Assigment .Apa seven . All instructions attached.

1

CAPSTONE: PART I

Enhancing the Early Identification of Sepsis Symptoms Among Nursing Staff: Evaluating

the Efficacy of a Comprehensive Training Module

Mariela Sanchez

Florida National University

MSN Capstone Project-DBX-DL02

Professor: Carmen Lazo

September 9, 2023

2

Introduction to your proposed problem

Significance of the Practice Problem: Sepsis, a potentially life-threatening condition

caused by the body's extreme response to an infection, remains a dominant challenge within

global healthcare settings. It often leads to tissue damage, organ failure, and death. Despite its

critical nature, timely identification of sepsis remains a significant hurdle in many healthcare

settings, a concern directly correlated to nursing staff's awareness and training on the condition

(Joffre et al., 2020).As a response to infections, sepsis can rapidly escalate into severe stages if

not promptly identified and treated. The importance of early recognition lies in the resultant

patient outcomes: a mere hour's delay in intervention can significantly increase the mortality rate

associated with sepsis. Thus, the early identification and subsequent intervention hinge

predominantly on the front-line staff – the nurses (Huang et al., 2019).

Topic Introduction

This paper centers on the role of nursing staff in the early identification of sepsis

symptoms. Through a rigorous evaluation of the current training methods in contrast to a

proposed comprehensive training module, this research aims to discern the most effective

approach to augment the confidence and competence of nurses in sepsis identification.

Description of the Health Problem

Sepsis emerges as a severe health complication when the body’s response to infection

damages its tissues and organs. Globally, an estimated 30 million people are affected by sepsis

annually, with potentially 6 million resulting deaths (World Health Organization, 2020). This stark

3

statistic, compounded by the knowledge that early detection can dramatically improve outcomes,

underscores the urgency for more effective training methodologies for healthcare

professionals (Geng et al., 2020).

Purpose Statement

The core objective of this research is to examine the effectiveness of a comprehensive

training module on early identification of sepsis symptoms. By comparing this module to existing

training paradigms, we aim to establish if the proposed program can markedly elevate the

confidence and capability of nursing staff in both recognizing early sepsis symptoms and

initiating immediate interventions.

Proposed Outcome

By the culmination of an 8-week training period, we anticipate a measurable 20%

increase in nursing staff's confidence in early sepsis identification and immediate interventions.

This projection is based on pre-and post-training confidence assessment scales. A follow-up

survey and evaluation three months post-training will provide insights into the long-term retention

and application of the training.

PICOT Question

In nursing staff (P), how does the introduction of a comprehensive training module on

early identification of sepsis symptoms (I) compared to current training methods (C) affect the

4

confidence in early sepsis identification and immediate interventions (O) over a period of 8

weeks (T)?

P (Population): The population of interest consists of the nursing staff working in

medical and surgical units. This group is selected as they frequently encounter patients at varying

degrees of illness and are at the forefront in identifying and addressing emerging health concerns.

I (Intervention): The proposed intervention is the introduction of a comprehensive

training module focusing on early identification of sepsis symptoms. This module would

encompass both theoretical aspects of sepsis identification and practical simulations or case

studies to reinforce the training.

C (Comparison): The comparison intervention pertains to the existing or traditional

training methods on sepsis identification. These may include periodic seminars, brief workshops,

or on-the-job training, which may not be as exhaustive or structured as the proposed

comprehensive module.

O (Outcome): The primary outcome being studied is the improved confidence of nursing

staff in early sepsis identification and immediate interventions. This will be gauged through pre-

and post-training assessments, measuring the change in knowledge and confidence levels.

T (Timeframe): The duration for this study is set at 8 weeks, providing adequate time for

training module delivery, practice, assessment, and observation of any immediate behavioral

changes in the nursing staff.

