When the 2024 first-quarter sepsis three-hour bundle compliance fell to 75.2 percent at the Clara Maass Medical Center ED, shared governance nurse leaders designed the Sepsis Scribe

Clara Maass Medical Center Emergency Department, RWJBarnabas Health

Program. Specially trained scribes and front-line nurse sepsis champions provide real-time bundle tracking, time-zero identification, escalation support and closed-loop communication with providers. By December 2024, three-hour bundle compliance reached 100 percent and held at 95.2 percent through 2025. The program contributed to a reduction in sepsis-related mortality from 49.69 percent in 2023 to 24.92 percent in 2025. Recognized for its impact, the program was adopted enterprise wide.

The ED also developed an internal ED Technician IV certification course to empower techs to initiate IV access and collect specimens early in the patient encounter. Clinically, certified EDTs function as an extension of the nursing team, enabling earlier interventions, smoother patient flow during high-acuity periods and allowing nurses to focus on complex clinical decision-making. The program also created a career advancement pathway. Since implementation, 92 percent of EDTs have completed the program. Of them, 14 went on to nursing school, nine are now practicing RNs and four moved into other health care roles. The ED Technician IV certification program was also adopted across the hospital network.