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1.
Rev Infirm ; 69(260-261): 16-18, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32600588

RESUMO

Septic shock, defined as the combination of sepsis, a requirement for catecholamines to maintain systolic blood pressure above 65 mmHg and a serum lactate level above 2 mmol/L despite adequate volume resuscitation is a life-threatening condition. The Quick Sepsis-related Organ Failure Assessment (qSOFA), which can be used by all nurses with a high-risk patient presenting with infection, enables the patient to be transferred rapidly to specialist care units.


Assuntos
Sepse/enfermagem , Choque Séptico/enfermagem , Humanos , Insuficiência de Múltiplos Órgãos , Medição de Risco
3.
Clin Nurse Spec ; 33(6): 273-278, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31609911

RESUMO

PURPOSE: The aims of this study are to describe a program to achieve disease-specific care (DSC) certification from The Joint Commission and highlight the value of the advanced practice nurse in the certification outcome. DESCRIPTION OF PROGRAM: The expertise in clinical practice, performance improvement, and leadership skills demonstrated by the clinical nurse specialist (CNS) can be instrumental in building a strong foundation for a DSC certification program. As an organization prepares for a DSC on-site review, the CNS can guide the program stakeholders in identifying gaps in care, developing action plans to meet certification standards, and preparing team members for the DSC on-site review. OUTCOME: At this Midwestern, 504-bed facility, The Joint Commission DSC certifications were achieved in 5 separate categories: diabetes, stroke, sepsis, total hip replacement, and total knee replacement. CONCLUSION: By influencing a certain patient population throughout the organization, population-focused CNSs are in a unique role to lead an interprofessional team or serve as an expert consultant in pursuing DSC certification from The Joint Commission.


Assuntos
Certificação/organização & administração , Enfermeiras Clínicas , Artroplastia de Quadril/enfermagem , Artroplastia do Joelho/enfermagem , Diabetes Mellitus/enfermagem , Humanos , Joint Commission on Accreditation of Healthcare Organizations , Sepse/enfermagem , Acidente Vascular Cerebral/enfermagem , Estados Unidos
4.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1307-1311, out.-dez. 2019. ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022248

RESUMO

Objective: The study's goal has been to describe the antecedent signs and symptoms of sepsis in patients hospitalized in the Medical Clinic of a Federal Hospital in Rio de Janeiro city, which are identified by a Registered Nurse; to analyze how the Nurse correlates the signs and symptoms with Sepsis-1, Sepsis-2 and Sepsis-3. Methods: It is a descriptive study with a quantitative approach; the population were 10 Registered Nurses who worked daytime shifts in the nursing ward. Data collection was performed through a structured questionnaire, addressing the identification of signs and symptoms that precede sepsis, including the characteristics and peculiarities of sepsis. Results: The Nurses have adequate understanding regarding the concept of sepsis, although they have showed difficulties in correlating some of the signs and symptoms. Conclusion: The Nurses are aware that sepsis is a health problem and that they provide direct care to the patient, therefore, it is important to identify the signs and symptoms that precede it in order to offer quality assistance and to help reducing new cases


Objetivo: Descrever os sinais e sintomas que antecedem a sepse em pacientes internados na Clínica Médica de um Hospital Federal no Rio de Janeiro identificados pelo Enfermeiro; analisar como o Enfermeiro correlaciona os sinais e sintomas com a Sepsis-1, Sepsis-2 e Sepsis-3. Métodos: Estudo descritivo com abordagem quantitativa, a população foram 10 Enfermeiros em plantões diurnos na enfermaria da Clínica. A coleta de dados foi um questionário estruturado, abordando identificação dos sinais e sintomas que antecedem a sepse, englobando as características e particularidades da sepse. Resultados: Evidenciou-se que possuem entendimento sobre o conceito de sepse, entretanto apresentaram dificuldades em correlacionar alguns dos sinais e sintomas dos tipos de sepse. Conclusão: Ciente que a sepse é um problema de saúde e o Enfermeiro presta cuidado direto ao paciente, percebe-se a importância na identificação dos sinais e sintomas que a antecedem para oferecer assistência de qualidade e auxiliar na redução dos casos


