Management and prevention of Sepsis during hospitalization proposal

NURS 502: SIGNIFICANCE OF THE PRACTICE PROBLEM AND THEORETICAL FRAMEWORK 1

Title: Significance of the Practice Problem and Theoretical Framework

Name: Isel de la Torre

Course: Nurs SC & Research Process 502

Professor: Dr. Andrés Caiaffa

February, 2021

Facilitator: Dr. Andres Caiaffa

Significance of the Practice Problem

	Sepsis, a definition collected by a group of experts in their Third International Consensus as "life-threatening organ dysfunction due to a dysregulated host response to infection." Although it does not constitute a redefinition of the concept, it does give rise to recommendations based on clinical criteria, given the lack of a Golden Rule for the diagnosis of certain sepsis; element that affected the precision and accuracy of the therapeutic conduct to be followed in those cases and, with it, the failure of the fight against a problem that manifests itself in increasing terms, both in magnitude and severity, as it affects millions of hospitalized people , each year, of which a significant proportion have an unfavorable outcome, ending in lethal death (Seymour, 2016). .

	The investigations carried out have contributed that although most sepsis originates in the community environment and that only between 10% and 20% of all sepsis occurs at the hospital level, the risk of dying increases When the infection originates in the hospital, reaching up to 50% of the total, the aforementioned justifies the search for strategies aimed at the prevention of sepsis, as well as its early detection and timely treatment, oriented on the Basis of the results from reliable and valid diagnostic tests or clinical criteria, defined and agreed internationally (Baghdadi, 2020)

	Early identification of sepsis is very important to the success of the care team. Today, it is recognized that early diagnosis and management of sepsis saves lives, while delay costs lives, hence the time variable is crucial for the outcome. Multiple professionals take care of the patient affected by this syndrome or at risk of it. They should think about possible sepsis, to assume an adequate and early diagnostic and therapeutic conduct. However, it is the nurse who, due to her ongoing relationship with the patient and her training in patient care, who is best prepared to foresee a possible sepsis and act accordingly, hence her leading role in such actions (Bleakley, 2020). Perfecting nursing work in the early recognition of sepsis in the hospital setting is a challenge, for whose coping, research constitutes a powerful tool, not only because of the evidence it generates but also because it leads the way forward during the intervention

Theoretical Framework

DOROTHEA OREM THEORY

When Dorothea Orem brought her theory to light in 1958, she was bequeathing one of her General Theories to nursing, made up of: The Theory of Self-Care, the Theory of Self-Care Deficit and the Theory of Nursing Systems. Of these, the Self-Care Deficit Theory constitutes the central axis of the general theory, as it explains when nursing is needed. Among its theoretical references, some point out the influence of Henderson, a contemporary nursing theorist, who had to his credit the development of the criterion of independence of the patient in the assessment of health, by identifying 14 basic human needs in which the nursing care. This last element in common between the two, makes some consider that Orem took up Henderson's ideas to develop universal self-care requirements, with emphasis on the needs that allow preserving the functionality of the person; the demand for self-care that arises when the sick individual cannot carry out their care by himself and his theory of nursing systems where the nurse-patient relationship occurs to satisfy the requirements of self-care (HARTWEG, 2015).

. Roughly speaking, Orem's theory of self-care deficit is a product of the author's effort working with the purpose of raising the quality of nursing in the general hospitals of her state. This model interrelates the concepts in such a way that it generates a different vision of such a particular phenomenon. His theory is relatively simple, but has a high generalizability, hence its applicability to diverse patients. It can be applied by nurses to guide and improve nursing practice, but must be consistent with other validated theories, laws, and principles. Among its assumptions are: people must be self-sufficient and responsible with care; Nursing is a form of action and interaction between two or more people; knowledge of possible problems on the part of a person is necessary to promote self-care behaviors (HARTWEG, 2015)

 	The prevention of sepsis in the hospital setting is a common practice, which is justified by the high frequency with which it occurs, and the severity expressed in the complications of the patients and the frequency with which the fatal death occurs as a final event. For the prevention of sepsis, the nurse has the necessary tools to address it. In the process of caring for patients at risk of sepsis, who are often unable to respond to certain stimuli, the nurse must grasp the theoretical elements provided by this theory, to provide the appropriate preventive approach to each case.

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References
Baghdadi, D. B. (2020). Association of a Care Bundle for Early Sepsis Management with Mortality Among Patients with Hospital-Onset or Community-. JAMA Intern Med. 2020;180(5), 707-716. doi:doi: 10.1001/jamainternmed.2020.0183Internal 
Bleakley, G. C. (2020). Recognition and management of sepsis: the nurse’s role. . British Journal of Nursing, 2020, 29(21), 1248-1252 .
HARTWEG, D. (2015). Dorothea Orem’s Self-Care Chapter 8 Deficit Nursing Theory. . In S. a. Marlaine C, (Fourth Edition). Nursing Theories and Nursing Practice (pp. 105-132). . Philadelphia, USA: Library of Congress Catalogingin Publication Data.
Seymour, C. L.-H. (2016). Assessment of Clinical Criteria for Sepsis For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 315(8), 362-374. doi: doi: doi:10.1001/jama.2016.0288