Assigment .Apa seven . All instructions attached.

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Capstone Part II: Literature Review

Mariela Sanchez

Florida National University

MSN Capstone Project-DBX-DL02

Professor: Carmen Lazo

September 19, 2023

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Literature Review

Sepsis, which may cause tissue damage, organ failure, and death, is a worldwide

healthcare priority. Nursing personnel are crucial in identifying sepsis early to reduce its

catastrophic consequences (Joffre et al., 2020). Early detection is vital to patient outcomes; even

an hour's delay may increase mortality by 30% (Huang et al., 2019). Thus, front-line healthcare

personnel, especially nurses, must be competent and prepared to identify and treat sepsis (Huang

et al., 2019). This literature analysis examines the data on early sepsis detection in nurses and

compares extensive training modules to older techniques. The goal is to inform the PICOT

question: In nursing staff (P), how does a comprehensive training module on early sepsis

symptom identification (I) compared to current training methods (C) affect confidence in early

detection and immediate interventions (O) over 8 weeks (T)?

Significance of Timely Sepsis Identification

The issue of sepsis is undoubtedly a significant worry in healthcare, as Geng et al. (2020)

highlighted. The research conducted by the authors emphasizes the significant worldwide

consequences of sepsis, which is predicted to afflict around 30 million individuals each year and

possibly lead to six million fatalities (World Health Organization, 2020). In conjunction with the

understanding that timely identification may significantly enhance results, the figure mentioned

above emphasizes the need to develop more efficient training approaches for healthcare

practitioners. According to Geng et al. (2020), the fast diagnosis of sepsis is of utmost

importance due to the possibility of rapid development from a moderate infection to severe

sepsis or septic shock if not immediately detected and managed. It is essential to consider the

preexisting training methodologies to assess the effectiveness of comprehensive training

modules. In their study, Choy et al. (2022) undertook a thorough evaluation to determine the

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effects of sepsis education on healthcare personnel, explicitly focusing on nurses. The

researchers discovered that conventional instructional approaches, such as seminars and

workshops, had inconsistent impacts on the results of both learners and patients. This paper

elucidates the unpredictability and constraints inherent in conventional training, establishing a

foundation for juxtaposing conventional approaches with the suggested complete training

module. Numerous studies have investigated the efficacy of comprehensive training modules in

enhancing sepsis detection skills among nursing personnel. The research undertaken by Adams et

al. (2022) included many sites and aimed to assess the adoption of a machine learning-based

early warning system for sepsis. The main emphasis of their research is on the technology itself.

Still, it also indirectly highlights the potential of technical improvements to assist nurses in the

early identification of sepsis, thereby complementing thorough training initiatives. The study

conducted by Adams et al. (2022) demonstrates the dynamic characteristics of the healthcare

sector and the significance of advancing technology in improving the detection of sepsis.

One of the main focal points of the PICOT question is to enhance the nursing staff's confidence

and understanding in detecting sepsis. In research done by Kim and Park (2019), particular

emphasis was placed on the timely identification and enhanced management of sepsis. Although

not explicitly designed as a training study, this research underscored the significant importance

of knowledge and awareness in the effective and timely treatment of sepsis. In this study, Kim

and Park (2019) provide evidence to support the notion that enhancing knowledge may

substantially affect sepsis outcomes, even without explicitly assessing training interventions.

Identifying sepsis poses a challenging and intricate endeavor, as shown by the research

conducted by Harley et al. (2021). The research analyzed the significant challenges involved in

identifying and treating pediatric sepsis. The need for specialized training and expertise,

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especially concerning vulnerable groups, was underscored. The authors Harley et al. (2021)

emphasize the difficulties that nurses may have while caring for distinct patient groups,

highlighting the need to develop comprehensive training programs specifically designed for

different clinical settings.

Guideline-Based Approaches

The guidelines established by the Surviving Sepsis Campaign include crucial advice

about treating sepsis (Evans et al., 2021). These criteria are often used as the foundation for

training programs. Nevertheless, it is crucial to acknowledge that healthcare workers may exhibit

varying degrees of adherence to rules, necessitating extensive training to guarantee the uniform

and consistent application of those recommendations. Evans et al. (2021) highlight the

significance of ensuring that training endeavors are under established norms to foster uniform

care. In research done by Saeed et al. (2019), a multi-center investigation was undertaken to

identify illness progression in patients with probable infection at an early stage. Although not

limited to sepsis, this research underscored the need to use a multidisciplinary strategy, which

could be integrated into complete training programs. The enhancement of early detection efforts

may be facilitated by collaboration among healthcare professionals, especially nurses. The

authors, Saeed et al. (2019), emphasize the significance of interprofessional cooperation in sepsis

detection. They argue that comprehensive training efforts should include other healthcare

workers, not limited to nursing personnel. The detection of sepsis in some healthcare settings,

particularly those in socioeconomically disadvantaged areas, is further complicated by

inadequate resources and low levels of health literacy (Mahapatra & Heffner, 2023). This

underscores the need for flexible and environmentally aware training modules that cover a wide

range of topics. Mahapatra and Heffner (2023) highlight inequalities in healthcare resources and

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literacy, which may impact the ability to identify sepsis. They propose that customized training

interventions should be developed to address these distinct issues.