Objetivo: Describe los síntomas y antecedentes de la sepsis en pacientes internados en la Clínica Médica de un Hospital Federal en Río de Janeiro por el enfermero; analizar cómo el enfermero correlaciona los signos y síntomas con Sepsis-1, Sepsis-2 y Sepsis-3. Métodos: Estudio descriptivo con abordaje cuantitativo, la población fue 10 enfermeros en turnos diurnos en la enfermería de la Clínica. La recolección de datos fue un cuestionario estructurado, abordando identificación de los signos y síntomas que anteceden a la sepsis, englobando las características y particularidades de la sepsis. Resultados: Tienen un entendimiento adecuado sobre el concepto de sepsis, sin embargo, presentan dificultades en correlacionar algunos de los signos y síntomas. Conclusión: Es consciente de que la sepsis es un problema de salud y el enfermero presta atención directa al paciente, se percibe la importancia en la identificación de los signos y síntomas que la anteceden para ofrecer asistencia de calidad y auxiliar en la reducción de los casos


Assuntos
Humanos , Masculino , Feminino , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Sepse/enfermagem , Sepse/prevenção & controle , Diagnóstico , Sinais Vitais
5.
Enferm. glob ; 18(56): 159-171, oct. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-188269

RESUMO

Objetivo: Construir y validar el contenido de un checklist para evaluación de la capacitación de profesionales del área de la salud en la atención al paciente séptico con simulación clínica. Método: Estudio de validación metodológica de instrumento, con delineamiento estructural en dos etapas: construcción del instrumento y validación de contenido del checklist utilizando la técnica Delphi en dos rondas. Resultados: La validación de contenido fue compuesta por diez ítems y cuarenta y tres subítems analizados por los evaluadores. A través del Índice de Validez de Contenido, se identificaron cuatro ítems con fuerte evidencia de validación, Índice de Validez de Contenido ≥ 0,8. En la segunda ronda Delphi presentó un porcentaje de concordancia superior al 80% para todas las variables pertinentes al instrumento. Se reestructuró el checklist según recomendaciones de los evaluadores, manteniendo los diez ítems, pero con reducción para veintiséis subítems, que en la segunda ronda Delphi presentó un porcentaje de concordancia superior al 80% para todas las variables pertinentes al instrumento. Conclusión: Método fue eficaz para validar el contenido de un checklist que evaluará la capacitación de profesionales de la salud en la atención al paciente séptico, por medio de simulación clínica


Aims: Development and validation of the contents of a checklist to evaluate the qualification of health professionals in septic patient care with clinical simulation. Method: instrument validation study, with two-stage structural design: instrument construction and validation of the checklist contents using the Delphi technique in two rounds. Results: The content validation was composed of ten items and forty-three sub-items analyzed by the evaluators. Through the Content Validity Index, four items with strong validation evidence were identified, Content Validity Index ≥ 0.8. We restructured the checklist according to the evaluators recommendations, maintaining the ten items, but reducing them to twenty-six sub-items, which in the second round Delphi presented a percentage of agreement above 80% for all variables relevant to the instrument. Conclusion: This method was effective to validate the checklist contents that will evaluate the qualification of health professionals in septic patient care, through clinical simulation


Objetivos: Construir e validar o conteúdo de um checklist para avaliação da capacitação de profissionais da área da saúde no atendimento ao paciente séptico com simulação clínica. Método: Estudo de validação metodológica de instrumento, com delineamento estrutural em duas etapas: construção do instrumento e validação de conteúdo do checklist utilizando a técnica Delphi em duas rodadas. Resultados: A validação de conteúdo foi composta por dez itens e quarenta e três subitens analisados pelos avaliadores. Por meio do Índice de Validade de Conteúdo, identificaram-se quatro itens com forte evidência de validação, Índice de Validade de Conteúdo ≥ 0,8. Reestruturou o checklist conforme recomendações dos avaliadores, mantendo os dez itens, porém com redução para vinte e seis subitens, que na 2ª rodada Delphi apresentou percentual de concordância acima de 80% para todas as variáveis pertinentes ao instrumento. Conclusão: Método foi eficaz para validar o conteúdo de um checklist que avaliará a capacitação de profissionais da saúde no atendimento ao paciente séptico, por meio de simulação clínica


