SEPSIS KILLS

1. No. A01 “Sepsis…….is a medical emergency just like a heart attack or a stroke because there is an interruption of oxygen and nutrients to the tissues including the vital organs such as the brain, intestines, liver, kidneys, and lungs….” (Society of Critical Care Medicine, 2008). SEPSIS KILLS Andrew Martin RN, Scott Riley CNS, & Lauren Jenkins CNS Presented by: Wendy Brown NUM Royal Newcastle Centre, NSW Health, Hunter New England Local Health District Introduction: Sepsis is the leading cause of death in critically ill patients within Australia and New Zealand with one study showing a 27.6% hospital wide mortality rate (Orford et al, 2008) . Worldwide, an estimated 1400 deaths are attributed to sepsis each day (Society of Critical Care Medicine, 2008). A study of postcystectomy patients by Davies, Allareddy, and Konety (2009) showed that those patients who developed sepsis had an increased length of stay and cost three times greater than those who did not. At RNC Ward 2 our goal is to increase the early detection and intervention of sepsis. This is being achieved through the continual education and up-skilling of staff, simulation training and auditing of patient records. • Results: • RNC Ward 2 achieving 100% compliance with DETECT training. • 10 staff able to cannulate/perform venepuncture. • Team leader has the flexibility to work supernumerary as a result of nursing hours per patient day ratios. • Increasing compliance with use of SAGO chart as a result of independent auditing. • An increase in urgent medical reviews and rapid response calls due to staff becoming more confident in the early detection of sepsis secondary to continued education and correct use of the SAGO chart. • Senior staff developing a quick reference sepsis pathway in accordance with Hunter New England Health sepsis clinical guideline (2010), NSW Agency for Clinical Innovation, and NSW Health Clinical Excellence Commission . • Aim: • To increase the awareness of sepsis amongst staff. • To initiate early intervention through early detection. • To utilise all available resources in the diagnosis and treatment of sepsis. • To reduce the potential impact of sepsis on cost and length of stay . • Methods: • Correct use of the Standard Adult General Observations (SAGO) chart and introduction of the between the flags and DETECT program. • Winning of nursing hours per patient day staffing ratios. • Creation and utilisation of a Clinical Support Nurse/Patient Care Co-ordinators position. • Supported orientation of new staff to RNC Ward 2. • Increased numbers of staff undertaking and achieving accreditation in IV cannulation and blood collection. • Utilisation of intensive care and infectious disease liaison personnel. • Continued education of staff about early and late warning signs of sepsis through participation in ward based scenario and simulation training. • Regular independent auditing of SAGO charts and patient records. ). Conclusion: Through the utilisation of all available resources by nursing staff, the early detection and intervention of sepsis on RNC Ward 2 can potentially lead to improved patient outcomes in the form of decreased admissions to ICU, reduced length of stay, and overall decreased severity of infection. Acknowledgments: Darling, D. (n.d.) Sepsis. Retrieved from http://www.daviddarling.info/encyclopedia/S/sepsis.html Davies, B.J., Allareddy, V., & Konety, B.R. (2009). Effect of postcystectomy infectious complications on cost, length of stay, and mortality. Urology, 73(3), 598-602. Hunter New England Health (2010). Fever and sepsis in adults. Retrieved from http://intranet.hne.health.nsw.gov.au/__data/assets/pdf_file/0010/67744/HNEH_CPG_10_07_Fever_and_Sepsis_in_Adults.pdf Orford, N.R., Faulkner, C., Flintoff, W., Eddey, D., Lamb-Jenkins, J., Henry, M., Corke, C., Stow, P., & Green, D. (2008). Implementation of a severe sepsis protocol in an Australian tertiary hospital. Critical care and resuscitation, 10(3), 217-224. Society of Critical Care Medicine (2008). Surviving sepsis campaign – about the campaign. Retrieved from http://www.survivingsepsis.org/About_the_Campaign/Pages/default.aspx Images supplied by Google Images SEPSIS CASCADE Invasive Infection: Of foreign antigens from cell walls of bacteria and fungi, bacterial DNA, RNA from viruses, etc. Body’s Immune Cells: Macrophages, neutrophils, endothelial cells, monocytes. Cytokine Release: Interleukins, interferons, tumour necrosis factor, etc. Inflammation, coagulation, fibrinolysis suppression. Severe sepsis/ septic shock Multiple organ dysfunction syndrome Death (Darling, n.d.) Poster presentation sponsor