Early Detection of Sepsis in Patients

Addressed gap 

It is estimated that sepsis affects about 650,000 individuals each year and costs approximately $17 billion. Moreover, in preterm infants the toll of sepsis has a mortality rate of 20% and also increases the risk for neurologic impairment among survivors (Fairchild, 2013). Authors have stated that the most effective way of reducing the associated risks is through the advanced preparation of the healthcare professionals (Hooper et al., 2012). Nurses are best placed to mitigate the risks brought by sepsis since they are in constant interaction with the patient. The unique position of nurses could be better used to play a more significant role in the identification of patients with sepsis at an early stage. However, the early diagnosis of sepsis in healthcare setting proves to be challenging because of the unconnected information systems from laboratory and other data systems. 

Since sepsis is a systematic response to infection, adequate preparations by the nurses will enable them to be better placed in identifying infected patients early enough. The preparations will ensure that there is enough room for the patients to be treated and in so doing, the deaths and risks associated with advanced levels of sepsis will be moderated. Lack of specific educational programs that seek to prepare and educate the nurses to be thoroughly equipped for the early detection of sepsis in patients is what makes it difficult for the practitioners to actively and effectively alleviate the risks associated with the infection. The creation and implementation of the educational sepsis-training program for nurses and nursing students will go a long way in countering the delayed patient treatment results such as numerous organ failure and increased rates of morbidity and mortality. 

Organizational trends 

Most hospitals have lacked the preparedness to deal with the emergence of sepsis in their patients especially on the part where, the healthcare professionals, in particular, nurses are not equipped with vast knowledge on the detection of the infection in the early stages. In the United States hospitals, sepsis has been recorded as the 10 th cause of death, and the status is expected to get worse if no actions are taken since the population continues to age and the use of life-sustaining technologies in hospitals continues to rise rapidly (Hermandez, 2015) . Like in most hospitals, Dimmit Regional Hospital, Carrizo Springs Texas needs to implement evidence-based training and educational programs to overcome the challenges associated with sepsis. The paper is going to give an in-depth view of the conditions at the Dimmit Regional Hospital about the early detection of sepsis in patients. In Texas, sepsis has been termed a leading cause of hospital mortality, and this is well reflected in the Dimmit regional Hospital statistics. It is necessary for a project to be established that aims at enhancing early detection of sepsis in patients at the Dimmit Regional Hospital, Carrizo Springs Texas 

The project will make it possible for an improvement to be achieved by reducing the high levels of mortality rates in the population. Evidence-based and educational training programs for the healthcare practitioners will ensure that the hospital remains at the forefront in detecting sepsis in their patients. It will, therefore, be possible for treatment to be administered to the patients early enough and this will significantly increase their chances of recovery. 

Explanation of causes 

Mainly the causes of the problem are associated with the status of the majority of the patients that seek medical care at the Dimmit Regional hospital. Most of the patients are low-income earners, and as such, they often delay before seeking healthcare for the infections, and this highly increases their chances of having sepsis. The problem is also associated with the difficulties linked to obtaining initial stages of antibiotic therapy. What intensifies and escalates the crisis is the lack of evidence-based and educational programs that train the healthcare professionals especially nurses on how best to detect sepsis in patients in the formative stages of the infection. The situation associated with the mortality and morbidity rates related to sepsis in patients is primarily affected by lack of sepsis training for the practicing nurses that work in various healthcare departments (Davis-Patrick, 2017) . It is lack of educational and evidence-based sepsis training that incapacitates the nurses and various healthcare practitioners in the early detection of sepsis in patients in the Dimmit Regional hospital as well as in other hospitals. 

Identification of target audience 

The target audience for this project is practicing nurses in the Dimmit Regional hospital as well as the nursing students that will be attached to the hospital. The audience will facilitate the implementation of the training program for the early detection of sepsis in patients. The practicing nurses will be provided with the necessary skills for the early detection of sepsis in patients, and this will make them thoroughly equipped for the mitigation of the risks associated with the infection. Incorporation of the nursing students in the training program will serve to prepare them adequately to become effective nurses shortly particularly in matters of sepsis in patients. 

Characteristics of the target audience 

The education level of the majority of the nurses and healthcare practitioners will be a minimum of the first degree and the nursing students admitted for their undergraduate studies. Education setting where the target audience will receive the proposed solution is in Dimmit Regional hospital whereby the evidence-based education training program will be implemented. The project's setting will offer a good and practical environment in which the training program will be implemented and efforts made to detect sepsis in the patients. It will also offer a good platform for solutions to be established on any concerns and challenges experienced in the implementation of the program. 

