Purpose Statement The purpose of this project is sepsis prevention and reduction of sepsis-related mortality in patients who are admitted into the ICU. Early detection and treatment of infection with antimicrobials and antibiotics, in addition to utilization of preventative measures should ultimately decrease antibiotic resistance, recurrences of resistant infection [that could potentially develop into sepsis], and decrease mortality in patients admitted to the intensive care unit (ICU). Education of clinicians, patients, and families are essential to stop the spread of infection that could ultimately result in the formation of sepsis.
Theoretical Basis The Synergy Model of Patient Care will be utilized to express the APRN’s influences, actions, and outcomes with regard to caring for critically ill patients. The Synergy Model for Patient Care was created by a panel of AACN nurses during the early 1990s, in order to link nursing practice with patient outcomes (Hardin, 2013). The model is
…show more content…
Most of the articles were recent and within the last five years, with the exception of seven articles. The oldest article was from the year 2000. The keywords and terms used in the research was: sepsis, sepsis prevention, antibiotic resistance, mortality rates in sepsis, AACN Synergy Model, septicemia, severe sepsis, septic shock. Other database sites utilized was the Up-to-Date, Center for Disease Control and Prevention (CDC), Agency for Healthcare Research and Quality (AHRQ), Google and MedScape. Two of the four textbooks and the two online textbooks were utilized to obtain material on nursing theories. The rationale for choosing these articles were to become informed on the phenomenon of sepsis, understanding the etiology, and become knowledgeable of preventive measures for patients admitted into the
Antimicrobial therapy is the cornerstone sepsis treatment, and the therapeutic goal should be centered around administration of effective IV antibiotics within 60 minutes of septic shock or severe sepsis (without shock) recognition. The initial antimicrobial therapy should be empiric and focused on having activity against all expected pathogens (bacterial, fungal, viral), based on each individual patient situation. Daily reassessment of antimicrobial therapy should be performed, with de escalation in mind; procalcitonin levels can be of use to direct discontinuation in patients with no evidence of infection following initial septic
normal saline, lactated Ringer solution, etc), volume expanders (e.g. albumin and others), antibiotics (e.g. cefotaxime, metronidazole, ciprofloxacin, cefepime, etc), and corticosteroids (e.g. hydrocortisone, dexamethasone, etc).Medications and surgery are often the most effective and most definitive treatments that a doctor or certified medical professional can give to a septic shock patient. However most of those treatments are administered in a hospital setting. Prehospital treatment and management for septic shock would include proper management of ABC’s (Airway, Breathing, Circulation), identifying the source of infection and treat accordingly if possible, and monitoring of the patient's vital signs. Not much definitively can be done in a prehospital setting but prehospital management is vital for patient survivability.Some complications that can occur as a result of septic shock include acute respiratory distress syndrome (ARDS), respiratory failure, heart failure, renal failure or injury, and abnormal blood clotting. Sepsis is listed by The Agency for Healthcare Research and Quality as the most expensive condition treated in the U.S. with an overall cost of more than $20 billion in 2011. Sepsis and sepsis
However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
Research by Hotchkiss, Monneret, & Payen’s (2013) has revealed that sepsis is an immunosuppressive disorder, therefore patients can benefit from immunostimulatory therapies used to treat those who have lowered immune systems. Accordingly, focusing on boosting the immune system has been shown to decrease mortality in patients (Hotchkiss et al. 2013). Hotchkiss et al. (2013) announces that while these statistics are encouraging, the mortality rate is still considered high and further research and techniques are needed in order to continue the downward trend. Hotchkiss et al. (2013) states that it is unclear why some patients survive sepsis and others do not recover. Until the true cause of death in sepsis is understood, the best course of action is prevention, early detection, and immune system support.
As future Advanced Practice Registered Nurses (APRN), it is our role to improve patient care
According to the Clinical Excellence Commission (2014), approximately 6,000 deaths per annum are caused by sepsis in Australia alone. These mortality figures are higher than breast cancer (2,864) and prostate cancer (3,235) combined (Cancer Australia, 2014). Despite advances in modern medicine and increased understanding of the need for timely recognition and intervention (Dellinger et al, 2013), sepsis remains the primary cause of death from infection worldwide (McClelland, 2014). Studies undertaken by The Sepsis Alliance (2014) and Schmidt et al, (2014) state that 40% of patients diagnosed with severe sepsis do not survive.
