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Sepsis Recognition and Management

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CE1022 | Contact Hours: 2

COURSE OBJECTIVES

The purpose of this course is to inform health care professionals about sepsis recognition and management that can be used to improve patient safety. After studying the information presented here, you will be able to:

1. Demonstrate an understanding of the Systemic Inflammatory Response Syndrome (SIRS), sepsis and septic shock
2. Recognize the early signs of sepsis
3. Identify the interventions to treat sepsis
4. Explore avenues of effective clinical documentation strategies for sepsis
5. Describe the best practices for sepsis prevention
6. Recognize the issues associated with Post-intensive Care Syndrome

RELEASE DATE

09/20/2022

EXPIRATION DATE

09/20/2024

AUTHOR

Natalie Dycus, MSN, BSN, RN

CRITERIA FOR SUCCESSFUL COMPLETION

All learners must complete the entire activity and complete the evaluation to receive contact hours.

APPROVAL STATEMENT (ACCREDITATION INFORMATION)

This nursing continuing professional development activity was approved by the Ohio Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. (OBN-001-91).

In addition to states that accept American Nurses Credentialing Center (ANCC) courses, CE Leaders is an approved provider by the Florida Board of Nursing, and a registered provider with the Arkansas State Board of Nursing, District of Columbia Board of Nursing, Georgia Board of Nursing, Kentucky Board of Nursing, New Mexico Board of Nursing, South Carolina Board of Nursing and West Virginia Board of Registered Nurses (Provider # 50-33450).

RELEVANT FINANCIAL RELATIONSHIP

No one with the ability to control content of this activity has a relevant financial relationship with an ineligible company.

INTRODUCTION

The CDC defines sepsis as the body’s extreme response to an infection and is a life-threatening emergency. It can occur after an infection already in the body sets off a chain reaction in the body. Infections in the lung, urinary tract, skin and gastrointestinal tract are the most common infections that can lead to sepsis. It can lead to tissue damage, organ failure, and death. The sepsis criteria for an adult patient must include a presumed infection and organ dysfunction (7).

It is reported that the occurrence of sepsis is increasing, especially in the older population with more comorbidities and better recognition from clinicians. At least 1.7 million adults in the United States develop sepsis each year and of that population, 270,000 will die of sepsis complications. Alarmingly, 1 in 3 patients that die in the hospital die of sepsis. The patients that happen to survive sepsis often have long-term physical and cognitive disabilities that affect their quality of life (7).

Sepsis prevention involves early recognition, adoption of a systematic evidence-based bundle of care, and timely escalation to higher care (6). Patients can lower their risk by taking care of their chronic conditions, staying up-to-date on vaccinations, maintaining proper hygiene habits, keeping wounds clean and protected, and seeking medical help if sepsis is suspected (7).

Nurses play an essential role in recognizing sepsis symptoms and providing the necessary interventions. Nursing interventions should be performed appropriately and quickly to increase the chances of positive patient outcomes. Interventions should involve collaboration with team members, infection control, management of fevers, monitoring blood levels, assessment of physiologic status and pharmacologic therapy (5).

REFERENCES

1. Seetharaman S, Wilson C. Landrum M, et al. Does Use of Electronic Alerts for Systemic Inflammatory Response Syndrome (SIRS) to Identify Patient with Sepsis Improve Mortality? Am J Med 2019; 132:862.

2. Usman OA, Usman AA, Ward Ma. Comparison of SIRS, qSOFA, and NEWS for the early identification of sepsis in the Emergency Department. Am J Emerg Med 2019; 37:1490.

3. Evans L. Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med 2021; 49:e1063.

4. Meyer N, Harhay MO, Small DS, et al. Temporal Trends in Incidence, Sepsis-Related Mortality, and Hospital-Based Acute Care After Sepsis. Crit Care Med 2018; 46:354.

5. Kahn JM, Davis BS, Yabes JG, et al. Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults with Sepsis. JAMA 2019; 322:240.

6. Rababa M, Bani Hamad D, Hayajneh AA. Sepsis assessment and management in critically Ill adults: A systematic review. PLoS One. 2022 Jul 1;17(7):e0270711. doi: 10.1371/journal.pone.0270711. PMID: 35776738; PMCID: PMC9249173.

7. CDC: Sepsis. Available at https://www.cdc.gov/sepsis/index.html. Last accessed on 8/26/22.

8. Lippincott Advisor: Nursing Care Plans for Medical Diagnoses: Sepsis, April 2022.

9. Nurseslabs. Available at https://nurseslabs.com/sepsis-and-septic-shock/. Last accessed on 8/27/22.

10. Sepsis Alliance. Available at https://www.sepsis.org/. Last accessed on 8/27/22.

11. The UK Sepsis Trust. Available at https://sepsistrust.org/. Last accessed on 8/27/22.

12. Sepsis campaign: Critical Care Medicine: November 2021 - Volume 49 - Issue 11 - p e1063-e1143 doi: 10.1097/CCM.0000000000005337.

13. Sepsis and septic shock: Guildeline-based management. Siddharth Dugar, Chirag Choudhary, abhijit Duggal. Cleveland Clinic Journal of Medicine Jan 2020, 87 (1) 53-64; DOI: 10.3949/ccjm.87a.18143.

14. Mikkelson ME, S Mikkelsen ME, Still M, Anderson BJ, et al. Society of Critical Care Medicine's International Consensus Conference on Prediction and Identification of Long-Term Impairments After Critical Illness. Crit Care Med 2020; 48:1670.

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