Sepsis Patients: A Case Study

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

Program identified patients in decline, and although the final diagnosis of sepsis was only 17%,

Utilizing the five points mentioned would transition the information from the systematic review into practice. The review would identify as an evidence summary in the model, producing a more manageable quantity of information. It can then be translated as it is combined with clinical expertise and tailored to the clinical setting. The setting that would benefit the most from this change would be those in the critical care setting, as septic patients are in a critical state and are monitored closely. Having strong supporting evidence will make a substantial argument to change practices. Utilizing the data, combined with clinical expertise and experience, supports the changes needed to provide the most up to date, evidence based care. Clinical expertise regarding sepsis benefits the healthcare team in acknowledging other clinical data that could be used to determine fluid volume status, straying away from depending on central venous pressure. The goal would be to transition from using central venous pressure as a reliable indicator of fluid volume status to utilizing noninvasive cardiac output monitoring, when possible, and other clinical indicators. Another change would involve discrediting the validity of central venous pressure as a volume status indicator to clinicians. Mark, Monnet, and Teboul (2007) noted that 90% of intensivists use central venous pressure

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%.

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

Aitken, L., Williams, G., Harvey, M., Blot, S., Kleinpell, R., Labeau, S., & ... Ahrens, T. (2011). Nursing considerations to complement the Surviving Sepsis Campaign guidelines. Critical Care Medicine, 39(7), 1800-1818.

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.

According to the National Institute of General Medical Sciences severe sepsis strikes about 750,000 people in the United States each year and kills an estimated 28 to 50 percent of those individuals. The most vulnerable populations for sepsis are the elderly and newborns. After completing the whole eleven segments, I learned that anyone with an infection may be at risk for developing sepsis. The whole scenario helped me how to screen for sepsis and how important is to recognize and respond appropriately to early signs of sepsis in hospitalized patients. Once sepsis is diagnosed, early and aggressive treatment can begin which greatly reduces mortality rates associated with sepsis. After completing the whole scenario I learned how to approach

People with weakened immune system, those suffer from severe burns or trauma, those in intensive care unit (ICU), those that are very ill from infections, the elderly and the young children are the greatest risks in developing sepsis.

Sepsis is the body’s response to infection. The onset of sepsis is often undetected until the condition has become critical. Sepsis progresses into severe sepsis, septic shock, and eventually death; typically from organ failure. The condition affects over 500,000 individuals annually, has a mortality rate of over 25%, and presents a risk to patients in every inpatient setting regardless of acuity level (Whelchel et al., 2011). My first experience with sepsis was enlightening because it affected a patient under my care. I was surprised at the insidious onset of the symptoms, the rapid decline in the patient’s condition, and the missed opportunities that the healthcare team had to implement the recommended care bundle protocols.

Sepsis still represents a major cause of morbidity and mortality in critically ill patients despite the use of modern antibiotics and resuscitation therapies. There is a lack of early diagnosis and timely intervention for sepsis in the emergency department (ED), and recent interest has focused on biomarkers for early diagnosis, risk stratification, and evaluation of prognosis of sepsis.

Sepsis is a condition of growing concern for nursing professionals, as the mortality rate has increased each year since its initial documentation in the early 1990s (Levy et al., 2012). Sepsis was first defined in 1991 as a systemic inflammatory response syndrome (SIRS). Since this time, improvements have been made in developing a worldwide definition of sepsis (Levy et al., 2012). Specifically, sepsis is considered to be a life-threatening dysfunction of the organs that results from the dysregulation of a host response to an infectious agent (American Association of Critical-Care Nurses, AACN, 2018).

Studies show that 43% to 76% of all the severe sepsis presentations are initially detected in the ED [9]. For the patients who died in hospital within 72 hours of ED attendance but were not admitted to ICU, the most common reason was a delay or absence of suitable treatments [20]. M eanwhile, the length of stay of the patients in the ED who need to be transferred to ICU may increase due to capacity limitations of the ICU [10]. These patients are recommended to receive early goal-directed therapy (EGDT ) and the severe sepsis resuscitation bundle, as suggested by Surviving Sepsis Campaign (Dellinger, et al. 2008). This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand [19]. Several studies applied the scoring systems that were initially developed for the ICU environment directly to the ED. For example, Nguyen et al. (2008) used APACHE II and SAPS to obtain a result that these existing scoring systems have limited ability to identify non-survivors from survivors (Nguyen, et al. 2008). Thus, developing a scoring system specifically targeting the ED has received increasing interest. Shapiro et al. (2003) developed a prospectively validated scoring system, Mortality in ED Sepsis (MEDS) (Shapiro, et al., 2003). Early warning score (EWS) systems were

With sepsis becoming a growing concern with each passing day, we must develop new ways to combat it aggressively. With EMS becoming a more advanced, educated, and integral member of the health care team; there must be an inclusion of them into the early and advanced treatment of sepsis. According to a research team in the Netherlands 3.3 out of every 100 patients encountered by EMS in the United States have severe sepsis diagnoses, compared to only 2.3 per 100 for myocardial infarction and 2.2 per 100 for stroke (Van der Wekken et al., 2016). This is massive considering it is not considered a time critical diagnosis like myocardial infarction and stroke already are. The Revised Sepsis Syndrome Classification and Prehospital Sepsis Alert Score are the potential solution to these issues and look to increase rapid recognition, advanced treatment, and decrease mortality from this destructive and aggressive pathological process.