Hour 1 Sepsis Bundle Audit
Hour 1 Sepsis Bundle Audit
Faadumo Osman
Osman, Faadumo
Age: 63Sex: FMRN: 98589-02

Admitted: Today

Unit: Med-Surg 4W

Dx: Acute confusion

Allergies: NKDA

The Hour 1 Sepsis Bundle requires all components to be completed within 60 minutes of sepsis recognition. Review what happened in this case and reflect on the timeline.
Hour 1 window
07:45to08:45
Alert initiated 07:45
Window closed 08:45
Case timeline
07:20Pre-alert
Nurse begins assessment
Faadumo confused and attempting egress. Vitals obtained with help of her son, Cabdilaahi.
07:45Alert, clock starts
SIRS criteria identified, sepsis alert activated
Temp 38.4 C, HR 102 bpm, Resp 26. Hour 1 window now open.
08:0015 min
NS 0.9% rate verified and documented
IV fluids already running on admission. Confirming the rate and settling the agitated patient took additional time.
08:2035 min
Blood cultures x2 drawn and serum lactate sent on ice
Drawn together in one encounter. Patient combative, several positioning attempts with her son's help before access was achieved. Lactate transported immediately.
08:4257 min
Urine specimen collected by straight catheterization
FGM/C Type II required careful, respectful technique and additional positioning, which took extra time to do safely. Specimen sent to lab. Collected ahead of the antibiotic.
08:4863 min, past window
Provider confirms Ceftriaxone dosing
Brief call to confirm dosing given CKD. No adjustment required.
08:5267 min, bundle complete
Ceftriaxone 1g IV administered and bundle documented
All steps confirmed and timestamped. The bundle closed 7 minutes outside the window. The added time came from each step safely taking longer in a complex case.
Reflect with your group
1. Which step in the timeline created the longest delay, and what caused it?
2. Which factors were specific to Faadumo, such as her history, her presentation, or her identity, that made this bundle more complex to complete than a straightforward sepsis case?
3. Name one change at the system level, such as a hospital policy, unit workflow, or staffing decision, that could help nurses complete the bundle faster for patients like Faadumo.
4. Name one thing you would carry into your own practice from this case.
Before you take the final card
Practice giving shift report
Your shift is ending. As a group, give a brief SBAR report as if you are handing off Faadumo's care to the next nurse. Include everything they need to keep her safe.
(S) Situation: Who is this patient and what is happening right now?
(B) Background: What does the next nurse need to know about her history and this admission?
(A) Assessment: What are the most important current findings?
(R) Recommendation: What does the next nurse need to do, watch for, or follow up on?
Bundle audited! 🎉
You have successfully completed the Hour 1 Sepsis Bundle and started this patient on the path to an excellent outcome. You are an excellent nurse!
Take card #9
Card 9 back