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Sepsis Case Studies

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Background Sepsis is a common life threatening condition that unless promptly recognized and treated, can progress to septic shock. In the United States, sepsis is the 10th leading cause of death, and is suspected to have an increased prevalence due to the aging population; an increase in immunocompromised patients; greater use of invasive medical technologies; and greater antimicrobial resistance (Vanzent, 2011). It accounts for a mortality rate of 35%, and 20,000 deaths per day worldwide (Kafle & Nath, 2014). This is substantial because there are few disease processes that are associated with such a high mortality rate. The unregulated inflammatory response leads to intravascular volume loss, cellular hypoxia, and multisystem organ failure. …show more content…

Health care workers in the Emergency Department (ED) have the opportunity to improve patient care outcomes related to sepsis through earlier detection and goal directed therapy. The international sepsis campaign further defined key elements or “bundles” that need to be completed within 3 hours of the ED admission for a patient with sepsis. Nurses compose the majority of these front line workers and have the opportunity to make an impact on improving their patients’ outcomes. Unfortunately, many EDs have not adopted clinical practice guidelines to reflect these expert recommendations, and continue to struggle with a multitude of …show more content…

In many cases, ED nurses are the first health care provider to assess patients; therefore, it is essential that they have the clinical knowledge necessary to identify those at risk for sepsis, or exhibiting signs of early or even late sepsis. Quality improvement initiatives in the ED should include thorough educational efforts to ensure that nurses understand the sepsis condition in relation to the pathophysiology; the clinical triggers; its progression and implications; and the appropriate treatment that is best supported by evidence based research. Additional quality improvement measures should include the implementation of tools, processes, protocols/guidelines, and procedures required to assist nurses in the early identification and treatment of sepsis. Frontline nurses play an important role on the health care team, and perhaps are the key to reducing the morbidity and mortality of septic patients. The purpose of this quality initiative is to provide measures necessary to facilitate the frontline ED nurses in the early identification and treatment of sepsis. The clinical question for this scholarly project is as follows: “In the emergency department, will quality improvement initiatives, improve the frontline nurses’ early recognition and treatment of

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Risk for Infection Next, by implementing the VAP bundle, it did help to prevent further decline. All aspects of the bundle should be continued; the Heparin, sequential compression devices, oral care, Pepcid, and all other bundle activities. Having the head of the bed up was essential to prevent VAP, but it did end up making her body move to the foot of the bed. Pillows were used to help keep her further up and off the side of the bed.

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Objective One During my clinical day three, I demonstrated entry-level competence in professional nursing practice in caring for patients with multiple and/or complex unmet human needs. I addressed safety needs, safety in medication administration, effective communication, and surveillance for my patients. First, I addressed safety needs my ensuring the appropriate safety measures were implemented for the patients. Some of the safety measures included, wearing non-skid socks, wearing a yellow armband which indicated fall risk, keeping the bed in lowest position, two side rails up, bed locked, and the call light within reach.

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626 Words | 3 Pages

QSEN Competencies allow nurses to improve the safety and quality of existing healthcare institutions by continually understanding the KSAs – knowledge, skills, and attitudes. These competencies include patient-centered care, teamwork and collaboration, evidence-based practice (EBP), quality improvement (QI), safety, and informatics. The following paper discusses the above competencies and evaluates how systems thinking affects the quality and safety of the regulators and accreditors. According to Case Western Reserve University (n.d.), nurses should integrate patient-centered care values by communicating sensibly and respectfully while addressing patients' needs to other staff members.

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642 Words | 3 Pages

The Effects of Sepsis Bundle on Mortality Rates: Background and Significance Historians in the medical field such as Hippocrates and Pasture have referenced symptomologies associated with sepsis of today (Angus & Van der Poll, 2013). Sepsis received its official definition of severe sepsis and septic shock in 1992; with terminology being based on the accompanying disease processes present (Angus & Van der Poll, 2013). The definition of severe sepsis indicates the presence of organ dysfunction along with sepsis. Additionally, septic shock is related to the presence of hypotension not responding to fluid resuscitation (Cawcutt, & Peters, 2014). A diagnosis of severe sepsis or sepsis shock has an increased risk of patient mortality, length of stay, and a higher probability of long-term disability (Cawcutt & Peters, 2014; Whittaker, et al. 2015).

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Hospitals frequently enhance their quality of care by improving their best practices. Bedside reporting is a best practice that has numerous benefits including a decrease in the potential for mistakes, increased patient involvement and understanding of their care, increased teamwork among nurses, and an increased accountability of nurses (AHRQ, 2013). A review of the literature was run and showed several studies and literature reviews on bedside reporting. The majority of these articles were conducted on adult medical-surgical

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573 Words | 3 Pages

Each year, the goals are analyzed and if necessary, updated. The 2016 National Patient Safety Goals aim to: 1) Improve the accuracy of patient and resident identification; 2) Improve the effective communication of caregivers; 3) Improve the safety of medication use; 4) Improve the safety of clinical alarm systems; 5) Reduce the risk of health care associated infections; 6) Organize identification of safety risks evident in patient populations; and 7) Set universal protocol for preventing wrong site/procedure/person surgeries (TJC, 2016). These safety goals are mandated so that medical errors are reduced and patients are given the best quality care possible. Some of the steps nurses can take in association with these goals include: using at least two patient identifiers to ensure correct patient treatment and reduce patient misidentification; making timely reports of critical test and diagnostic results; maintaining accurate patient medication information, and labeling all medications and containers removed from original containers; quickly responding to medical equipment alarms, and maintaining their upkeep; following hand hygiene guidelines, and using evidence-based practices to prevent infections due to multi drug-resistant organisms, surgical sites, or indwelling catheters; identifying patients at risk for suicide; and ensuring that sites are correctly marked for surgery through marking the procedure site and undergoing a verification process (Cherry & Jacobs,

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1289 Words | 6 Pages

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1016 Words | 5 Pages

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In the leadership in care delivery course, we were assigned to a hospital to perform clinical hours and provide care to four patients. Additionally, the purpose of this paper is to explain and provide examples on how our patient care included the concepts of Quality and Safety Education for Nursing (QSEN) competencies, delegation, handoff reporting, and a reflection of the clinical experience. Quality and Safety Education for Nursing (QSEN) Competencies QSEN consists of six competencies: patient centered care, quality improvement, teamwork and collaboration, safety, informatics, and evidence based practice. To provide patient-centered care, I had to educate the patient when administering medications on why the patient was taking the medication and side effects. Care had to be individualized with each patient and it included providing respect with his or her decisions in their care.

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