Enhancing RN Confidence in Early Recognition and Treatment of Sepsis

Background: Sepsis is a leading cause of mortality in U.S. hospitals, with delays in recognition and treatment significantly contributing to poor patient outcomes. Nurses are essential to early identification and timely intervention; however, gaps in confidence and preparedness persist, particularly among newly hired staff. Traditional educational approaches may be insufficient to support rapid clinical recognition and evidence-based management. Purpose: This staff education project evaluated whether participation in a virtual sepsis escape room during general nursing orientation improved newly hired nurses’ confidence in early identification and treatment of sepsis. Methods: A virtual escape room was integrated into an existing general nursing orientation program at a healthcare organization. Newly hired inpatient nurses participated in the intervention during their first week of orientation. Learner confidence was measured using pre- and post-intervention Likert-scale surveys assessing sepsis recognition, initiation of appropriate interventions, application of the sepsis bundle, communication with the healthcare team, and clinical reasoning. A total of 122 learners completed the pre-intervention survey, 121 participated in the virtual escape room, and 116 completed the post-intervention survey. Results: Pre-intervention data demonstrated low baseline confidence in sepsis identification and management. Post-intervention results showed increased confidence across all domains. Mean confidence scores increased from 2.88 pre-intervention to 3.60 post-intervention (+0.72). The greatest improvement was observed in initiating appropriate interventions for patients with suspected sepsis (+0.88). Performance data from the virtual escape room demonstrated high accuracy in early identification of patient deterioration but lower accuracy in evidence-based treatment components, including fluid resuscitation and escalation of care. Conclusion: Implementation of a virtual sepsis escape room during nursing orientation significantly improved learner confidence in early recognition and management of sepsis. Gamification-based education represents a feasible, and sustainable strategy for staff development that supports clinical competency, critical thinking, and timely evidence-based care. This approach has the potential to improve patient outcomes and reduce health disparities by promoting consistent early identification and prompt treatment across diverse patient populations.