Assuntos
Humanos , Lista de Checagem/classificação , Treinamento por Simulação/métodos , Sepse/enfermagem , Competência Profissional/estatística & dados numéricos , Capacitação Profissional , Educação Continuada em Enfermagem/métodos , Papel do Profissional de Enfermagem , Avaliação Educacional/métodos , Testes de Aptidão/estatística & dados numéricos , Pesquisa em Enfermagem Clínica/métodos
6.
Emerg Nurse ; 27(5): 32-41, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31475503

RESUMO

Sepsis is a common phenomenon surrounded by uncertainty and misunderstanding. The urgency for treatment is complicated by the vagueness of signs and symptoms and lack of a conclusive diagnostic test. This article unpicks the signs and symptoms of sepsis with guidance for emergency department nurses who are responsible for assessing patients with potential sepsis. The article also relates monitoring, investigation and treatment expectations to the underlying pathophysiology and refers to the individual and global implications of the condition.


Assuntos
Enfermagem em Emergência , Sepse/diagnóstico , Sepse/enfermagem , Sepse/fisiopatologia , Diagnóstico Diferencial , Humanos , Diagnóstico de Enfermagem
8.
J Emerg Nurs ; 45(6): 690-698, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31235077

RESUMO

PROBLEM: Sepsis, a life-threatening condition, can rapidly progress to death. The Hospital Inpatient Quality Reporting program has implemented bundled care metrics for sepsis care, but timely completion of these interventions is challenging. Best-practice interventions could improve patient outcomes and reimbursement. The purpose of this project was to improve the timeliness of sepsis recognition and implementation of bundled care interventions in the emergency department. METHODS: This evidence-based practice improvement project implemented a Detect, Act, Reassess, Titrate (DART)-based nursing protocol embedded within a checklist communication tool in the emergency department of a tertiary level-2 trauma center. Data comparisons between preintervention and post-DART protocol/checklist implementation included compliance with the individual Inpatient Quality Reporting 3-hour bundled elements, number of hospital days, and time to screen. Staff also completed a survey designed to assess their satisfaction with the DART algorithm/checklist. The Pearson χ2 test was used to assess bundled-care intervention variables. Wilcoxon rank sum tests were used to explore hospitalization outcomes. Staff satisfaction survey results were summarized. RESULTS: Improvement was statistically significant for lactate levels, blood cultures, and early antibiotic administration in the intervention period compared with baseline. Time to screen, ED length of stay, and number of hospital days improved between baseline and the intervention period, with an average number of hospital days decreasing by 2.5 days. Compliance with all Inpatient Quality Reporting metrics increased from 30% to 80%. DISCUSSION: When the nurse-driven protocol and communication tool were implemented, compliance with time-sensitive sepsis bundled interventions improved significantly. The outcomes suggest nurse-driven protocols can improve sepsis outcomes.


Assuntos
Protocolos Clínicos , Enfermagem em Emergência/métodos , Pacotes de Assistência ao Paciente/métodos , Melhoria de Qualidade , Sepse/enfermagem , Antibacterianos/uso terapêutico , Hemocultura , Serviço Hospitalar de Emergência , Humanos , Sepse/diagnóstico , Sepse/terapia , Tempo , Resultado do Tratamento
10.
Australas Emerg Care ; 22(2): 119-125, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31042531

