Nurse-Initiated Standing Orders for Sepsis Across Hospital Care Settings - Takeaways - MDSpire
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Nurse-Activated Standing Orders for Sepsis in Diverse Hospital Care Settings

  • By

  • Bhushan R. Deshpande

  • Jennifer K. Horowitz

  • Megan Cahill

  • Jessica Jones

  • Elizabeth McLaughlin

  • Abigail West

  • Patricia Posa

  • Hallie C. Prescott

  • October 29, 2026

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  • 1

    In a 2025 survey of 68 Michigan hospitals, 48 (71%) reported sepsis-specific nurse-initiated standing orders (NISOs).

  • 2

    Among 84 sepsis-specific NISOs, 39 (57%) were in emergency departments, 22 (32%) on inpatient wards, and 23 (34%) with rapid response teams.

  • 3

    Lactate testing appeared in 80 of 84 NISOs (95%), while intravenous fluids appeared in 27 (32%) and antibiotic orders appeared in none.

  • 4

    Only 11 of 84 NISOs (13%) were used in more than half of sepsis cases, and usage data were unavailable for 30 (36%).

  • 5

    The single-state survey could not assess NISOs’ effects on sepsis management or outcomes and was limited by potential response inaccuracies and setting-level nonindependence.

Original Source(s)

Nurse-Initiated Standing Orders for Sepsis Across Hospital Care Settings

  • by Bhushan R. Deshpande, Jennifer K. Horowitz, Megan Cahill, Jessica Jones, Elizabeth McLaughlin, Abigail West, Patricia Posa, Hallie C. Prescott

  • October 29, 2026

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