Sepsis is a severe medical condition that is caused by an infection in the body that travels to the blood stream. This infection has extremely high death rates and can be linked to most admissions in the intensive care unit. There is a series of events that happens once an infection occurs in the body. These events are preventable if caught early on in this cascade.
Infection
The initial cause of all further problems is the infection. This can occur anywhere in the body. The most common sites of infection that can lead to sepsis include: urinary tract, skin, abdominal, and respiratory. These infections can occur at any time, in any population; however, there are some groups of people who are at a higher risk. These include individuals who have been diagnosed with: diabetes mellitus, renal failure, heart failure, and chronic obstructive pulmonary disease (Leon, Hoyos, Barrera, De La Rosa, Dennis, Duenas, Granados, Londono, Rodriguez, Molina, Ortiz, Jaimes, 2013). The infection is the first step in patients who go into septic shock. Performing cultures and treating this infection e...
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
Renal and hepatic function tests include creatinine test, blood urea nitrogen (BUN) test, alkaline phosphatase (ALP) test, bilirubin test, and others. Urinalysis includes urine osmolality tests and urine culture tests. The sooner one’s sepsis is diagnosed and managed, the better the chances are one has to survive. There are three identifiable stages of sepsis. The three stages are, in order, sepsis, severe sepsis, and septic shock. The stage of sepsis is achieved when an infection enters the bloodstream and enacts inflammatory responses throughout the body. This stage is not as life threatening as the next two stages but should be assessed and treated for as soon as possible. The stage of severe sepsis is achieved when an infection disrupts the flow of blood to the brain or renal organs resulting towards organ failure. There can be an occurrence of gangrene in the arms, legs, fingers, and toes exhibiting tissue death caused by blood clots. If treatment is not given quickly in this stage then septic shock is bound to occur. The stage of septic shock is achieved when the overall blood pressure drops drastically leading to respiratory, cardiac, or organ failure and likely death This stage demands
In one of the meetings with the mentor regarding altered and/or impaired homeostatic function, a case study of a patient admitted with sepsis was discussed. Assessment, care and evolving treatment provided was looked into. Following the discussion, the management of sepsis has been examined further by the learner as she was not familiar with the bundle of six sepsis mentioned by the mentor. The learner looked on the situation and reflected back on the occurrence that took place realizing if appropriate measures were implemented and how things can be different in future practice (Schon, 1987). This
Signs and symptoms greatly depend on the initial site of infection, the causative microorganism, the underlying health history and status of the patient, the pattern of acute organ dysfunction as well as the period of time from initial onset to initiation of treatment (Angus & Van der Pol, 2013). However, classic Signs of sepsis may include but are not limited to fever, hypotension, cloudy-blood tinged urine, oliguria with sequential anurina, delirium, tachycardia, tachypnea, skin pallor, decreased temperature in extremities due to inadequate perfusion, increased lactate as well as altered blood glucose levels and blood cell
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
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 an exaggerated, overwhelming and uncontrolled systemic inflammatory response to an initially localised infection or tissue injury, which may lead to severe sepsis and septic shock if left untreated (Daniels, 2009; Robson & Daniels, 2013; Dellinger et al, 2013; Perman, Goyal & Gaieski, 2012; Vanzant & Schmelzer, 2011). Septic shock can be classified by acute circulatory failure as a result of massive vasodilation, increased capillary permeability and decreased vascular resistance in the body, causing refractory hypotension despite adequate fluid resuscitation. This leads to irreversible tissue ischaemia, end organ failure and ultimately, death (McClelland & Moxon, 2014; Sagy, Al-Qaqaa & Kim, 2013, Dellinger et al, 2013).
Capriotti & Frizzell (2016) explain that sepsis is often seen in those who have a weak immune system. These individuals are at an increased risk of developing sepsis from microorganisms that a healthy immune system would normally fight off (Capriotti et al. 2016). The elderly, infants, and immunosuppressed patients are the most at risk for developing the condition (Capriotti et al. 2016). Sepsis can be caused by any microbe, but is most often caused by bacteria (Capriotti et al. 2016). Since sepsis has such a broad reach and can develop as a secondary infection after an initial injury or illness, Capriotti & Frizzell (2016) further explain the di...
Sepsis is also called Septicemia and is a poisoning of the blood. This is an attack of bacteria into the bloodstream. Sepsis does not need blood poisoning to occur; it can affect multiple organs or the entire body without it happening. Sepsis is the body’s systematic inflammatory response to a bacterial infection (Jones, 2017). The infection can also have a wound or a chest infection or can be spread throughout the entire body. Sepsis’ definition is “a life-threatening condition that arises when the body’s response to infection injures its own tissues and organs” (McClelland, 2014). Sepsis is a leading cause of hospital admissions and can lead to death in hospital patients worldwide. The death rate associated with
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)
wards. Clinical Microbiology And Infection: The Official Publication Of The European Society Of Clinical Microbiology And Infectious Diseases, 18(12), 1215-1217. doi:10.1111/j.1469-0691.2011.03735.x
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...
Sepsis is a “cunning, insidious and non-specific illness” (Raynor, 2012) but progression can be rapturous with a sudden catastrophic circulatory collapse and mortality up to 50%. (Angus et al., 2001) Over five million cases arise per year of maternal sepsis, resulting in an estimated 62,000 maternal deaths globally (WHO, 2008) During the 18th and 19th century, puerperal sepsis resulted in 50% of maternal deaths over Europe (Loudon, 2000). The World Health Organisation (WHO) defined puerperal sepsis as ‘infection of the genital tract occurring at any time between the rupture of membranes or labour, and the 42nd day postpartum, of which two or more of the following are present: pelvic pain, fever 38.5C or more, abnormal vaginal discharge, abnormal smell of discharge, and delay in the rate of reduction of size of uterus (less than 2 cm a day during the first 8 days)’ (WHO, 1992).
It starts as sepsis then progresses to severe sepsis and then septic shock. In the United States alone there are 751,000 cases of severe sepsis a year with a hospital mortality rate of 28.6% or 215,000 deaths a year. For comparison there are 180,000 deaths a year from heart attacks and 200,000 deaths a year from lung or breast cancer (Nguyen et al). When compared to the numbers for diseases that are talked about every day, it is staggering the impact that sepsis has. Not only is it a lethal disease but it is costly as well. Sepsis took up $16.7 billion in national hospital costs (Nguyen et
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.