Response 1

Response- 200- 300 words with references

  Annotated Bibliography

 

Does continued education for nurses in the emergency room on sepsis identification and management reduce mortality in patients diagnosed with sepsis?

Berg, D., & Gerlach, H. (2018). Recent advances in understanding and managing sepsis. F1000Research, 7(1570), 1-8. doi:10.12688/f1000research.15758.1

This article discusses the milestones attained over the past years regarding the management and treatment of sepsis. It gives further insights into post-infection defenses and traditional approaches to sepsis pathophysiology. Researchers analyzed data from the past, which provides an opportunity to explore sepsis from a new angle. In addition, it helps in further defining the disease by highlighting protocols that should be used for follow-ups to reduce mortality rates by the disease.  The article demonstrates and highlights the ever-changing medical field and medical advancements by capturing sepsis as a case study and showing how nurses stand to be of assistance to patients by furthering and refreshing their education.

Gyawali, B., Ramakrishna, K., & Dhamoon, A. (2019). Sepsis: The evolution in definition, pathophysiology, and management. Sage Open Medicine, 7, 1-13. doi:10.1177/2050312119835043

The article highlights the significant evolution regarding the definition of sepsis and its management within the last thirty years. Advances in care are driven by new advancements that have taken place in the understanding of the pathophysiology of sepsis. It discusses the evidence that shows the patterns of sepsis manifestations. The article also discusses the need for revolutionary changes in sepsis management that need to be instilled in caregivers and nurses. These involve early detections among high-risk patients and the recommended treatment, and the appropriate supportive care. The article will show the need for embracing change within the management and treatment of sepsis, particularly since it highlights the evolutions in the treatments.

Harley, A., Johnson, A.N.B., Denny, K.J., Keijzers, G., Crilly, J., Massey, D., (2019). Emergency nurses’ knowledge and understanding of their role in recognizing and responding to patient with sepsis: A qualitative study. International Emergency Nursing, 43,106-112. https://doi.org/10.1016/j.jenj.2019.01005 (Links to an external site.)   

Sepsis is a global problem resulting in approximately 18 million cases annually. Sepsis bundles using evidence-based practices have contributed to the decline in fatality rates. A descriptive qualitative design was conducted to understand the emergency room nurses’ knowledge of sepsis and identify the causes of any gaps in sepsis care. Obtained data through semi-conducted interviews of emergency department nurses provided information regarding their experiences and perceptions of the care provided for patients with sepsis. During the interviews, the nurses acknowledged specific education on sepsis, yet only one of the nurses could recall SIRS criteria. The nurses reported there were tools available to help with screening patients but could not recall the tool's name.  The failure to recognize subtle cues in a patient’s condition can delay providing life-saving interventions that are time-sensitive. Nurses agreed on the importance of their role in sepsis management. Nurses should be familiar with se4psis criteria and recognition of the symptoms of sepsis. The nurses believe that a single educational interaction is insufficient. Education needs to be repeated and in the context of the clinical environment.

McVeigh, S. (2019). Sepsis Management in the Emergency Department. The Nursing Clinics of North America, 55(1), 71-79. doi:10.1016/j.cnur.2019.10.009.

This article discusses sepsis and its negative aspect, including its high cost of treatment and its extremely dangerous nature. It discusses what emergency departments can do to help manage sepsis within the emergency room to improve their patient's outcomes. It also discusses the critical components of sepsis management and its challenges in the various emergency department setups. In addition, it gives interventions that can help improve early identification and treatment alongside providing ways through which care can be standardized through the provision of continuing education for nurses and feedback implementation. The article seeks to define the benefits of continued education for nurses in the emergency room in dealing with various emergencies. It explores the sepsis angle of infection through this light and gives the benefit of nurses being prepared for such emergencies through continued learning. The article will be used to highlight the need for embracing better treatment patterns in the emergency room by nurses to reduce mortality rates caused by sepsis.

Martin, S. & McMurtry-Baird, S.  (2018). Sepsis and septic shock in pregnancy: Early identification of sepsis is critical to identify the source of infection, maintain perfusion, and initiate appropriate antibiotic therapy. Contemporary OB/GYN, 63(6), 10–18.

Each year over year 31 million people suffer from sepsis, and sepsis results in approximately 6 million deaths. Mart et al. (2018) define sepsis as  the current definition of sepsis was established as a life-threatening multiorgan failure resulting from an abnormal immune response caused by patient infection. The pathobiological approach rejects the current method of diagnosing sepsis based on the occurrence of SIRS because many other non-infectious diseases may also cause its occurrence. A nurse spends the most time with a patient, thus becoming the best observer of changes in his/her vital functions and well-being. Nurses working in primary health care, hospital emergency wards, and all departments not involved in intensive medical care have an essential role in preventing infections, as over 70% of sepsis cases begin in a non-hospital environment, and the current level of public knowledge reaches only 14%.

