ICU Safety Essay

Patient safety is number one in hospitals. Every staff member that comes into contact with a patient should always have the question, “Will the patient be safe?” in the back of

Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency

The term “safety comes first” or more simply put, “safety first,” is a message that patients not only want to hear, but also want to know is the focus of the professionals that are caring for them; in particular, when they are under anesthesia and have limited or no ability to speak up or lookout for themselves. The National Patient Safety Agency (NPSA) has implemented two initiatives; Rocognising and Responding Appropriately to Early Signs of Deterioration in Hospitalised Patients (NPSA, 2007) and How to Guide: Five Steps to Safer Surgery (NPSA, 2010). Understanding that human beings make up the healthcare professional workforce, it is evident that tools and checklist can and will only be as good as the how people utilize and follow

healthcare organization accrediting bodies, and to maintain credibility with patients and peers alike, must adhere to the National Patient Safety Goals. As stated by Ulrich and Kear (2014), "Not only are nurses responsible for providing safe patient care, we are also responsible for creating an environment in which others can provide safe patient care, and for being the last line of defense when needed between the patient and potential harm. Having a deep understanding of patient safety and patient safety culture allows nurses to be the leaders we need to be in ensuring that our patients are always

According to information published by the Mayo Clinic, sepsis has three stages: sepsis, severe sepsis and septic shock. The mortality rate for septic shock is nearly 50 per cent, and an episode of severe sepsis increases the risk of future infections. Severe sepsis causes blood flow to the vital organs, such as the brain, heart and kidneys, to become impaired. Sepsis can also cause blood clots to form in organs and extremities such as arms, legs, fingers and toes, which can lead to organ failure and tissue death (gangrene).

As sepsis progresses, tissues become less perfused and acidotic, compensation begins to fail, and the patient begins to show organ dysfunction. The cardiovascular system also begins to fail, the blood pressure does not respond to fluid resuscitation and vasoactive agents, and signs of end-organ damage are evident (e.g., renal failure, pulmonary failure, hepatic failure). As sepsis progresses to septic shock, the blood pressure drops, and the skin becomes cool, pale, and mottled. Temperature may be normal or below normal. Heart and respiratory rates remain rapid. Urine production ceases, and multiple organ dysfunction progressing to death occurs. Adventitious lung sounds occur throughout the lung fields, not just in the upper fields of the lungs.

The unresolved infection has landed the patient on septic shock. Sepsis is the body’s response to inflammation of a particular or unknown infection. The presence of hypotension despite adequate fluid infusion and inadequate tissue perfusion is the result of septic shock. The treatment of shock is centered on the restoration of blood pressure to normal, the presence of adequate tissue perfusion, making sure organs return to functioning well, and avoiding further complications (Lewis, Dirksen, Heitkemper, Bucher, & Harding,

The aim of the study was to explore family members’ experiences with the use of a diary when a sick relative did not survive the stay in the ICU. The overall study findings revealed that the diary was experienced as a medium for interpersonal communication, where it was perceived as a social medium maintaining communication and the relationship with the patient. But the diary was also a common interest affecting writers and readers in different ways, thus sharing information, emotions and thoughts enabled relationships, which grew. Not only relationships developed but also participants as humans due to the course of events and finally the death of the patient. The experience was compared to taken on a journey but in an existential way by the participants. To understand the unfamiliar in a way different from the way in which it has been understood so far, also include a way to understand him/herself in a new way (Gadamer, 1989).

Severe Sepsis affects 750,000 Americans and causes more than 200,000 deaths annually. Sepsis is a complex condition that results from an infectious process that represents the body's response to infection and involves systemic inflammatory and cellular events that result in altered circulation and coagulation, endothelial dysfunction and impaired tissue perfusion (Kleinpell, 2005). Associated mortality rates with sepsis in the United States have remained largely unchanged for several decades. Through an international collaboration known as the

Septic shock is the stage of sepsis when multiple organ failure is evident and uncontrolled bleeding of the body occurs. Septic shock results from the complication of an infection where toxins initiate a full body inflammatory response. Viral, fungal, and bacterial infections can all lead to septic shock, but the most common causes of sepsis are gram- negative bacteria and gram-positive bacteria. Sepsis causes severe hypovolemic shock and hypodynamic cardiac function to affect the body, platelets and clotting factors are consumed and thus the body cannot clot blood. Capillary leak occurs and cardiac contractility is poor from cellular ischemia (Ignatavicius & Workman, 2011). For a person to be diagnosed with septic shock, they must have symptoms

Sepsis can develop into septic shock which is the point where the patient’s blood pressure drops to a dangerous level due to the presence of bacteria in the body.

Severe sepsis and septic shock are major healthcare complications that affect millions of individuals worldwide each year, killing approximately one in four and is growing in incidence. Similar to acute myocardial infarction or stroke, the quickness of appropriate treatment administration, especially in the initial hours after severe sepsis development, is crucial and will most likely influence the patient’s outcome (Dellinger, et al., 2013, p. 583).

Sepsis is a potentially fatal medical condition where the blood is overwhelmed by the presence of bacteria; activating the immune response and potentially causing organ dysfunction due to the disruption of homeostasis, tissue perfusion and limited oxygen supply. Systemic inflammatory response syndrome can be a key to the recognition of the illness. This condition can be treated with antibiotics intravenously or by draining the infected fluid. However, treating the infection with appropriate anti-microbial medication does not always cure the illness. Understanding the activation of inflammation, coagulation and fibrinolysis in the pathophysiology of sepsis, has allowed further research and development of therapeutic agents in its clinical

The review presents different aspects of the pathogenesis of sepsis and septic shock, particularly, the scenarios of sepsis development dependent upon bacterial resistance to killing by oxidation in the bloodstream. The manuscript shows a neglected factor in sepsis pathogenesis: oxidation of plasma components by oxygen released from erythrocytes. It also attracts the attention of readers to: 1) the role of erythrocytes in the clearing of bacteria from the bloodstream in bacteremia and sepsis; 2) the mechanisms of bacterial defense against killing by oxidation in the bloodstream; 3) the consequences of colonization of the inner space of erythrocytes by bacteria and the problems of antibacterial therapy in case of available bacterial reservoir

In today’s health care system, “quality” and “safety” are one in the same when it comes to patient care. As Florence Nightingale described our profession long ago, it takes work and vigilance to ensure we are doing the best we can to care for our patients. (Mitchell, 2008)