5

Describe the Vulnerable Population

The vulnerable population in this context, while indirectly, includes patients at risk of

developing sepsis or those who are diagnosed but not identified early due to gaps in healthcare

staff training. Impact of Social Determinants: Sepsis risk can be exacerbated by various social

determinants such as lack of access to timely medical care, residing in areas with limited

healthcare infrastructure, socioeconomic constraints, and limited health literacy. Patients in

socioeconomically deprived regions might be at a higher risk due to a combination of these

factors (Menon et al., 2023).

Risk Factors: Several risk factors make patients vulnerable to sepsis.

Advanced Age: The elderly, due to weaker immune systems and the presence of co-

morbidities, are at increased risk. Immunocompromised Status: Patients with conditions or

undergoing treatments that suppress the immune system (e.g., HIV, chemotherapy) are at

heightened risk. Chronic Medical Conditions: Conditions like diabetes, kidney disease, and lung

disease can predispose individuals to infections leading to sepsis. Recent Hospitalization:

Exposure to hospital settings, especially in ICUs or post-surgical wards, can increase sepsis risk

due to potential exposure to resistant pathogens (Rozenfeld et al., 2020).

Evidence: According to a study by Seymour et al. (2017), patients with chronic medical

conditions and those in higher age groups had an increased likelihood of developing sepsis.

Moreover, hospitals were identified as the primary source of infections leading to sepsis,

emphasizing the need for early detection and intervention.

6

Research from Scholarly Journals

Several evidence-based studies have emphasized the importance of early detection and

intervention in sepsis management. For instance: This research underscores the vital need for the

quick identification of sepsis to ensure timely intervention.

Proposal

Given the critical nature of early sepsis identification, a comprehensive training module

seems apt. This module will: Incorporate the latest evidence-based practices for sepsis detection.

Use mixed-media training tools - videos, simulations, and real-life case scenarios. Include post-

training assessments to gauge knowledge absorption and skill acquisition (Gyawali et al., 2019).

Resources Necessary

Training content from evidence-based studies. Simulation tools or software. Expert

personnel for training delivery and evaluation. Funds for module development and

implementation.

Individuals Involved

A curriculum developer with expertise in evidence-based healthcare practices. A

facilitator or trainer, preferably with ICU or ER experience. A team for post-training evaluation.

Nursing staff as participants.

7

Feasibility for an Advanced Role Nurse: An advanced role nurse, with their depth of

clinical experience and knowledge, can drive the development and delivery of the module. They

can lend their expertise in curating the content, ensuring it is up-to-date, practical, and

beneficial (Gysin et al., 2019)

Timeline

Weeks 1-2: Development of the training module. Weeks 3-4: Training sessions for the

nursing staff. Week 5: Initial post-training assessment. Weeks 6-8: Observation and collection of

feedback. End of Week 8: Final evaluation and assessment.

Theoretical Framework/Nursing Theory

The Knowles’ Adult Learning Theory can be the backbone of this project. The theory

posits that adults learn best when: They understand the importance of what they're learning. They

have some experience with the content. Learning is problem-centered rather than content-

oriented. Given that nurses have clinical experience, a training module that aligns with real-world

challenges and emphasizes the significance of the knowledge can be more effective. This theory

accentuates the need for problem-centered learning, making it ideal for training modules like

sepsis detection where timely intervention can save lives (Joseph et al., 2019).

Significance to the Healthcare System: Early identification of sepsis can significantly reduce

8

Patient mortality rates. The length of hospital stays, thereby reducing costs. Risk of

readmissions due to complications. Moreover, it can enhance the quality of life of patients,

ensuring quicker recovery and fewer post-hospitalization complications (Gyawali et al., 2019).

References

Geng, Y. J., Wei, Z. Y., Qian, H. Y., Huang, J., Lodato, R., & Castriotta, R. J. (2020).

Pathophysiological characteristics and therapeutic approaches for pulmonary injury and

cardiovascular complications of coronavirus disease 2019. Cardiovascular Pathology, 47,

107228.

Gyawali, B., Ramakrishna, K., & Dhamoon, A. S. (2019). Sepsis: The evolution in definition,

pathophysiology, and management. SAGE open medicine, 7, 2050312119835043.

