New Sepsis Guidelines and Nurses: Factors, Compliance and Consideration
In this article, the authors highlight how serious sepsis is and how even in recent times it has remained a pressing concern, despite efforts to manage this condition better with aggressive preventative efforts. Kleinpell and colleagues address the new guidelines for the management of this condition to better minimize it for both adult and child patients. Nurses are at the front lines of patient care, but critical care nurses are even more pivotal at prevention efforts as they have immediate involvement with evaluating patients who are particularly vulnerable for sepsis and with those who are already afflicted. Kleinpell and colleagues highlight how and why its so important for nurses to follow guidelines as they can impact the most change and improvement in patients. “Nurses’ knowledge of the recommendations in the new guidelines can help to ensure that patients with sepsis receive therapies that are based on the latest scientific evidence” (Kleinpell et al., 2013). The authors highlight some of the most important protocols to prevent and treat sepsis, continually connecting it back to the pivotal role of nurses.
Similarly, Kleinpell’s later work returns to these same themes, in the research study “Targeting Sepsis as a Performance Improvement Metric” (Kleinpell & Schoor, 2014). This study focuses as well on the critical role the nurse plays in controlling, preventing and treating sepsis. In particular, this study finds that specific performance improvement methods directed at early recognition and specific treatment can improve sepsis care through the professional excellence and responsibility of the nurse.
Focusing on the responsibility of the nurse is a wise decision when it comes to successfully treating and thwarting sepsis in patients of all ages. The study, “Nursing considerations to complement the Surviving Sepsis Campaign guidelines” by Aitken and colleagues (2011) sought to fine-tune the current sepsis guidelines based on current evidence in order to guide clinicians to offer the best patient care in treating aggravated or minor sepsis. At the end of this study, “Sixty-three recommendations relating to the nursing care of severe sepsis patients are made. Prevention recommendations relate to education, accountability, surveillance of nosocomial infections, hand hygiene, and prevention of respiratory, central line-related, surgical site, and urinary tract infections, whereas infection management recommendations related to both control of the infection source and transmission-based precautions” (Aitken et al., 2011). This study shows that preventing and minimizing sepsis is a truly involved process, one that has numerous aspects and requires the utmost professional excellence.
For pediatric cases of sepsis, there needs to be an aggressive strategy in place, to minimize mortality. This was the focus of the research study, “Implementation of Goal-Directed Therapy for Children With Suspected Sepsis in the Emergency Department” by Cruz and colleagues (2011). This study particularly targeted the proper strategy for use in ERs when identifying septic shock, adding that symptoms such as slower recognition and incomplete fluid resuscitation were common. These researchers highlighted the importance of a computerized triage system, which set off an alarm whenever the vital signs of the child became abnormal. Such a technological tool can pinpoint sepsis faster and help facilitate time-sensitive interventions (Cruz et al., 2011).
However, so many of the sepsis guidelines are in place to prevent sepsis and to minimize the infection if it does in fact manifest. The research study “Adherence to PALS Sepsis Guidelines and Hospital Length of Stay” by Paul and colleagues (2012) sought to assess the adherence to sepsis guidelines within a pediatric…
Numerator: number of patients for whom administration of low-dose glucocorticoids for septic shock was determined in accordance with a standardized ICU policy over the first 24 hours following the time of presentation Denominator: total number of patients with septic shock *Low-dose glucocorticoids refer to a daily dose of 200 300 mg of hydrocortisone or equivalent. Quality Indicator No. 6: Administration of drotrecogin alfa (activated) for severe sepsis and/or septic shock in accordance with a standardized
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