A new strategy to treat sepsis quickly

Sepsis is a worldwide healthcare problem, affecting more than 27 million people and taking more than 7 million lives every year. This means that there is a sepsis-related death every 3.5 seconds (Sepsis Alliance, 2019). According to the Indiana Hospital Association (IHA), in 2018 there were more sepsis patient deaths than any other diagnoses. Jennifer Rechter, MSN, RN-BC, AGCNS-BS, sepsis coordinator, Parkview Health, tells us more about this condition and what Parkview is doing to minimize instances of sepsis.  

While most people believe otherwise, around 80% of sepsis cases are acquired outside the hospital, which makes it a public health issue, not just a condition hospitals need to address. Surprisingly, a recent survey (IPSC IHA, 2019), conducted in 2018, showed that only 65% of adults in the United States have heard of sepsis. As a result, the IHA is campaigning to increase sepsis awareness and educate people on the signs and symptoms, and the importance of acting quickly if they or a loved one becomes ill. Their hope is to reach, not just those in the medical field, but also families, patients and communities.

What is sepsis?

Sepsis is the body’s overwhelming and potentially life-threatening response to an infection, which can lead to tissue damage, organ failure and even death (Sepsis Alliance, 2019).

Who is at risk for sepsis?

Sepsis can affect anyone, but according to the Centers for Disease Control and Prevention (CDC), some populations are at a higher risk. Specifically, those who:

• are under age 1 or over age 65

• have a weakened immune system or chronic illness (diabetes, cancer, kidney, liver disease, splenectomy, dialysis, etc.)

• have a severe burn or wound

• have an indwelling catheter or IV

• recently had surgery or have been hospitalized

What causes sepsis?

Any type of infection can lead to sepsis. Here are the four most common infections associated with sepsis:

  • Lungs (pneumonia)
  • Kidney (urinary tract infection)
  • Skin (new or worsening injury or wound)
  • Abdomen or gut
What are the signs or symptoms of sepsis?

Unfortunately, there is no single sign or symptom of sepsis because sepsis occurs from any infection. Diarrhea, vomiting and a sore throat are common signs/symptoms of an infection. In addition, those suffering from sepsis might experience:

Shivering, fever, feeling very cold

Extreme pain or feeling worse than ever

Pale or discolored skin

Sleepiness, difficulty waking up, confusion

I feel like I might die

Shortness of breath

What is Parkview doing to identify sepsis early?

In January of 2019, the Sepsis Task Force Team, in collaboration with the Business Intelligence-Analytic Team, implemented the “Early Detection of Sepsis” predictive model (Verona, WI) to assist healthcare providers with early detection and interventions for our sepsis patients.

When a patient meets a specific threshold score, low and high alerts are triggered to nurses and a high alert is triggered to the provider. Within the alert, healthcare providers can see the contributing factors and an assessment for clinical presentations of sepsis which are: fever, hypothermia, fast respiratory rate, fast heart rate (>90 beats per minute), altered mental status (confusion/coma), and low blood pressure or mean arterial pressure.

If there are any concerns for sepsis, the nurses have a protocol to follow and the providers have links to specific sepsis orders, along with proper acknowledgement actions. 

Implications

Since implementing the “Early Detection of Sepsis” predictive model, early data demonstrates an increase in the number of sepsis diagnoses and a reduction in sepsis mortality. We are conducting ongoing data tracking to look at the implication of this model on our sepsis outcomes.

We will continue to enhance this evidence-based practice, which allows caregivers to implement sepsis treatment to our patients more rapidly, through early identification and recognition.

 

 

Sources

CDC
Global Sepsis Alliance
Sepsis Alliance
National Institute of General Medical Sciences

Facts for the state of Indiana come from the 2018 IHA Inpatient Discharge Study

 

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