Sepsis In Adults: A Case Study

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.

showing signs of sepsis) then start the planning of care, implementing care, and evaluating whether or not your interventions helped the patient or if a new plan needs to be initiated. One also needs to know that these standards are always being revised and updated when new technology or procedures are implemented (American Nurses Association, 2010).

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

Immediately life threatening A patient with chest pain, severe blood loss, MVA, sepsis. These types of patient are prompt to deteriorate, and their life could be at risk if not treated within 10 min of arrival in ED. (Basnet, Bhandari and Moore, 2012)

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

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.

A total of 60 patients, mean age of 66.3 years and 86.7% male admitted to the ED and who received resuscitation using the standard EGDT algorithm for severe sepsis and septic shock and who were treated with CRRT because of septic AKI. The study conducted from June 2008 to February 2013 at a tertiary hospital in Seoul, Korea. The participants were assigned to two groups; on the basis of the median between the time they started the EGDT and the CRRT. The main outcomes measure the cause of 28-day mortality. The 28-day mortality rate was 43.3%. The overall cause of mortality rate was significantly higher for the late CRRT groups, than the early CRRT group 56.7 versus. 30.0%. The authors conclude that initiating CRRT early may be beneficial to improving mortality rate among patients with severe sepsis or septic shock, but indicate that more clinical trials are needed to accurately determine whether early CCRT is more efficacious than late CRRT in the treatment of septic

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.

Thirty to 50 percent of the 400,000 to 500,000 cases of sepsis in the United States each year are fatal, emphasizing the seriousness of this public health concern [2]. Recent research into possible alternative treatment options indicates that patients being treated with statin therapy are less likely to develop sepsis from a serious infection, die from sepsis or develop serious complications due to sepsis; however, the mechanism of action is unknown and therefore is the focus of this study [2, 6, 10-12]. Possible mechanisms of action include a direct interaction of the statin with the sepsis-causing organism, an interaction between the statin and the host immune system or a combination of the two [9, 14, 16-17]. Additionally, recent studies indicate that statins may have a direct antimicrobial effect and has suggested that statins may diminish the replication and infectivity of some pathogens responsible for sepsis [11, 14, 16-17]. Thus, we hypothesized that statins could benefit septic patients by

Early identification of sepsis in emergency department patients could be the difference between life and death. An emergency department nurse should be able to recognize the signs and symptoms of sepsis, know the proper fluid bolus rate for resuscitation, and initiate intravenous antibiotics within an hour of the patient arriving to the emergency department. According to the sepsis alliance website, "The word sepsis comes from the Greek meaning "decay" or "to putrefy." In medical terms, sepsis is defined as either "the presence of pathogenic organisms or their toxins in the blood and tissues" or "the poisoned condition resulting from the presence of pathogens or their toxins as in septicemia" (Definition of Sepsis, n.d). Sepsis is a life threatening illness but if signs and symptoms are recognized early enough the outcome is generally good. Remember, "Time is Tissue."

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

As a Hospitalist NP, the patients that I admit for our group are not critically ill. Most times, the conditions for which are they are admitted warrant an admission, but they are treatable conditions. If the treatment is successful, the patients are discharged within two to four days. If they decompensate during their hospitalization, a rapid response code is called. Their disposition

Sepsis is a debilitating, potentially life threatening condition that has become a big burden on the health system worldwide. Early recognition and aggressive timely treatment have proven to be life saving interventions. South Miami Hospital (SMH) aims to provide safe care to our community by implementing and utilizing evidence –based guidelines and protocols. According to research, early identification of patients presenting with signs and symptoms of sepsis is crucial to patients’ survival. In order to achieve this goal SMH Emergency Department (ED) implemented a triage sepsis-screening tool, an intervention that as evidenced by research helps to recognize patients at risk for developing sepsis or presenting with this devastating disease.