Matching Items (4)

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A Review of Prevention, Early Recognition, and Directed Therapy of Sepsis

Description

Sepsis is a global health problem, and millions of people die annually from sepsis around the world (Centers for Disease Control and Prevention, 2018). The purpose of this literature review

Sepsis is a global health problem, and millions of people die annually from sepsis around the world (Centers for Disease Control and Prevention, 2018). The purpose of this literature review is to discuss the prevention, recognition, and treatment of sepsis as well as the need for more public health education to raise awareness of the significant burden of sepsis. It is difficult to recognize because there are several nonspecific symptoms, and there is not a comprehensive diagnostic tool. Diagnosis is based on evidence of infection, organ dysfunction, and clinical judgment (Fay et al., 2020). The definition of sepsis has evolved over the last three decades, though the most recent update is not widely accepted by all healthcare systems. There remains debate about treatment practices as well, including the following: whether one or multiple antibiotics should be used, which type of fluids should be used for rapid resuscitation, and the number of fluids that should be given to the patient. However, evidence agrees that treatment should be started within the first hour of symptom onset for the best chance of survival (Gyawali, Ramakrishna, & Dhamoon, 2019). Despite the significant burden that sepsis places on families, healthcare team members, and hospitals, there is not enough public awareness of the issue (Jabaley et al., 2018). There should be a greater push for public education using technology, social media, and mass media campaigns to increase awareness and prevention of infection.

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Date Created
  • 2020-12

Demographic and Geographic Disparities in the Incidence of Neonatal Abstinence Syndrome (NAS) in the United States (2012-2015)

Description

The purpose of this study was to examine the demographic and geographic disparities in the incidence of newborn babies with Neonatal Abstinence Syndrome (NAS) in the United States from 2012

The purpose of this study was to examine the demographic and geographic disparities in the incidence of newborn babies with Neonatal Abstinence Syndrome (NAS) in the United States from 2012 to 2015. Specifically, I examined the prevalence of NAS according to geographic location (i.e. urban versus rural) and race while also controlling for mother’s insurance type, median household income, and trends over time. Additional analyses explored the relationship between NAS and delivery method, birth weight, and neonatal candidiasis that causes sepsis. Understanding the disparities in NAS and birth outcomes during this period (2012-2015) can help better target interventions for combating the health and economic burdens of NAS since maternal opioid use has continued to rise since 2015. Additionally, existing research into geographic disparities in NAS have only been region-specific. This study expands the scope of this literature by considering urban versus rural disparities across the country.

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Date Created
  • 2021-05

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The Reality of Sepsis

Description

Background: Sepsis is a potentially life-threatening infection affecting millions of individuals. Nearly three million individuals are affected annually, killing one in every two to four individuals. Sepsis mortality rates are

Background: Sepsis is a potentially life-threatening infection affecting millions of individuals. Nearly three million individuals are affected annually, killing one in every two to four individuals. Sepsis mortality rates are highest in those 65 and older, making it the most expensive diagnosis paid by Medicare and worldwide at $24 billion dollars. Early goal directed therapy (EGDT), created by the International Surviving sepsis campaign, is a bundled protocol created to decrease mortality rates, however, utilization and completion remains a problem in the emergency department (ED).

Purpose: This project sought to evaluate the gap that exists between best practice and current practice, for sepsis identification and EGDT implementation.

Methods: The project was completed over a four-month period with prior Institutional Review Board (IRB) approval and consisted of evaluation of sepsis knowledge and barriers to EGDT. Questionnaires included demographics, sepsis knowledge, barriers to EGDT and AHRQ quality indicators toolkit.

Results: Sample (N=16) included registered nurses (RN) and healthcare providers. Descriptive statistics were utilized for evaluation of questionnaires. Results indicate staff have sound understanding of signs and symptoms of sepsis, however application through case studies demonstrated lower performance. Overall system barriers were minimal, with greatest barriers in central line monitoring and staff shortages. High level unit teamwork exists within the ED, however collaboration is lacking between ED staff and upper management. Results demonstrate moderate disengagement between upper management and staff leading to miscommunication. Recommendations included increased, consistent sepsis education, utilization of Institution for Healthcare Improvement (IHI) triple aim framework for evaluating systems, implementing a closed loop approach to communication, and having a staff champion for sepsis be included in meetings with upper management.

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Created

Date Created
  • 2018-04-30

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Using a Clinical Guideline Coupled with Education to Improve Healthcare Providers' Knowledge of Early Sepsis Recognition in the Post-Acute Care Setting: A Quality Improvement Project

Description

Aims: The goals of this project were (1) develop a sepsis clinical guideline, (2) enhance direct patient care staff knowledge of sepsis and (3) survey staff comfort level with identifying

Aims: The goals of this project were (1) develop a sepsis clinical guideline, (2) enhance direct patient care staff knowledge of sepsis and (3) survey staff comfort level with identifying sepsis post intervention.

Background: Sepsis remains a significant healthcare problem associated with high treatment costs and high mortality rates. Older adults are at an increased risk for developing sepsis, especially when age is combined with any type of compromising factor, such as chronic illness, recent hospitalizations, wounds, or invasive devices. Current evidence demonstrates that sepsis screening is effective for early identification of sepsis. Early identification of sepsis improves time to treatment initiation, which improves outcomes.

Methods: An evidence-based, provider approved clinical guideline was developed for a post-acute care facility after an extensive review of the literature. Upon implementation, brief educational sessions were provided to direct patient care staff. Participants completed pre- and post-tests as well as a demographic survey. A satisfaction survey was administered 30 days post intervention. A paired samples t-test was used to analyze the difference in test scores. Pearson's correlation was used to analyze the relationship between staff comfort levels and the clinical guideline.

Results: The samples included 25 participants in the educational intervention and 18 in the satisfaction survey. There was a significant difference in the scores between pre-test (M = 72.3, SD = 12.43) and post-test scores (M = 86.6, SD = 10.2); t(24) = -5.578, p < 0.001. There was a significant correlation between staff who felt comfortable in identifying sepsis with ease of screening (r = .831, p < .01) and high comfort levels with the policy (r = .889, p < .01).

Conclusion: Utilizing a clinical guideline, coupled with education, improves staff knowledge and comfort identifying sepsis in the post-acute care setting, which may improve early recognition and treatment initiation. This outcome is clinically significant as patients in this setting represent a vulnerable population.

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Date Created
  • 2017-04-29