Sepsis Case Studies

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.

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

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