Professional development 

The education training program for the nurses and the nursing students will go a long way in ensuring that the healthcare practitioners are thoroughly skilled and equipped enough to facilitate the early detection of sepsis in patients. Evidence-based approaches will also provide the healthcare practitioners with the necessary knowledge and experience that is paramount in the detection of sepsis in patients in the early stages of the infection. Especially since the nurses are in constant interaction with the patients, they are better placed to identify the intrusion of the sepsis infection in the patients early enough to facilitate smooth running and administering of the treatment. The program will offer high levels of professional development in the nursing practices since it will ensure that the patients do not suffer the sepsis infection as they undergo treatment in the hospital (Movement, 2016) . It will make it possible for a safer environment to be created for the patients in the hospital since there will be reduced risks of contracting infection as they undergo the treatment for the diseases they suffer from. 

Proposed solution 

The project aims at establishing comprehensive means through which nurses and other healthcare professionals can have effective sepsis management. The training program will focus on the three major requirements for early detection of sepsis, and this is solely determined by early recognition of the infection in patients. For improvement to be achieved, there is a need for considerable planning to be done, elaborate development of metrics and tools as well as education of all the involved stakeholders. 

The program will enhance techniques of screening all the patients especially those that are most likely to develop sepsis. It will also train on the most effective ways through which nurses can recognize the early signs of the infection. The nurses will also be trained on how to administer treatment to the patients immediately through interventions to be administered at intervals of 1, 3 and 6 hours from the detection of sepsis and how to follow the procedure strictly. Education program to also offer algorithms on the processes by which the nurses on shifts can activate the sepsis alerts to call for more help in administering the necessary interventions promptly and consistently. 

The training will target four major areas of sepsis care: antibiotics, urine, blood, and oxygen. The nurses will also be trained on the best ways through which they can respond to the sepsis alerts with urgency to ensure that they are in a position to attain the early recovery procedures. The objective of significantly reducing the high mortality rates associated with sepsis in patients is founded on the early detection of the infection corresponding with early treatment. 

Intended outcomes 

The sepsis education program is a project intends to bring out the best in nurses by equipping them with current sepsis recognition skills as a way of promoting early detection of the infection in patients. It is expected that through the program, the nurses will understand the best ways to recognize sepsis in patients early enough for treatment to be administered. From the training, the nurses are expected to gain vast knowledge and skills on recognition of the sepsis infection and on the best ways to offer healthcare affected by the infection. The practicing nurses in the hospitals should be thorough in comprehending and recognizing the early signs and symptoms of sepsis by the end of the training program, and they should also be able to effectively initiate management strategies of the infection within the stipulated timeline. 

The project aims at availing training both through presentation and practice to bring benefits not only to the patients but also to the hospital and the community. The training program will offer education and knowledge on sepsis to the practicing nurses and the nursing students, and it is too be implemented immediately and applied in the clinical application. By the end of the project, the nurses should be thoroughly equipped on how to detect sepsis in patients early enough for effective treatment. 

Evidence summary 

Numerous studies have been conducted in the detection and treatment of sepsis, and the common ground is the need to reduce the high mortality rates associated with the infection. In December 2015, an education program that was the evidence-based approach to sepsis was conducted by the University of Nevada (Perez, 2015). The research implemented an evidence-based educational program to better the understanding of nurses and healthcare practitioners on the current evidence-based procedures necessary to offer effective care to the patients with sepsis or those that were at high risk of developing the infection. It was implemented in Las Vegas in the Nevada acute care hospital. 

During the study, the most current evidence-based standards were recognized and used to better the management and the ways of treating patients infected with sepsis. Also, new sepsis protocols were established, and this was used to develop the education presentation on sepsis. By the end of the study, all the participants of the sepsis education program rated it as good or excellent, and the results also showed that they were able to identify essential aspects that they were expected to apply in their practice immediately (Perez, 2015) . 

A different study was conducted on the promotion of early identification of sepsis in hospitalized patients through the use of nurse-led protocols. It determined that early detection of sepsis is an effective way through which treatment can be given effectively (Kleinpell, 2017) . From the study, the best way of detecting sepsis in patients early enough is through the use of nurse-based protocols and interventions since the nurses are better placed as a result of their constant interaction with the patients. The nurse-driven care resulting from the sepsis protocol was recorded to lead to increased compliance with the survival of more patients. The study implemented a program for early detection and immediate treatment of sepsis, and it proved effective. 

