Nurses: Screen for Sepsis--Every Patient, Every Shift

Christa A. Schorr, RN, MSN; Mary Ann Barnes-Daly, MS, DC

Disclosures

January 26, 2017

In This Article

Sepsis and Mortality: Sober Facts

Sepsis is the body's systemic response to an infection that, when severe, can lead to life-threatening damage to vital organs. Those with weakened immune systems—such as infants and elderly persons—are at increased risk for sepsis.[1] Health statistics demonstrate that sepsis was listed among the causes of death for 6% of all decedents in the United States from 1999 through 2004.[2] During the same period, sepsis-related deaths increased by 31%.[2]

In light of the increasing incidence of and mortality from sepsis , the Center for Medicare & Medicaid Services has now mandated evidence-based care and reporting for all patients with sepsis, under the Severe Sepsis and Septic Shock Management Core Measure.[3] The measure includes the Surviving Sepsis Campaign, including a 3-hour bundle and a 6-hour bundle.[4]

Nurses Positioned to Transform Sepsis Care

Nurses are the main caregivers in the hospital setting. As frontline staff, nurses with the skill set and empowerment in sepsis awareness can truly influence sepsis outcomes. Nurses in the emergency department (ED), patient wards, and intensive care units (ICUs) evaluate and recognize changes in the patient's clinical condition—putting these nurses in a position to identify early signs of sepsis, and to prevent worsening of the patient's condition. Partnering with physicians enables nurses to swiftly coordinate a response that may include escalation of care to a rapid response team (RRT)—in some hospitals, a sepsis response team—or, if needed, transfer to the ICU.

Early sepsis recognition followed by timely intervention is the key to reducing morbidity and mortality. Engaging nurses through education, beginning with the pathophysiology of sepsis and the trajectory of the sepsis continuum, is the first step toward meaningful sepsis screening; swift diagnosis; and timely, appropriate treatment. Delays can lead to multiple organ failure, resulting in poor patient outcomes.

Hospitals have traditionally focused on sepsis awareness in the ED and ICU. However, worse patient outcomes on the patient wards are thought to be due to delays in sepsis recognition or treatment.[5,6]

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