Developing Sepsis Protocol

Developing Sepsis Protocol to Improve Patient Outcome

Wing Ho Ng

Aurora University

NURS 4620 01

September 17, 2014 Abstract

According to the Center for Disease Control and Prevention (CDC) (2014), “the number of times people were in the hospital with sepsis or septicemia (another word for sepsis) increased from 621,000 in the year 2000 to 1,141,000 in 2008. Between 28 and 50 percent of people who get sepsis die”. Sepsis is a complication of serious infection and has a high mortality rate. The CDC (2014) also mentioned the high risk groups are immunocompromised, infants and children, elderly, and patients with chronic illness. According to Gauer (2013), “Sepsis is responsible for 20% of all in-hospital deaths each year (210,000), which

A sepsis protocol gives the clinicians evidence-based practice guidelines provide the most appropriate care to the patients. The Surviving Sepsis Campaign (2012) provides diagnostic criteria for sepsis such as suspected infection, abnormal vital signs, alter mental status, etc. However, compare to SI, it is a convenient, quick, and cost-free assessment tool to alert the nurses to facilitate sepsis assessment and initiate aggressive treatment for patients with sepsis. According to the research by Berger et al. (2013), “The shock index (SI) is a bedside assessment defined as heart rate divided by systolic blood pressure, with a normal range of 0.5 to 0.7 in healthy adults” (p. 169). This assessment tool is easy to use and give the clinicians quick direction and prioritize the care immediately. When patients present in the ED, many factors contribute to the abnormal vital signs or even the alter mental status, which might not fit the diagnostic criteria, then exclude to the alert of sepsis. Other manifestations may indicate the possible infectious diseases. Utilize the SI can complement the deficiency of the diagnostic criteria. For instance, patient with a chief complaint of cough and a temperature of 99 Fahrenheit, which can be the manifestations of infectious diseases. However, if the patient with a heart rate of 92 per minute and a systolic blood pressure of 112 mm Hg may not fulfill three criteria to be alerted as at-risk but the out of range SI of 0.8 helps. Based on the chief complaint and SI, clinicians can initiate the protocol to do further assessment for