance Nursing Practice Nurses play a crucial role in educating their community members about sepsis. They are uniquely positioned to provide information to patients upon discharge, highlighting the dangers of sepsis. Rechter et al. (2022) found that when nurses prioritize teaching their patients about 30 sepsis, it fosters a strong connection for community sepsis education. Nurses should stress the importance of early recognition and treatment when offering education. This principle extends to community education, where public awareness campaigns can help individuals identify early signs of sepsis and seek prompt medical attention. Nurses should continuously engage in education to enhance their knowledge of sepsis, which they can share with their patients and peers in the community. By utilizing insights and strategies from healthcare-centered sepsis education programs, community sepsis education can be structured to raise awareness, promote early detection, and encourage preventive measures among the public (Rechter et al., 2022; Davino et al., 2022). The nurse leader in the MSN project will leverage their education and, alongside a team, provide a community education program that fosters collaboration between the public and healthcare providers. This initiative will ensure that individuals understand when and how to seek assistance. Nurses can contribute by offering community education focusing on preventive measures such as vaccination, hygiene practices, and timely treatment of infections to minimize the risk of sepsis (Davino et al., 2022). Implications This MSN project identifies the strengths and limitations of the sepsis campaign. The project's strengths include various educational methods and deliverables, such as handouts, infographics, pre- and post-surveys, posters, in-person education, and online material. Utilizing different educational resources helps the campaign reach more community members and provides diverse avenues for distinct learning styles (Rechter et al., 2022). By combining these methods, communities can be better educated about sepsis, its symptoms, and the importance of early recognition and treatment. The project can use website analytics to monitor traffic and page views (Fiest et al., 2022). This project is based on the Iowa model and follows the steps ensuring 31 the best results possible. The lack of community education on sepsis is an issue, and the team identified this barrier and explored evidence-based practice strategies to address it (Brown, 2014; Buckwalter, 2017). The purpose and priority of education are clearly outlined, and the community's needs are addressed. Utilizing this framework, a solid foundation was established for offering public education. The project used various evaluation methods, open discussions, and meetings to incorporate and improve community education (Cullen et al., 2022). The limitations of this project include sample size, difficulties in measuring participants' confidence levels, and language barriers. The sample size is small because this project will be implemented locally in the Weber County area. Recording the exact number of participants may be challenging, as materials will be distributed online throughout the community. Utilizing online resources widens the gap, and page views will help track the number of visitors to the page. However, accurately recording the number of participants and their confidence levels is more complex, as many may choose not to utilize the surveys provided in the course. Lastly, an individual’s understanding may vary, potentially excluding those with special needs or who speak a language other than English or Spanish (Leigh et al., 2022). The project can enhance the public’s understanding and knowledge of sepsis, potentially saving lives (Fiest et al., 2022; Ables et al., 2024). This initiative will help community members feel more comfortable discussing sepsis and raise awareness that it often begins at home. It will guide them on when to seek care and provide education about warning signs to reduce the risks associated with sepsis (Gaddis & Gaddis, 2021; Leigh et al., 2022). Recommendations The project examined the benefits of educating the public about sepsis through an awareness campaign and providing educational resources. An extensive literature review 32 highlighted the advantages of establishing a sepsis campaign and its positive impact on mortality rates, ultimately saving lives. The literature outlines recommendations and options for creating and offering community sepsis education courses. However, evaluating whether the rates of sepsis decrease because of this education is more challenging due to the varying methods and the fact that much of the information people receive comes from online sources. Additional research should be conducted and reviewed to determine how to assess better, measure, and evaluate the confidence levels of individuals who receive community education. This further research would be beneficial in refining and directing the necessary changes to enhance the learning experiences of all individuals involved. It would also provide guidance on how information is shared, disseminated, and adapted to meet the unique needs of individual communities (Feist et al., 2022; Gaddis & Gaddis, 2021). Finally, collaborating with healthcare professionals and ensuring that nurses receive training about sepsis and begin patient education in the hospital setting when a patient has an infection can better facilitate the start of this community education and help guide the necessary changes to improve outcomes and prevent mortality from sepsis (Rechter et al., 2022; Davino et al., 2022). Conclusions Sepsis is a preventable condition that can affect anyone. However, over 1.7 million Americans develop it each year, and many die as a result. Community education and awareness programs are essential for improving an individual’s understanding of sepsis (Srzić et al., 2022). 87% of cases originate at home, often going untreated and leading to death (Gaddis & Gaddis, 2021). Raising public awareness about the dangers of sepsis and when to seek prompt medical care helps save lives (Peters et al., 2023). Numerous studies demonstrate that sepsis awareness 33 campaigns, combined with education, improve understanding and build trust between the community and healthcare providers, encouraging individuals to seek care when needed (Peters et al., 2023). Various educational approaches offer a comprehensive strategy and enable more individuals to be informed, increasing their confidence in recognizing sepsis and obtaining prompt treatment (Fiest et al., 2022; Leigh et al., 2022). 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(2024, May 3). Sepsis. https://www.who.int/news-room/factsheets/detail/sepsis 40 Appendix A Pre- and Post-survey 41 42 43 44 Appendix B Community Poster 45 Appendix C Infographic 46 Appendix D Community Sepsis Education Website Adobe Express Website https://express.adobe.com/page/n9zwa9fSL5qNG 47 Appendix E Timeline