Mazur, N., & Czarkowska-Pączek, B. (2018). The role of nursing staff in the early identification, prophylaxis and treatment of sepsis in the light of the new definition of sepsis. Nursing in the 21st Century, 17(4), 47–52. https://doi.org/10.2478/pielxxiw-2018-0034 (Links to an external site.)

Systemic inflammatory response syndrome (SIRS) and sepsis is frequently identified by observing vital signs and detecting subtle signs of impending organ failure during triage. This study used a before-and-after intervention study in one emergency and community hospital within the Mid-Norway Sepsis Study catchment area. All patients with confirmed bloodstream infections have been prospectively registered continuously since 1994. Retrospective chart audits were conducted. The study found that the post-intervention group had a greater odds of surviving sepsis than the control group.

Qalehsari, M., Khaghanizadeh, M., & Ebadi, A. (2017). Lifelong learning strategies in nursing: A systematic review. Electronic Physician, 9(10), 1-50. doi:10.19082/5541

The article discusses nursing and its lifelong learning expectations for purposes of ensuring their professional performance. It highlights how this belief correlates with nurses' success in nursing schools and how strategies need to be infused within the profession to ensure lifelong learning. It also explains how lifelong learning in healthcare professions is significant to nurse’s awareness and development. The acquisition of new skills through learning eventually improves the care quality nurses accord to patients. The article will show the benefits of continued nurses’ education for both the nurse's effectiveness when dealing with sepsis and the patient.

Rajan, J. J., & Rodzevik, T. (2021). Sepsis Awareness to Enhance Early Identification of Sepsis in Emergency Departments. Journal of Continuing Education in Nursing, 52(1), 39–42. https://doi.org/10.3928/00220124-20201215-10 (Links to an external site.)

This article stressed the importance of early sepsis identification. Early identification is always a challenge. According to this article, the nurses who received education on the early identification and treatment of sepsis in emergency department nurses performed well with sepsis standing orders. The use of a sepsis standing order set combined with education helped to identify and elevate the care of sepsis patients.  Most of the organization is using the national guidelines to improve patient care.

Storozuk, S, Macleod, M. Freeman, S., and Banner, D., (2019). A survey of sepsis knowledge among Canadian emergency department registered nurses. Australasian Emergency Care, 22)2). 119-125. https://doi10.1016/j.auec.2019.01.007 (Links to an external site.)  

This study evaluated the knowledge of emergency room nurses on sepsis and the application of the knowledge to patients. A descriptive cross-sectional survey was used to survey registered nurses from four emergency departments in Canadian. Most of the nurses scored poorly on questions on the inflammatory process, assessment, and definitions. The mean score was 51.8%. The survey demonstrated that nurses acknowledged a lack of knowledge of sepsis and desired further education. The study concluded that nurses would benefit from an educational opportunity that focused on the triage and prompt implementation of interventions for patients with sepsis.

Sutherland, A., Thomas, M., Brandon, R. A., Brandon, R. B., Lipman, J., Tang, B., & Venter, D. (2011). Development and validation of a novel molecular biomarker diagnostic test for the early detection of sepsis. Critical care, 15(3), 1-11.

This article states about the importance of early detection and treatment of sepsis. Sepsis is an immunological response to infection According to this article using a multi marker approach to detect sepsis improved patient’s condition. Early detection and treatment helped to prevent complications. Research has identified biomarkers that may identify early sepsis patients.Thus, the primary objective was to apply these gene expression biomarkers to distinguish patients with sepsis from those who had undergone major open surgery and had clinical outcomes consistent with systemic inflammation due to physical trauma and wound healing. These evidenced base articles demonstrate that this novel gene expression biomarker test (SeptiCyte Lab) has the ability, based on diagnostic performance outcomes, to accurately detect early evidence of sepsis well before the availability of microbiology results.

Torsvik, M., Gustad, L. T., Mehl, A., Bangstad, I. L., Vinje, L. J., Damås, J. K., & Solligård, E. (2016). Early identification of sepsis in hospital inpatients by ward nurses increases 30-day survival. Critical Care, 20, 1–9. https://doi.org/10.1186/s13054-016-1423-1 (Links to an external site.)

Early identification of sepsis is challenging acute care nurses.  Often, a gap exists between existing policies for sepsis identification and structured education to support these policies. The study used a quantitative methodology and descriptive correlational design. A correlation nurses who received education on the signs and symptoms of early between emergency department nurses who received education on the early identification and treatment of sepsis and emergency department nurses who did not receive this education. Descriptive statistics, independent descriptive statistics, and independent t-test were used, (p=.018).  The use of a standardized protocol reduced the mean time to identify sepsis was decreased by 33 minutes. The protocol coupled with  set with nursing education demonstrated improvements in the quality of care provided to patients with sepsis. Screening tools such as the Surviving Sepsis Campaign provide additional resources for emergency room nurses.