Limitations Of Rapid Diagnostics

Proper collection of blood cultures are necessary and the most direct method of determining whether or not a patient is septic. The purpose of obtaining blood cultures is to identify and isolate the bacteria that are causing an illness and then determine the best course of treatment based on the sensitivity of the bacteria to particular antibiotics. One of the most frustrating problems plaguing hospitals is the increased rate at which blood culture results are being returned as contaminated specimens. These results can lead to a significant increase in cost to the hospital and patient as well as an increased length in hospital

Sepsis is both best known yet most poorly understood medical disorders [1]. Sepsis leads to shock, multiple organ failure and death if not recognized early and treated promptly [2]. It is a serious clinical condition that represents a patient’s response to infection and has a high mortality rate [3]. Sepsis remains the dominant challenge in the care of critically ill patients [4]. Up to 19 million cases of sepsis worldwide per annum is estimated. The true incidence is higher [1]. Sepsis is associated with a mortality rate of 25 - 30% and mortality due to septic shock is 50-85% [6-8]. Patients with sepsis requiring intensive care unit (ICU) admission had high rates of ICU and overall hospital mortality, ranging from 18 to 50% [9-12]. The most common sites of infection are

Gold standard procedures should be implemented with the aim of providing timely and accurate results. (Schentag) The culture result should be accompanied by its clinical significance, selective reporting of susceptibility testing results in accordance with hospital antimicrobial therapy guidelines and suggested management. (Schentag) This encourages appropriate prescribing and minimises unnecessary use of antimicrobials. The clinical microbiology team should also provide reports to AMS regarding resistant organisms.

Septic shock is the leading cause of death for patients in intensive care units and is the final stage in a continuum of infectious and inflammatory processes. This continuum begins with bacteremia, which is the presence of bacteria in the blood. Normally the body’s immune system can fight off a localized infection caused by a small amount of bacteria in the blood and the person will remain asymptomatic. However, a hospitalized patient could be immunocompromised, have a

The number of documented cases has been rising every year. “This may be due to the aging population, the increased longevity of people with chronic disease, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents” (National Institute of General Medical Sciences, 2014). The mortality rate for sepsis ranges from about thirty percent for patients with sepsis to fifty percent in patients who develop septic shock. Mortality rate varies as to how many organs have been affected. Twenty percent mortality for one organ failure, forty percent for two organs failing, sixty-five to seventy percent for three failed organs, and seventy-five to eighty-five percent when four or more organs have failed. The cost related to sepsis is about seventeen billion dollars per year (about twenty-two thousand dollars per patient), which is six times greater than the cost of patients without sepsis.

Burney, M., Underwood, J., McEvoy, S., Nelson, G., Dzierba, A., Kauari, V., & Chong, D. (2012). Early detection and treatment of severe sepsis in the emergency department: identifying barriers to implementation of a protocol-based approach. Journal Of Emergency Nur

There is a disease continuum with increasing severity if not treated or not responsive to treatment o Sepsis

Under the Core measures, Sepsis is one of the problem-focused trigger for systemic infection and if untreated which can lead to death. In United States, it is the 11th leading cause of death and consumes the large amount of costs about $20.3 billion in 2011 (Jones et al.,2016). According to Centers for Disease Control and Prevention (CDC), more than 1.5 million people diagnosed with sepsis, and at least 250,000 patients die from that yearly (CDC, 2017). The evidence-based research revealed with results of certain pre existing conditions, pathophysiological studies, preventive measures and sepsis bundle for treating and preventing sepsis to save the life of the patients.

The set of diagnostic procedures and the necessary treatment within this bundle is based on the EBP suggested guidelines. By following the recommended guidelines, I can assure the improvement of quality of care by providing my patient with the best current practice. According to the randomized study over a 12-month period conducted in the Emergency Departments (ED) in New Wales, Australia the introduction of sepsis guidelines in ED improved the early assessment and management of septic patients including reduction in time to antibiotic administration by 230 minutes and the improved urgent triage time by 49.1 % (Romero, Fry, & Roche, 2017).

The identification of unknown organisms carries important ramifications that can be applied to many real world scenarios. In keeping with quality assurance beverages, food, cosmetics, and other products are frequently inspected for contaminants resulting from a presence of pathogenic bacteria. In medicine, a physician’s diagnosis and consequent treatment is largely determined from samples collected from infection sites that have been analyzed using microbial tests.

Checking in to the hospital comes with a heavy price tag, and sometimes you get more than what you bargained for. As highly trained doctors, nurses, and staff make their way through the hospital, they carry with them microbial agents of disease. Although regarded as centers for treatment and prevention, hospitals are also known to harbor nosocomial, healthcare-associated, bacterial infections. These infections can be a result of overused or inappropriately used antibiotics and the breaching of infection containment policies by patients and staff. Though health-care-associated infections have been decreasing, one infection inciting nosocomial bacterial, Clostridium difficile has been rampant. It is important that inefficiencies in health-care be met with stringent efforts for prevention as they may lead to distressing financial, emotional, and medical repercussions.

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

Blood culture (BC) contamination is a common, yet preventable problem for emergency departments (EDs) across the country (Self et al., 2014). Erlanger Hospital’s ED is no different and being the region’s only Level 1 Trauma Center, it is called to an excellent standard of practice. BC testing is a routinely applied intervention used to diagnose infections in symptomatic patients who arrive at the ED (Denno & Gannon, 2013). BCs are essential as they help identify accurate pathogens and provide targeted antibiotic therapy (Denno & Gannon, 2013). They are often viewed as the standard for diagnosing illnesses such as septicemia and other

The increase in infection-related health activity is the result of a gradual increase in specific risk factors such as antibiotic pressure and the greater complexity of patients’ conditions. Despite their strong impact, both socially and economically, the surveillance systems and programs currently deployed for the prevention of nosocomial infections are quite dishomogeneous and, in many situations, do not exist at all.

Methods: Using Optum Clinformatics with matched Premier hospital dataset (08/2009-03/2013), we conducted a case-control study to assess inpatient mortality among adult (≥18 years) bacteremic patients who received at least two consecutive days of antibiotic therapy within the first three days of admission. Cases were bacteremic patients with an inpatient mortality, and controls were patients who did not die during a hospitalization and matched to cases using Disease