The Importance Of Sepsis

Sepsis is both best known yet most poorly understood medical disorders [1]. Sepsis leads to shock, multiple organ failure and death if not recognized early and treated promptly [2]. It is a serious clinical condition that represents a patient’s response to infection and has a high mortality rate [3]. Sepsis remains the dominant challenge in the care of critically ill patients [4]. Up to 19 million cases of sepsis worldwide per annum is estimated. The true incidence is higher [1]. Sepsis is associated with a mortality rate of 25 - 30% and mortality due to septic shock is 50-85% [6-8]. Patients with sepsis requiring intensive care unit (ICU) admission had high rates of ICU and overall hospital mortality, ranging from 18 to 50% [9-12]. The most common sites of infection are

Sepsis is the number one cause of death in intensive care units in the U.S. More than 750,000 cases of sepsis occur each year and about one third of those patients die from it (McKinney, 2014; Ulloa, 2011). Sepsis is a serious condition that is a result of an inflammatory response to infection that can damage organs if left untreated. Severe sepsis occurs when the infection leads to organ dysfunction. Septic shock is when multiple organ failure occurs due to infection and is worse than sepsis and severe 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.,

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.

Blood culture (BC) contamination is a common, yet preventable problem for emergency departments (EDs) across the country (Self et al., 2014). Erlanger Hospital’s ED is no different and being the region’s only Level 1 Trauma Center, it is called to an excellent standard of practice. BC testing is a routinely applied intervention used to diagnose infections in symptomatic patients who arrive at the ED (Denno & Gannon, 2013). BCs are essential as they help identify accurate pathogens and provide targeted antibiotic therapy (Denno & Gannon, 2013). They are often viewed as the standard for diagnosing illnesses such as septicemia and other

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

The early sepsis protocol has a huge impact on Emergency Department (ED) patients that are suspected of sepsis. The studies have shown that early recognition has a significant effect on the patient’s outcome. My paper will only analyze data collected in the critical care settings and focus mainly on the importance of early recognition of the signs and symptoms of sepsis to meet the three hour window treatment as recommended by the Surviving Sepsis Campaign (SSC).

Knapp (2012) describes sepsis as the systemic inflammatory response to a pathogen. Sepsis can be a fatal condition which occurs when the body retaliates to an infection by attacking the body’s own tissues and organs. Sepsis has many symptoms that can be attributed to other illness such as flu, which can make it difficult to recognise and treat in time (CDC Sepsis 2016). Due to this every year in the UK there are 150,000 cases of sepsis, which leads to 44,000 deaths, in perspective sepsis results in more deaths than bowel, breast and prostate cancer collectively (Sepsis Trust, 2016). Sepsis costs the NHS £15.6 billion a year (Sepsis Trust 2016). As the NMC code of conduct describes, healthcare professionals have a ‘duty of condor’ to preserve the safety of patients, reducing the potentials of harm and mistakes to the service users (NMC Code of Conduct 2015), thus with improved management and early detection of sepsis e.g. beginning a course of antibiotics within the hour of detection, will not only save the NHS £2.8 billion a year but thousands of lives (Sepsis Trust 2016).

Identifying microbes using a series of biochemical tests, like those performed by students, is used in a clinical settings for several important reasons other than taxonomy. It is used to determine susceptibility to antimicrobial drugs, gain information for future treatments, identify pathogens in terms of their potential danger, aid epidemiologists in tracing sources of infections, and to accumulate data of interest to those studying infectious diseases (Tortora, G. J., Funke, B. R., & Case, C. L., 2016).

Historically, gram-negative bacteria contributed principally to the case frequency of sepsis, yet the frequency of gram-positive etiologies have approached the historic gram-negative trend12. Currently, both gram-negative and gram-positive bacteria comprise the major contributors to cases of sepsis12. Multiples studies have demonstrated the prevalence of gram-positive microbial sepsis in recent years12,14. Sepsis originating from a multi-microbial infection produces 4.7% of cases 12. Sepsis of a fungal etiology is responsible for 4.6% of cases, and the incidence of fungal cases have increased proportionally with the overall incidence of sepsis12. Anecdotally, concerns exist regarding the effects of climate change on selecting temperature-tolerant

Kacey, thank you for provide your insight on the framework for praxis discussion. Kacey, we have same phenomenon of interest (POI), which is sepsis prevention. Kacey, as you had stated that sepsis is a major issue in the emergency rooms (ERs). However, sepsis is also a major factor for the medical-surgical units and intensive care units (ICUs). Sepsis within the United Stated represent 2 % of patients admission to the hospitals, additionally, 10% of those admissions are treated in the ICUs. (Kleinpell & Schorr, 2014).

4SS recognizes that some hospitals have limited operating cash flow, or are engaged in other clinical initiatives and are therefore unable to make the initial investment to start a sepsis improvement program. Based on hospital need and qualifications, C4SS can provide performance grants to allow the facility to be able to take the first step in making the commitment to reduce sepsis mortality. We can also link hospitals to business partners that can assist hospitals in program financing.

L. (2013). Early recognition and management of sepsis in adults: The first six hours. American Family Physician, 1(44), 44-53. Retrieved from

Sepsis will be defined as SIRS with positive microbiological cultures whether respiratory, blood, or urine. Participants in the suspected sepsis group are those who meet SIRS criteria but have negative microbiological findings but have positive screening results such as elevated lactate, glycemic instability, thrombocytopenia, or abnormal radiological findings such as consolidation on chest x-ray, patchy infiltrates, etc. Finally, septic shock will be defined as sepsis with hemodynamic instability as evidenced by persistent hypotension despite fluid resuscitation measures and the need for inotropic or vasoactive infusions (Asadi,

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.