RESUMO

BACKGROUND: With the rise of patients with sepsis presenting to emergency departments, emergency nurses, as frontline healthcare workers, require current clinical knowledge of sepsis. The aim of this study was to assess emergency department registered nurses' knowledge of sepsis and their perspectives of caring for patients with sepsis. METHODS: A descriptive cross-sectional survey was used to survey Registered Nurses from four emergency departments in a western Canadian city (N=312). RESULTS: The majority of nurses scored poorly on questions examining knowledge of systemic inflammatory response syndrome variables associated with sepsis, and sepsis definitions, general knowledge, and treatment (mean score 51.8%). Nurses acknowledged their lack of knowledge and indicated a desire for further sepsis education. Challenges in providing sepsis-related care concerned perceived heavy workloads and clinical implications related to the patient's status. CONCLUSIONS: Educational programs and coaching approaches that maximize nurses' abilities to enhance their decision-making with regards to early assessment and appropriate intervention for persons with sepsis are needed. Such multifaceted approaches would acknowledge nurses' existing knowledge and provide practical supports to help nurses extend and mobilize their knowledge for everyday decision-making within the complex clinical environment of the emergency department.


Assuntos
Competência Clínica/normas , Sepse/enfermagem , Adulto , Colúmbia Britânica , Competência Clínica/estatística & dados numéricos , Estudos Transversais , Avaliação Educacional/métodos , Enfermagem em Emergência/métodos , Enfermagem em Emergência/normas , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos
11.
J Hosp Palliat Nurs ; 21(2): 110-115, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30829931

RESUMO

Patients often affirm the goal to pursue comfort at the end of life, although clinicians may struggle with how best to provide comfort and face the ethical dilemma of treating or allowing a suspected infection to unfold. Treating an infection at the end of life does not allow for uniform improvement in symptoms and more time with family and friends. Additionally, there is potential for burden to the patient or health care system and treatment may occur to the exclusion of other comfort measures. Currently, the practice of providing or forgoing antibiotics at the end of life is variable, and literature supporting best practices can be contradictory. Data to support the use or withholding of treatment have been scant and vary across settings and patient populations. We review common obstacles providers face, prognostication tools that may assist in clinical decision making, the ethical support for withholding therapy, and how to factor in potential burdens of treatment. We propose that nurses, whether at the bedside in an acute care or nursing facility or in the home setting as a member of the interdisciplinary home hospice team, are uniquely qualified to help patients and families navigate this challenging clinical decision.


Assuntos
Tomada de Decisões/ética , Sepse/tratamento farmacológico , Assistência Terminal , Idoso de 80 Anos ou mais , Árvores de Decisões , Feminino , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Humanos , Sepse/enfermagem
12.
Br J Nurs ; 28(5): S24-S31, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30907655

RESUMO

Enterocutaneous fistula is an abnormal connection between the gastrointestinal tract and skin. Management includes early recognition and treatment of sepsis, reducing fluid and electrolyte homeostasis, nutrition support, wound management and a carefully timed surgical procedure. A multidisciplinary approach is required for successful management of these patients with one of the most challenging and resource-demanding aspects being local control of the effluent, requiring the skill and support of the specialist stoma care nurse. The inability to contain the fistula can be a source of morbidity for the patient, as they will experience pain and severe discomfort from the skin when leakages occur. Enterocutaneous fistula can result in intestinal failure, which is often fatal if not managed correctly.


Assuntos
Fístula Intestinal/terapia , Sepse/terapia , Higiene da Pele , Humanos , Fístula Intestinal/complicações , Fístula Intestinal/enfermagem , Apoio Nutricional , Sepse/complicações , Sepse/enfermagem , Cicatrização
13.
Am J Crit Care ; 28(2): 136-141, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824518