Gysin, S., Sottas, B., Odermatt, M., & Essig, S. (2019). Advanced practice nurses’ and general

practitioners’ first experiences with introducing the advanced practice nurse role to Swiss

primary care: a qualitative study. BMC family practice, 20, 1-11.

Harley, A., Johnston, A. N. B., Denny, K. J., Keijzers, G., Crilly, J., & Massey, D. (2019).

Emergency nurses’ knowledge and understanding of their role in recognising and

responding to patients with sepsis: A qualitative study. International emergency

nursing, 43, 106-112.

9

Huang, M., Cai, S., & Su, J. (2019). The pathogenesis of sepsis and potential therapeutic

targets. International journal of molecular sciences, 20(21), 5376.

Joffre, J., Hellman, J., Ince, C., & Ait-Oufella, H. (2020). Endothelial responses in

sepsis. American journal of respiratory and critical care medicine, 202(3), 361-370.

Joseph, M. L., Bair, H., Williams, M., Huber, D. L., Moorhead, S., Hanrahan, K., ... & Chi, N. C.

(2019). Health care innovations across practice and academia: A theoretical

framework. Nursing outlook, 67(5), 596-604.

Menon, K., Sorce, L. R., Argent, A., Bennett, T. D., Carrol, E. D., Kissoon, N., ... & Ranjit, S.

(2023). Reporting of social determinants of health in pediatric sepsis studies. Pediatric

Critical Care Medicine, 24(4), 301-310.

Rozenfeld, Y., Beam, J., Maier, H., Haggerson, W., Boudreau, K., Carlson, J., & Medows, R.

(2020). A model of disparities: risk factors associated with COVID-19

infection. International journal for equity in health, 19(1), 1-10.

Seymour, C. W., Gesten, F., Prescott, H. C., Friedrich, M. E., Iwashyna, T. J., Phillips, G. S., ... &

Osborn, T. (2017). Time to treatment and mortality during mandated emergency care for

sepsis. New England Journal of Medicine, 376(23), 2235-2244.

1

CAPSTONE: PART I

Enhancing the Early Identification of Sepsis Symptoms Among Nursing Staff: Evaluating

the Efficacy of a Comprehensive Training Module

Mariela Sanchez

Florida National University

MSN Capstone Project-DBX-DL02

Professor: Carmen Lazo

September 9, 2023

2

Introduction to your proposed problem

Significance of the Practice Problem: Sepsis, a potentially life-threatening condition

caused by the body's extreme response to an infection, remains a dominant challenge within

global healthcare settings. It often leads to tissue damage, organ failure, and death. Despite its

critical nature, timely identification of sepsis remains a significant hurdle in many healthcare

settings, a concern directly correlated to nursing staff's awareness and training on the condition

(Joffre et al., 2020).As a response to infections, sepsis can rapidly escalate into severe stages if

not promptly identified and treated. The importance of early recognition lies in the resultant

patient outcomes: a mere hour's delay in intervention can significantly increase the mortality rate

associated with sepsis. Thus, the early identification and subsequent intervention hinge

predominantly on the front-line staff – the nurses (Huang et al., 2019).

Topic Introduction

This paper centers on the role of nursing staff in the early identification of sepsis

symptoms. Through a rigorous evaluation of the current training methods in contrast to a

proposed comprehensive training module, this research aims to discern the most effective

approach to augment the confidence and competence of nurses in sepsis identification.

Description of the Health Problem

Sepsis emerges as a severe health complication when the body’s response to infection

damages its tissues and organs. Globally, an estimated 30 million people are affected by sepsis

annually, with potentially 6 million resulting deaths (World Health Organization, 2020). This stark

3

statistic, compounded by the knowledge that early detection can dramatically improve outcomes,

underscores the urgency for more effective training methodologies for healthcare

professionals (Geng et al., 2020).

Purpose Statement

The core objective of this research is to examine the effectiveness of a comprehensive

training module on early identification of sepsis symptoms. By comparing this module to existing

training paradigms, we aim to establish if the proposed program can markedly elevate the

confidence and capability of nursing staff in both recognizing early sepsis symptoms and

initiating immediate interventions.