In this event, the matter that is unusual can be the fact that I have experienced and witnessed the process for interprofessional collaboration between the community nurse and other professionals that I have never knew about before. This event made me realize that there are many aspects of community nursing that I have knew about before where in this situation it is the importance and accountability of interprofessional collaboration. From my nursing theory course I have learned that interprofessional collaboration is when the nurse forms relationships with other professionals that enable them to achieve a common goal to deliver care and strengthen the health system and clients involved in it. (Betker & Bewich, 2012, p.30) In this event, our mutual goal is to provide the appropriate care for the patients/residents so they can restore their health after their hip or knee surgery. In the nursing leadership and management textbook it stated “interprofessional practice removes the gatekeeper and allows client access to all caregivers based on expertise needed.” (Kelly & Crawford, 2013, p.35) In this event, my preceptor and I gained knowledge about Revera and will pass on this information to patients who are interested in staying at a retirement home after they discharge from the hospital. One literature talked about how according to the Institute of Medicine, it is critical to have the capacity to work together as part of the interdisciplinary team to assist in delivering high quality, patient-centered care. In addition, effective collaboration among health care professionals results in improved patient care and outcomes. (Wellmon, Gilin, Knauss & Linn, 2012) This indicates the importance of interprofessional collaboration to provide...
Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection, 69(3), 204-219. Revised 01/20 Haugen, N., Galura, S., & Ulrich, S. P. (2011). Ulrich & Canale's nursing care planning guides: Prioritization, delegation, and critical thinking. Maryland Heights, Mo. : Saunders/Elsevier.
The many concepts are very complex and have many dimensions. Concepts developed by Leininger, Watson, Gaut, Benner and Wrubel, Ihde, and many more were discussed and how they relate to ICU nurses and their caring practices. It is stressed in this article that ICU nurses have an important role of making sure they have insight into their specific behaviors so that nursing practices can be developed. Once these nursing practices are developed, ICU nurses can successfully care for their critically ill patients. Wilkin (2003) claims that caring is a, “dual component of attitudes/values and activities, which create an ongoing challenge for the ICU nurses” (p.
Many years from now, I will take this experience with me to better myself as a nurse. I know for the future that it is in my patient’s best interest, if I collaborate with other health care professionals. In order to maintain patient safety, I must always remember to work together with my fellow collogues to obtain a positive working environment. In order to be a good nurse, I need to always understand that I am part of a team to help those in need. I want to incorporate providing efficient care to each and every patient the best way I possibly
Sepsis has gained much focus as a major global health problem. Since 2003, an international team of experts came together to form the Surviving Sepsis Campaign (SSC), in the attempts to combat an effectively treat sepsis. Although, diagnostics and protocols have been developed to identify high risk patients, the need for human clinical assessment is still necessary to ensure a proper diagnosis is made and appropriate treatment is initiated in a timely manner. The use of a highly efficient and experienced team, such as, the electronic Intensive Care unit (eICU) could close the gap from diagnosis to treatment.
Sepsis is defined as a systemic inflammatory response caused by an infective process such as viral, bacterial or fungal (Holling, 2011). Assessment on a patient and starting treatment for sepsis is based on identifying several factors including the infective source, antibiotic administration and fluid replacement (Bailey, 2013). Because time is critical any delay in identifying patients with sepsis will have a negatively affect the patients’ outcome. Many studies have concluded every hour in delay of treatment mortality is increased by 7% (Bailey, 2013). Within this assignment I will briefly discuss the previous practice and the recent practice including the study based on sepsis. I will show what enabled practice to change and I will use the two comparisons of current practice and best practice.
Everyday nurses utilize collaboration; perhaps not even realizing they are doing it. By definition collaboration is, exerting together, to cooperate, and to work with one another in joint effort toward mutual goals (White & O’Sullivan, 2012). Models of how nurses utilize this in a hospital setting is by asking questions to other nurses on the unit when one is unsure of something. If one is uncertain of the best practice, or how to do a certain nursing procedure, collaboration is a great tool in order to enhance one’s understanding. While it can be a simple process, it is an essential one. In nursing nurses are to look out for the well being of their patient’s. In everyday situations, nurses are face with uncertainties. It is vital to keep the fact that the quality of care nurses provide, along with their patient’s safety should be kept at the forefront of nurses minds at all
“ Sepsis” according to the International Surviving Sepsis Campaign, is defined as the presence of infection together with systemic manifestations of infection (Dellinger et al., 2013) In todays modern society sepsis still accounts for 15% of maternal deaths a year worldwide (Dolea & Stein, 2003). Despite medical advances, aseptic technique, and antibiotic use, sepsis is the most common cause of direct maternal death in the UK. According to the CMACE report the maternal mortality rate increased from 0.85 deaths per 100,000 maternities in 2003–05 to 1.13 deaths in 2006–08 (Harper, 2011). Puerperal sepsis has a long history within obstetrics and midwifery, and yet despite this knowledge it has become, yet again, the leading cause of direct maternal death. Therefore due to the increased maternal mortality, I have chosen to focus on the care of a woman within ...