RESUMO

BACKGROUND: Septic shock is one of the main causes of mortality in intensive care units worldwide. Nutritional support can affect the survival of patients with sepsis. OBJECTIVE: To evaluate whether resting energy expenditure, respiratory quotient, and oxygen consumption and carbon dioxide production (measured by indirect calorimetry) differ between critically ill patients with vs without sepsis. METHODS: A total of 205 patients receiving mechanical ventilation were evaluated consecutively within the first 48 hours of admission. Demographic and clinical data were collected, including age, body mass index, oxygen consumption, carbon dioxide production, respiratory quotient, and resting energy expenditure, with the clinical data measured or estimated via indirect calorimetry. RESULTS: Of the 205 patients, 114 (56%) had no sepsis and 91 (44%) had sepsis. The median values of the studied variables in the no sepsis and sepsis groups, respectively, were as follows: age, 53 vs 58 years (P = .07); body mass index, 25 vs 26 (P = .14); Acute Physiology and Chronic Health Evaluation II score, 24 vs 25 (P = .04); death risk, 47% vs 63% (P = .04); oxygen consumption, 211 vs 202 mL/min (P = .72); and resting energy expenditure, 1434 vs 1430 kcal/d (P = .73). Analysis of receiver operating characteristic curves showed no significant differences between patients with and without sepsis for any of the indirect calorimetry variables. CONCLUSION: In clinical practice, patients with sepsis do not seem to require an increased energy supply. Additional studies are needed to confirm this conclusion.


Assuntos
Estado Terminal/terapia , Metabolismo Energético/fisiologia , Consumo de Oxigênio/fisiologia , Sepse/dietoterapia , Sepse/fisiopatologia , APACHE , Fatores Etários , Índice de Massa Corporal , Calorimetria Indireta , Estado Terminal/enfermagem , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Apoio Nutricional , Descanso , Sepse/enfermagem , Fatores Sexuais , Fatores Socioeconômicos
16.
Int Emerg Nurs ; 43: 106-112, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30733005

RESUMO

AIM: Sepsis is a significant and time-sensitive clinical concern for patients who present to Emergency Departments (EDs). Existing guidelines do not define nurses' roles in managing sepsis. This study explored ED nurses' experiences and perceptions around recognising and responding to patients with sepsis, and their awareness of sepsis screening and prognostic tools. The knowledge and insights gained from this study may be used to inform local and international ED policies, and enrich nursing educational packages that may be used to improve quality of patient care and patient outcomes. METHODS: Qualitative design incorporating semi-structured interviews with 14 ED nurses was undertaken. Thematic and consensus-based content analyses were used to explore transcripts. FINDINGS: Six key themes were identified; (1) contribution of the organisation, (2) appreciation of knowledge, (3) appreciation of clinical urgency, (4) appreciation of importance of staff supervision, (5) awareness of the importance of staff experience, and (6) awareness of the need to seek advice. CONCLUSION: ED nurses' identified deficits in their capacity to recognise and respond to patients with sepsis, despite their vital role within the multidisciplinary team that cares for patients with sepsis. The knowledge and insights gained from this study can be used to inform ED policies, to enrich context-specific educational packages that aim to improve quality of patient care and outcomes and identify areas for further research. Development and implementation of a nurse-inclusive sepsis pathway may address many deficits identified in this study.


Assuntos
Enfermagem em Emergência/normas , Papel do Profissional de Enfermagem/psicologia , Sepse/enfermagem , Adolescente , Adulto , Criança , Pré-Escolar , Competência Clínica/normas , Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Lactente , Entrevistas como Assunto/métodos , Masculino , Pesquisa Qualitativa , Queensland
17.
Nurse Pract ; 44(2): 26-33, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30614896

RESUMO

Despite numerous advances in understanding the pathophysiology of sepsis and its treatment, sepsis morbidity and mortality remain high. The 2016 Surviving Sepsis Campaign guidelines incorporated the latest research to formulate new sepsis diagnoses and updated treatment recommendations. This article reviews how to manage patients with sepsis and provides insight into the 2016 guidelines, updates, and suggestions.


Assuntos
Guias de Prática Clínica como Assunto , Sepse/enfermagem , Humanos
19.
Nurs Crit Care ; 24(1): 33-39, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30039637