Challenges and Impact on Vulnerable Populations

In their comprehensive study, Wiersinga et al. (2020) thoroughly examined the

pathophysiological mechanisms, modes of transmission, diagnostic approaches, and therapeutic

interventions associated with sepsis. The complete methodology used by the researchers

highlights the intricate nature of sepsis care. The proposition posits that to enhance the detection

and treatment of sepsis, it is essential to customize training programs to cater to individuals'

unique requirements and proficiency levels. The significance of individualized training methods

that consider the varied histories and skill sets of nursing personnel is emphasized by Wiersinga

et al. (2020). The research conducted by Rozenfeld et al. (2020) has particular relevance in light

of the vulnerable groups discussed in the introductory section. This research has highlighted

hospital environments, including intensive care units (ICUs) and post-surgical wards, as the

principal causes of infections resulting in sepsis. The need to provide comprehensive training to

nurses in such settings is underscored, focusing on enhancing their ability to identify sepsis cases

promptly. The study by Rozenfeld et al. (2020) provides valuable insights into the crucial

significance of nursing personnel in clinical settings with elevated risk levels, emphasizing the

need for specialized training in such environments.

Analyzing and Applying Knowledge

According to the synthesized evidence, sepsis is a worldwide healthcare issue with

significant fatality rates that requires early detection to reduce its deadly consequences.

Traditional training techniques have demonstrated varying degrees of efficiency in addressing

the difficulties of sepsis identification, spurring the development of more comprehensive training

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programs. According to reviewed research, comprehensive training modules may boost nurses'

sepsis identification confidence and knowledge. Some results indirectly support extensive

training, but additional research is required to assess its effects on nursing personnel in diverse

healthcare contexts.

Objectives for Practice Change

Improved early detection of sepsis signs among nursing personnel is the primary

objective of practice improvement. This requires a thorough sepsis identification training

package that incorporates theory and practice. Nurses will gain confidence and competence in

detecting early sepsis signs and implementing immediate interventions. The secondary goal is to

evaluate long-term retention and application of training to ensure that information and skills are

retained.

Where the Problem Exists and Why

Delays in sepsis identification occur in many healthcare settings owing to poor training,

awareness, and symptom complexity. Traditional training has struggled to address these issues. A

more extensive and targeted training strategy to provide nursing personnel with the knowledge

and confidence to recognize sepsis early is advocated to address this issue.

Pros vs. Cons

The recommended practice adjustment may minimize sepsis-related mortality, improve

patient outcomes, and boost nursing staff confidence. It can standardize sepsis identification and

treatment in healthcare. Cons may include the time and resources needed to execute complete

training sessions. Consider how to balance training with other healthcare goals and resource

restrictions.

Current State of the Problem

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Lack of consistency in sepsis identification by nursing personnel delays treatments and

worsens patient outcomes. Training effectiveness variability adds to this. Comprehensive training

modules may improve the situation by giving nurses the knowledge and confidence to diagnose

sepsis early. Improving patient safety and healthcare quality is the overall aim.

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References

Adams, R., Henry, K. E., Sridharan, A., Soleimani, H., Zhan, A., Rawat, N., Johnson, L., Hager,

D. N., Cosgrove, S. E., Markowski, A., Klein, E. Y., Chen, E. S., Saheed, M. O., Henley,

M., Miranda, S., Houston, K., Linton, R. C., Ahluwalia, A. R., Wu, A. W., & Saria, S.

(2022). Prospective, multi-site study of patient outcomes after implementation of the

TREWS machine learning-based early warning system for sepsis. Nature Medicine,

28(7), 1455–1460. https://doi.org/10.1038/s41591-022-01894-0

Choy, C. L., Liaw, S. Y., Goh, E. L., See, K. C., & Chua, W. L. (2022). Impact of sepsis

education for healthcare professionals and students on learner and patient outcomes: A

systematic review. Journal of Hospital Infection, p. 122.

https://doi.org/10.1016/j.jhin.2022.01.004

Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado,

F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga,

W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., &

Belley-Cote, E. (2021). Surviving sepsis campaign: international guidelines for

management of sepsis and septic shock 2021. Intensive Care Medicine, 47(47).

https://doi.org/10.1007/s00134-021-06506-y

Guarino, M., Perna, B., Alice Eleonora Cesaro, Maritati, M., Michele Domenico Spampinato,

Contini, C., & Roberto De Giorgio. (2023). 2023 update on sepsis and septic shock in

adult patients: Management in the emergency department. Journal of Clinical Medicine,

12(9), 3188–3188. https://doi.org/10.3390/jcm12093188

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Harley, A., Schlapbach, L. J., Johnston, A. N. B., & Massey, D. (2021). Challenges in the

recognition and management of paediatric sepsis — The journey. Australasian

Emergency Care, 25(1). https://doi.org/10.1016/j.auec.2021.03.006

Kim, H. I., & Park, S. (2019). Sepsis: Early recognition and optimized treatment. Tuberculosis

and Respiratory Diseases, 82(1), 6–14. https://doi.org/10.4046/trd.2018.0041

Mahapatra, S., & Heffner, A. C. (2023, February 6). Septic shock (sepsis). National Library of

Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430939/

Saeed, K., Wilson, D. C., Bloos, F., Schuetz, P., van der Does, Y., Melander, O., Hausfater, P.,

Legramante, J. M., Claessens, Y.-E., Amin, D., Rosenqvist, M., White, G., Mueller, B.,

Limper, M., Callejo, C. C., Brandi, A., Macchi, M.-A., Cortes, N., Kutz, A., & Patka, P.

(2019). The early identification of disease progression in patients with suspected

infection presenting to the emergency department: A multi-centre derivation and

validation study. Critical Care, 23(1). https://doi.org/10.1186/s13054-019-2329-5

Thompson, K., Venkatesh, B., & Finfer, S. (2019). Sepsis and septic shock: Current approaches

to management. Internal Medicine Journal, 49(2), 160–170.

https://doi.org/10.1111/imj.14199

Wiersinga, W. J., Rhodes, A., Cheng, A. C., Peacock, S. J., & Prescott, H. C. (2020).

Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019

(COVID-19): A review. JAMA, 324(8), 782–793.

https://doi.org/10.1001/jama.2020.12839