Implications of the New International Sepsis Guidelines for Nursing Care

Abstract

Sepsis is a serious worldwide health care condition that is associated with high mortality rates, despite improvements in the ability to manage infection. New guidelines for the management of sepsis were recently released that advocate for implementation of care based on evidence-based practice for both adult and pediatric patients. Critical care nurses are directly involved in the assessment of patients at risk for developing sepsis and in the treatment of patients with sepsis and can, therefore, affect outcomes for critically ill 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. This article presents an overview of new evidence-based recommendations for the treatment of adult patients with sepsis, highlighting the role of critical care nurses.

Publish (High-Quality Evidence For Clinical Practice) or (Patients May) Perish

“…Nursing implications of the revised Surviving Sepsis guidelines are summarized in this issue of AJCC by Drs Ruth Kleinpell, Leanne Aitken, and Christa Schorr, who were members of the revision committee. 4 Revisions to these 2 important guidelines illustrate how recent publications inform changes in clinical guidelines. Recommendations for practice continue to change as new research confirms, refutes, or modifies previous practices.…”

Sepsis: implication for nursing

“…Sometimes, the family of the patient must make a big effort to understand the criticality of the clinical picture and the nurse plays a fundamental role which is recognized by the international literature, to help family members to understand the situation, through continuous reports and talks. 1,22,23 Generally, for treatment of hospitalized patients with sepsis, it is fundamental: 6 i) to disseminate information on the new guidelines to the team members; ii) to include discussion of the guidelines during unit clinical care meetings and clinical rounds; iii) to constitute a multidisciplinary team and outline a timeline for implementing the guidelines; iv) to use the new guidelines as a performance improvement initiative for the Intensive Care Unit as well as noncritical care areas to improve recognition and treatment of patients with sepsis. Specific areas include: i) aid in the early identification of sepsis including recognizing patients at risk for developing sepsis (patients who are elderly, immunocompromised, patients with surgical/invasive procedures, indwelling catheters, mechanically ventilated patients) and monitoring physical assessment parameters including vital signs and perfusion status (urine output, mental status changes, skin color); ii) to provide comprehensive sepsis treatment (circulatory support with fluids, inotropes, and vasopressors; supportive treatment with oxygenation and ventilation; antibiotic administration; sepsis guideline recommendation measures; monitor and report patient response to treatment); iii) to promote patient and family centered care (patient and family teaching, addressing the needs of families of critically ill patients, setting goals of care, and holding family care conferences to discuss goals of care).…”

“…1,5 This can be considered a continuum that can evolve from one infection status to multi-organ failure that could lead to death. The origin of sepsis is varied, it was found that sepsis of respiratory origin is the most common in the industrialized world 4,5,[13][14][15] with an incidence rate ranging between 35% and 50%, followed by infections of urinary tract, intra-abdominal, catheter-related blood stream infection, device-related, central nervous system and others (e.g., cellulitis, intra-articular).…”

The New Sepsis Definitions: Implications for Critical Care Practitioners

“…[37][38][39] In tracking metrics such as time to measurement of lactate levels, time to collection of samples for blood cultures, time to administration of antibiotics, and other quality goals, individual institutions can improve sepsis care and outcomes. Using the new clinical criteria in Sepsis-3, for example, tracking use of SOFA or qSOFA, to evaluate possible additional sepsis-related metrics further may also be helpful.…”