RESUMO

BACKGROUND: The Sepsis Six bundle is designed to facilitate early intervention with three diagnostic and three therapeutic steps to be delivered within 1 h to patients with suspected sepsis. AIMS AND OBJECTIVES: To investigate the effects of delivering the 'Sepsis Six' bundle by the Critical Care Outreach team on patient outcomes. DESIGN: In a prospective observational study, all adult patients on the general wards from June 2012 to January 2014 with sepsis who were screened and treated by the Critical Care Outreach team were included. METHODS: The main outcome measure was the change in National Early Warning Score following the delivery of the Sepsis Six bundle within 24 h. Secondary outcomes were 90-day mortality and overall bundle compliance. RESULTS: A total of 207 patients were included in the analysis. Overall bundle compliance was 84%. National Early Warning Scores decreased significantly 24 h after administering the Sepsis Six, from 7·4 ± 2·6 to 3·1 ± 2·4 (p < 0·001). The distribution of the National Early Warning Score changed significantly. Mortality was lower at 90 days when patients who presented with signs of sepsis within 48 h of hospital admission were compared with those who presented with signs of sepsis after 48 h of hospital admission (14·5% versus 35·4% p < 0·03) despite similar baseline physiological variables. CONCLUSIONS: We found better outcomes after the administration of Sepsis Six. Reliable delivery of the bundle, defined as 80% of patients receiving the standard of care, is achievable, and our quality improvement data suggest that it is likely to be sustainable in our environment. RELEVANCE TO CLINICAL PRACTICE: Sepsis Six can reduce physiological impairment, monitored by the National Early Warning Scores. Consistent delivery of the bundle can lead to better patient outcomes.


Assuntos
Inovação Organizacional , Pacotes de Assistência ao Paciente/psicologia , Sepse/enfermagem , Sepse/terapia , Idoso , Estado Terminal/mortalidade , Feminino , Humanos , Masculino , Quartos de Pacientes , Estudos Prospectivos , Melhoria de Qualidade
20.
Am J Nurs ; 119(1): 52-58, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30589710

RESUMO

: Background: Sepsis is one of the leading causes of hospital mortality and readmission. For the past 20 years, sepsis research has focused on best practices for treating patients with the most severe manifestations of sepsis, while the treatment of patients outside of critical care or ED settings, who have early or less severe signs and symptoms of sepsis, have received little attention. OBJECTIVE: The goal of this quality improvement (QI) initiative was to promote early recognition and treatment of sepsis through the establishment of a multidisciplinary, executive-led sepsis guiding team that leveraged nursing skills and expertise. METHODS: To meet this objective, we decided to speed the initiation of sepsis treatment at our medical center, going beyond the Surviving Sepsis Campaign guidelines in place at the time and setting as targets the identification and treatment within one hour of all inpatients and ED patients with suspected sepsis, regardless of their illness severity or care unit. Our early intervention strategy incorporated a nurse-directed ED Code Sepsis, based on the characterization of sepsis as a systemic inflammatory response syndrome-a criterion widely used at the start of this QI initiative-and an inpatient Power Hour, which authorized nurses to initiate order sets independently for lactate levels, blood cultures, and fluid boluses when they suspected sepsis. The order sets both improved bundle adherence and signaled the pharmacy to expedite antibiotic preparation and delivery. To gauge the effects of our initiative, we conducted a retrospective, interrupted time-series cohort evaluation, using the in-hospital sepsis-related mortality rate as the primary outcome, and considered as process metrics the initiation of ED Code Sepsis and the inpatient Power Hour, order set use, bundle adherence, and sepsis-related rapid response team (RRT) calls. RESULTS: Over the course of the seven-year pre- to postintervention evaluation period, ED sepsis bundle adherence increased from 40.5% to 73.7% (P < 0.001), with a mean triage to antibiotic time of 80 minutes. Sepsis-related RRT calls decreased from 2.2% to 0.85% (P < 0.001). And the in-hospital sepsis-related mortality rate dropped from 12.5% to 8.4% (P < 0.001) with an absolute reduction of 4.5 deaths per 100 sepsisrelated discharges. CONCLUSION: This project demonstrates that using nurse-directed care to promote timely identification and early treatment of sepsis in the ED and in inpatient settings can improve bundle adherence and reduce in-hospital sepsis-related mortality rates.


Assuntos
Sepse/enfermagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Mortalidade Hospitalar , Equipe de Respostas Rápidas de Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade , Estudos Retrospectivos , Sepse/mortalidade , Washington
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