Sepsis Case Studies

The aim of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format.

The aim of this assignment is to critically discuss the nursing assessment individualised care and nursing interventions of the acutely ill patient. The patient discussed developed severe sepsis due to a urinary tract infection and her condition deteriorated during the recovery process in the nurse’s care. Lovick (2009) defines sepsis ‘as a known or suspected infection accompanied by evidence of two or more of the SIRS criteria’. SIRS is outlined as a ‘systemic inflammatory response’ consisting of two or more of the following symptoms ‘temperature >38 degrees Celsius or 90 beats per minute, respiratory rates greater than 20 breaths per minute and white blood count higher than 12,000 cells per microliter or lower than 4000 cells per

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

Is sepsis complicated by organ dysfunction, is diagnosed in more than 750,000 patients per year and has mortality rates as high as 28%-50%.

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.

Sepsis is a life-threatening and potentially fatal condition caused by the body’s reaction to an infection. Sepsis occurs when chemicals normally released in the bloodstream to fight infection trigger inflammation throughout the body. This can result in damage to multiple organs, which can cause organ damage and, in some cases, death.

The progress of my project to develop a nurse driven sepsis screening tool and an algorithm for implementation on the intensive care unit (ICU) for early identification and prompt treatment of septic patients has progressed remarkably well. I have been productive in gathering current guidelines for sepsis with the aid of my preceptor who is a critical care nurse practitioner on the ICU. With his help, I have been able to assemble key pieces of research to create a sepsis screening tool, and a treatment algorithm with sepsis resuscitation bundles. Extensive research has been conducted to integrate evidence-based practice in my project. I have also spent time with the unit educator, critical care intensivists, and my colleagues in brainstorming and collecting ideas about my project.

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).

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

The Coalition for Sepsis Survival (C4SS) is a 501(c)(3) organization created to raise awareness among both the general public and healthcare providers and to facilitate the reduction of sepsis mortality and morbidity in the United States. The terms "coalition" and "survival" were purposefully selected to represent the core values of our vision and mission. "Coalition" underscores our philosophy to bring together hospitals, healthcare providers, and other organizations into a coordinated partnership committed to reducing the mortality and morbidity of sepsis for achieving the best outcomes and value for patient care. "Survival" represents our commitment to hospitals and clinicians to provide access to the tools and financial support for increasing a patient 's chance of survival and the best quality of life.

Effective sepsis management not only reduces patient morbidity and mortality, but it can substantially impact the financial status of the hospital by reducing the cost of care, length of stay, readmissions and ultimately increase reimbursement. By lowering

At my organization, we have a SIRS and Sepsis alert that searches the electronic health record (EHR) for data that indicates a patient has sepsis. The alert goes to the nurse and has an option to document if they have notified the provider or if the patient is already being treated. We also have three order-sets sepsis from the ED, the Medical Floors, and Critical Care. These are evidence-based order-sets that include the 3-hour and 6-hour bundle components that are recommended by the Surviving Sepsis Campaign and the SEP-1 core measure data that is submitted to CMS (Surviving Sepsis Campaign, 2016). We are currently working on early identification if early sepsis in the ED, since most patients we see with Sepsis present to the