Sepsis Case Study Essay

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.

L.M. is a 75-year-old female who suffers from severe dementia and lives in a SNF. She was diagnosed with lung cancer in 2005 and as a result had a right upper and middle lobectomy. She also has a history of severe emphysema. L.M. has had several pneumonic infections and has an allergy to Pneumovax. She has a recurrent aspiration risk and received a tracheostomy and a PEG tube in January 2012.

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.

Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together with systemic manifestations of infection” (Dellinger et al.,

Sepsis is a rapidly progressive illness that must be treated early with antibiotics and supportive care.

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 evolution of this project cultivated from the need of improvement for patients suffering from sepsis at MacNeal Hospital. Sepsis is a potentially fatal host response to infection that occurs as a systemic inflammatory response syndrome (Schub & Schub, 2013). I felt it was very important to re-evaluate what I can do as a nurse to improve the expected outcomes of sepsis patients and decrease their length of hospitalization. If a patient is admitted with severe sepsis, it places the patient at a higher level of risk than if he/she was admitted with an acute myocardial infarction or acute stroke (Robson & Daniels, 2013). I became interested in sepsis as my project when I became informed that MacNeal had started a Patients With Sepsis Orders Daily Reports, I decided I could enhance and develop an educational tool to help the case managers, emergency room nurses, and staff nurses with early recognition of sepsis and decreasing the length of stay. Angus and Van der Poll (2013) stated that the United States reported 2% of patients that were admitted to the hospital suffered from severe sepsis.

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

A methodical search was undertaken of the databases – PubMed, CINAHL and ScienceDirect to ascertain the most appropriate evidence. Search terms used were “Sepsis Prevention”, “Sepsis Management” “Sepsis Early Recognition” and “Sepsis Detection” and merged using Boolean Logic (Glasper and Rees,

Education interventions are very significant in the understanding of different stages of sepsis such as septic shock, uncomplicated sepsis, and severe sepsis. The progression of this disease varies from one person to another, and it can occur to some people through the three stages. Therefore, having a clear understanding of all the three phases that sepsis exists can help in the diagnosis of the diseases effectively. Additionally, education will provide an avenue and strategy of providing optimal care to the patient, and that will contribute to managing their condition. Sometimes the patients may not respond to the treatment administered, and as a result, they can develop multiple organ diseases. Hence, education will provide all the required knowledge to understand and know the various dynamic of the diseases and how it progress in a patient.

1) Upon the story presented, necessary actions should be taken to overcome the hospital’s problems. St. Mary’s Hospital last year’s numbers showed the necessity of such actions. For the first time, since the hospital started operating, they presented deficit on its revenue. St. Mary’s hospital had some major problems in a few departments. During the last few years, the occupancy, or the number of patients in the hospital, has been declining. Such problem is explained by changes made to reimbursement policies, a larger emphasis on outpatient services, and an increase in local competition. Another major problem the hospital faces is the performance appraisal system. It seems inadequate for the system in

Acute renal failure, also known as acute kidney injury is described to be a rapid loss of

Blood gas analysis may be performed to determine if high concentration oxygen therapy is needed (Bush & Thomson, 2007). The management of fever would be a part of care plan when the infant is febrile due to infection (Axton & Fugate 2009).