Proposed Outcome

By the culmination of an 8-week training period, we anticipate a measurable 20%

increase in nursing staff's confidence in early sepsis identification and immediate interventions.

This projection is based on pre-and post-training confidence assessment scales. A follow-up

survey and evaluation three months post-training will provide insights into the long-term retention

and application of the training.

PICOT Question

In nursing staff (P), how does the introduction of a comprehensive training module on

early identification of sepsis symptoms (I) compared to current training methods (C) affect the

4

confidence in early sepsis identification and immediate interventions (O) over a period of 8

weeks (T)?

P (Population): The population of interest consists of the nursing staff working in

medical and surgical units. This group is selected as they frequently encounter patients at varying

degrees of illness and are at the forefront in identifying and addressing emerging health concerns.

I (Intervention): The proposed intervention is the introduction of a comprehensive

training module focusing on early identification of sepsis symptoms. This module would

encompass both theoretical aspects of sepsis identification and practical simulations or case

studies to reinforce the training.

C (Comparison): The comparison intervention pertains to the existing or traditional

training methods on sepsis identification. These may include periodic seminars, brief workshops,

or on-the-job training, which may not be as exhaustive or structured as the proposed

comprehensive module.

O (Outcome): The primary outcome being studied is the improved confidence of nursing

staff in early sepsis identification and immediate interventions. This will be gauged through pre-

and post-training assessments, measuring the change in knowledge and confidence levels.

T (Timeframe): The duration for this study is set at 8 weeks, providing adequate time for

training module delivery, practice, assessment, and observation of any immediate behavioral

changes in the nursing staff.

5

Describe the Vulnerable Population

The vulnerable population in this context, while indirectly, includes patients at risk of

developing sepsis or those who are diagnosed but not identified early due to gaps in healthcare

staff training. Impact of Social Determinants: Sepsis risk can be exacerbated by various social

determinants such as lack of access to timely medical care, residing in areas with limited

healthcare infrastructure, socioeconomic constraints, and limited health literacy. Patients in

socioeconomically deprived regions might be at a higher risk due to a combination of these

factors (Menon et al., 2023).

Risk Factors: Several risk factors make patients vulnerable to sepsis.

Advanced Age: The elderly, due to weaker immune systems and the presence of co-

morbidities, are at increased risk. Immunocompromised Status: Patients with conditions or

undergoing treatments that suppress the immune system (e.g., HIV, chemotherapy) are at

heightened risk. Chronic Medical Conditions: Conditions like diabetes, kidney disease, and lung

disease can predispose individuals to infections leading to sepsis. Recent Hospitalization:

Exposure to hospital settings, especially in ICUs or post-surgical wards, can increase sepsis risk

due to potential exposure to resistant pathogens (Rozenfeld et al., 2020).

Evidence: According to a study by Seymour et al. (2017), patients with chronic medical

conditions and those in higher age groups had an increased likelihood of developing sepsis.

Moreover, hospitals were identified as the primary source of infections leading to sepsis,

emphasizing the need for early detection and intervention.

6

Research from Scholarly Journals

Several evidence-based studies have emphasized the importance of early detection and

intervention in sepsis management. For instance: This research underscores the vital need for the

quick identification of sepsis to ensure timely intervention.

Proposal

Given the critical nature of early sepsis identification, a comprehensive training module

seems apt. This module will: Incorporate the latest evidence-based practices for sepsis detection.

Use mixed-media training tools - videos, simulations, and real-life case scenarios. Include post-

training assessments to gauge knowledge absorption and skill acquisition (Gyawali et al., 2019).

Resources Necessary

Training content from evidence-based studies. Simulation tools or software. Expert

personnel for training delivery and evaluation. Funds for module development and

implementation.

Individuals Involved

A curriculum developer with expertise in evidence-based healthcare practices. A

facilitator or trainer, preferably with ICU or ER experience. A team for post-training evaluation.

