Sepsis Is A Poisoning Of The System By Disease Carrying Bacteria And Their Toxins Absorbed Into The Bloodstream

The systemic inflammatory response is the next step in the continuum and is a nonspecific inflammatory state that may be seen with an infection. Sepsis is the presence of the systemic inflammatory response syndrome (SIRS) with evidence of infection. As the bacteria invade the bloodstream, they release endotoxins that damage the endothelial cell lining and impair the vascular system, coagulation mechanism, and immune system. These endotoxins also trigger the immune and inflammatory responses, which results in the activation of macrophages and CD4 cells that release proinflammatory cytokines to create a systemic inflammatory response to the pathogen. Hospitalized patients may quickly progress from bacteremia to sepsis and finally to septic shock, even with treatment.

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.

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.

Septic shock results from bacteria that multiply in the blood and then releases toxins that decrease blood pressure, thus, impairing blood flow to cells, tissues and organs. It is an acute infection, usually systemic, that overwhelms the body (toxic shock syndrome) (Huether & Mccance, 2012). This

Septicemia is an infection from a life threatening complication, such as pneumonia, kidney infections, a gunshot wound or have been severely burned. Septicemia is also known as bacteremia or blood poisoning, if it is left untreated it might progress into sepsis. Some symptoms pertaining to Septicemia are reduced urine volume, rapid respiration, fever and confusion to think clearly.

This leads us to the next step in the pathophysiology of Sepsis. Stage 2 of sepsis, which is when SIRS plus the confirmation of an infection has been made. At this stage, the patient’s body has been continuously fighting something in their body and it is starting to have an effect on the patient. Signs and symptoms of sepsis are often nonspecific and include the following: Fever, chills, or rigors, Confusion, Anxiety, Difficulty breathing, Fatigue, malaise, Nausea and vomiting. It is important to identify any potential source of infection. Localizing signs and symptoms referable to organ systems may provide useful clues to the etiology of sepsis and are as follows: Head and neck infections: Severe headache, neck stiffness, altered mental

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

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."

Sepsis also known as blood infection, primarily caused by bacteria is a major global healthcare problem claiming more than 600,000 infant lives, most of them in least developed and developing countries. Apart from Infants it is more common in elderly people and those with weak immune system. Sepsis occurs when the body's effort to fight an infection results in the immune system damaging tissues and organ. This chaotic response, designed to protect us, causes widespread inflammation, leaky blood vessels and abnormal blood clotting resulting in organ damage. In severe cases

A blood infection in a newborn older than 1 week and younger than 90 days. This is especially dangerous because the infection is not contained to one part of the body but it is coursing through the baby’s blood vessels that carry it throughout the entire body. This can lead to septic shock in which the infant’s organ systems begin to shut down and ultimately lead to death. Newborns are especially vulnerable due to their immature immune systems and organs which cannot properly fight off infections.

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.