Critical Care Nursing Commons^™

Oxygen Consumption In Sepsis, Julie Graham

Dissertations

Background: Sepsis is a life-threatening condition that can lead to septic shock and death. With over 300,000 annual cases (AHRQ, 2011) costing a staggering $1.5 billion (Health Care Utilization Project Brief #185), the importance of sepsis is becoming clear. However, some basic biological mechanisms are poorly understood. Study Purpose: This study investigated the relationships between select demographics, resting energy expenditure (REE), serum lactate, SOFA score mortality index, oxygen consumption [by way of measuring net oxygen consumed, (V02) and net carbon dioxide produced (VC02)], and sepsis. Specific Aims: Aims were to describe 1) patient demographics, serum lactate, SOFA score mortality index, …

Sepsis, Sarah Jones

Nursing Student Class Projects (Formerly MSN)

Sepsis is a dysregulation of the inflammatory response, termed systemic inflammatory response syndrome or SIRS, caused by stimulation of an infectious process. Sepsis often leads to organ dysfunction and increased morbidity, mortality and financial burdens. The goal of treatment is to initiate appropriate antimicrobial therapies, target the underlying infection, optimize intravascular volume, provide fluid resuscitation and maintain adequate perfusion and stroke volume (Taeb, Hooper & Marik, 2017).

Timing of treatment and early detection of sepsis is critical to patients with early warning signs. Sharing this information and potentially making a difference in the outcomes of patients presenting with early signs …

Sepsis To Septic Shock, Seth Whitlow

Nursing Student Class Projects (Formerly MSN)

Abstract

The diagnosis of sepsis has long been part of medicine, however ambiguous definitions, treatment modalities, and research criteria have not provided a unified understanding of the disease. In 2016, international healthcare practitioners convened a panel of experts and developed criteria that defined sepsis as ‘life-threatening organ dysfunction caused by dysregulated host response to infection’. The pathogenesis of sepsis and septic shock is complex and make understanding physiological host response to infection difficult. Evidence shows that with each passing hour patient mortality is increased when treatment is withheld. Sepsis has proven an elusive diagnosis where one size does not fit …

Evaluating Adherence To The Sepsis Bundle And The Effectiveness Of Best Practice Alerts, Kate M. Burnett

DNP Projects

PURPOSE: To evaluate the adherence to the CMS sepsis recommendations and sepsis bundle used by the study health system before and after the implementation of Best Practice Alerts (BPAs) and assessing the effect of these alerts on patient outcomes.

METHODS: The study was a single-center, process evaluation through a retrospective chart review within a southwest healthcare system. The sample consisted of 73 patients for the pre-implementation period (May 1, 2016-September 7, 2016) and 75 patients for the post-implementation period (September 8, 2016-April 30, 2017).

RESULTS: No major differences were found between the two groups with regard to patient age, ethnicity, …

Improving The Identification, Delivery Of Care, And Outcomes Of Hospital-Acquired Sepsis, Nicholas James Welker

DNP Projects

Sepsis syndromes that develop among a hospital inpatient population can be difficult to differentiate from other disease processes that share systemic inflammatory response syndromes. A bedside nurse-driven screening process was developed at Baptist Health Lexington to aid with early sepsis identification and foster prompt goal-directed therapy. This retrospective study of 26 patients identified over a 6 month period measures intensive care length of stay, mortality, and sepsis severity. Exclusion criteria were pregnancy and Do Not Resuscitate orders.

Screening compliance was poor at 23.1 percent (n=6). Complete compliance with goal directed therapy was 7.7 percent, though some components of therapy such …

Effect Of Enteral Feeding Timing In Septic Shock Patients, Shane D. Slone

DNP Projects

The goal of this research project was to identify the effect of the timing of enteral nutrition (EN) initiation timing on in-hospital mortality, ICU LOS and hospital LOS among patients with septic shock requiring norepinephrine. The study design was a cross-sectional analysis of retrospective electronic health record data. Patients who had received norepinephrine for septic shock were divided into early EN initiation (within 48 hours of ICU admission) and late EN initiation (Greater than or equal to 48 hours after ICU admission) groups. 680 subjects were included; 469 in the early group and 211 in the late group. Demographics, comorbidities, …

Sepsis Bundle Completion, Jenna Churnock

Dissertations

Background: Sepsis is a serious condition resulting in end organ damage and ultimately, death. Communication techniques for nurses and physicians on septic patients admitted to the hospital from the emergency department was evaluated. Paper communication was used in 2020 to facilitate serum diagnostic acquisition and antibiotic administration (i.e., sepsis bundle), but an electronic communication form was utilized in 2021.

Method: An observational, descriptive design utilizing a medical record review was completed to compare the same time-period in 2020 and 2021. Communication methods for sepsis bundle completion were compared.

Results: A total of 100 medical records were reviewed (N …