Nursing staff as participants.

7

Feasibility for an Advanced Role Nurse: An advanced role nurse, with their depth of

clinical experience and knowledge, can drive the development and delivery of the module. They

can lend their expertise in curating the content, ensuring it is up-to-date, practical, and

beneficial (Gysin et al., 2019)

Timeline

Weeks 1-2: Development of the training module. Weeks 3-4: Training sessions for the

nursing staff. Week 5: Initial post-training assessment. Weeks 6-8: Observation and collection of

feedback. End of Week 8: Final evaluation and assessment.

Theoretical Framework/Nursing Theory

The Knowles’ Adult Learning Theory can be the backbone of this project. The theory

posits that adults learn best when: They understand the importance of what they're learning. They

have some experience with the content. Learning is problem-centered rather than content-

oriented. Given that nurses have clinical experience, a training module that aligns with real-world

challenges and emphasizes the significance of the knowledge can be more effective. This theory

accentuates the need for problem-centered learning, making it ideal for training modules like

sepsis detection where timely intervention can save lives (Joseph et al., 2019).

Significance to the Healthcare System: Early identification of sepsis can significantly reduce

8

Patient mortality rates. The length of hospital stays, thereby reducing costs. Risk of

readmissions due to complications. Moreover, it can enhance the quality of life of patients,

ensuring quicker recovery and fewer post-hospitalization complications (Gyawali et al., 2019).

References

Geng, Y. J., Wei, Z. Y., Qian, H. Y., Huang, J., Lodato, R., & Castriotta, R. J. (2020).

Pathophysiological characteristics and therapeutic approaches for pulmonary injury and

cardiovascular complications of coronavirus disease 2019. Cardiovascular Pathology, 47,

107228.

Gyawali, B., Ramakrishna, K., & Dhamoon, A. S. (2019). Sepsis: The evolution in definition,

pathophysiology, and management. SAGE open medicine, 7, 2050312119835043.

Gysin, S., Sottas, B., Odermatt, M., & Essig, S. (2019). Advanced practice nurses’ and general

practitioners’ first experiences with introducing the advanced practice nurse role to Swiss

primary care: a qualitative study. BMC family practice, 20, 1-11.

Harley, A., Johnston, A. N. B., Denny, K. J., Keijzers, G., Crilly, J., & Massey, D. (2019).

Emergency nurses’ knowledge and understanding of their role in recognising and

responding to patients with sepsis: A qualitative study. International emergency

nursing, 43, 106-112.

9

Huang, M., Cai, S., & Su, J. (2019). The pathogenesis of sepsis and potential therapeutic

targets. International journal of molecular sciences, 20(21), 5376.

Joffre, J., Hellman, J., Ince, C., & Ait-Oufella, H. (2020). Endothelial responses in

sepsis. American journal of respiratory and critical care medicine, 202(3), 361-370.

Joseph, M. L., Bair, H., Williams, M., Huber, D. L., Moorhead, S., Hanrahan, K., ... & Chi, N. C.

(2019). Health care innovations across practice and academia: A theoretical

framework. Nursing outlook, 67(5), 596-604.

Menon, K., Sorce, L. R., Argent, A., Bennett, T. D., Carrol, E. D., Kissoon, N., ... & Ranjit, S.

(2023). Reporting of social determinants of health in pediatric sepsis studies. Pediatric

Critical Care Medicine, 24(4), 301-310.

Rozenfeld, Y., Beam, J., Maier, H., Haggerson, W., Boudreau, K., Carlson, J., & Medows, R.

(2020). A model of disparities: risk factors associated with COVID-19

infection. International journal for equity in health, 19(1), 1-10.

Seymour, C. W., Gesten, F., Prescott, H. C., Friedrich, M. E., Iwashyna, T. J., Phillips, G. S., ... &

Osborn, T. (2017). Time to treatment and mortality during mandated emergency care for

sepsis. New England Journal of Medicine, 376(23), 2235-2244.