The Centria University of Applied Science conducted a study to determine and analyze how nurses identify sepsis in patients and the procedures they use for assessment in the emergency department. The study aimed at availing knowledge to the nurses in the emergency department on early recognition of sepsis and training them on how to offer evidence-based care to the patients and administer treatment promptly (Sushma, 2016) . The study showed that early detection of sepsis significantly reduced the poor outcomes in the emergency department. From the conducted research, awareness was created among the emergency department nurses among other healthcare professional as well as among students on the early detection of sepsis in patients. The results were based on sepsis detection and assessment tool subsequent with the meta-synthesis as well as sepsis identification and assessment procedure corresponding to the meta-analysis. 

A research was conducted on the best ways through which treatment can be administered to sepsis patients. The study tackled methods of managing sepsis in the emergency department with the target of decreasing the mortality rates recorded in the ICU particularly in the Critical Care Cascade. The study established that most patients diagnosed with sepsis are at a higher risk of succumbing to the infection or developing organ dysfunction (Christ, 2014) . From the research, it was evident that severe sepsis is associated with numerous complexities and this makes it difficult to be treated especially due to the unclear symptoms found in various affected patients. The study concluded that it is not only easier but also effective for sepsis to be detected early and treated immediately. It increases the chances of recovery for the patients, and it is, therefore, crucial for evidence-based educational training programs to be established that prepare nurses adequately to detect the infection early and to administer treatment promptly. 

Research has also been done on the effects of sepsis on the patients in the hospital wards, and this shows that it contributes to half of the deaths of hospitalized patients. A study conducted on the identification of patients with sepsis in hospital wards revealed that the most effective way of reducing the patients succumbing to the infection is through the introduction of interventions at the early stages (Bhattacharjee, 2017) . The use of intervention such as the appropriate antibiotics proved to yield a positive outcome and improve the situation. The study also highlighted that most research had addressed the issue of early recognition and identification of sepsis and treatment of patients in the emergency departments and the intensive care units. A contrast was established whereby a majority of the patients acquire the infection while on the general words. The project aimed at establishing and implementing the current advancements that have been realized in the early detection of sepsis in patients particularly on the general wards. It was concluded that the best way to treat sepsis in patients is when the interventions are introduced early enough, and this is only possible with effective strategies to facilitate the early detection of sepsis in patients. 

Plan of action 

The initial program of the project will involve identification of the nurses that will actively be in the program with the direction of the hospital's management. After the establishment of the team, an outline of the training sessions will be highlighted to ensure that it is accommodative and will enable all the nurses especially the nursing students to actively participate. The initial stages of the program will seek to elaborately redefine the target gap and the review of literature that supports the project. An elaborate lesson plan will be developed to cover all the signs associated with sepsis in the formative stages and the interventions to be adopted to offer effective treatment. The first month of training will give detailed information on the signs and symptoms that the nurses need to look out for patients to detect the sepsis infection. In the last month of the project, the program will offer and establish the most current evidence-based techniques and strategies in administering treatment promptly. The entire educational training will endeavor to equip the nurses with sufficient knowledge and skills on how best to detect sepsis in patients early and the immediate interventions they are to introduce upon recognition of the infection. 

Timeline 

In most cases, nurses face new treatments and medication methods, and it is, therefore, necessary for them to be adequately prepared to encounter the upcoming issues as they offer nursing care to the patients. The education will be provided on favorable terms for all the nurses to access the training. It will accommodate nurses on both shifts during day and night. The training will also be offered on various days of the weeks, and it will incorporate both morning and evening sessions. The project will carefully consider the various working shifts for the nurses as well as the number of training sessions offered as a way of ensuring that the program will accommodate most nurses in the Dimmit regional hospital as well as the practicing nursing students. It will objectively target bringing all the nurses on board to ensure that they are knowledgeable and can comfortably recognize the formative stages of sepsis in patients. Due to the current programs of Dimmit Regional hospital, the program will only run for two months within which all efforts will be made to ensure that the relevant content is covered. 

Resources and personnel 

For the implementation of the project, various resources and personnel will be required. For the program to run effectively, there will be a need for experienced and qualified personnel to help in the training for the nurses. The first month will also require printing of materials to illustrate the signs and symptoms associated with the infection. The training will also require a room in the hospital for the sessions as well as various wards across all departments for the implementation of the project with the patients. The second month will require practical room for implementation of the strategic interventions upon early detection of sepsis in patients. The program will also require supplies of antibiotics and special equipment to help test the patients in the major areas associated with sepsis. Financial support will be needed to acquire all the necessities for the successful implementation of the project at Dimmit Regional Hospital. 

Proposed change theory 

For the implementation of this project, the proposed change theory is based on introducing new strategies that aim at educating nurses on the best ways to recognize sepsis in patients. It will involve four phases. In the first phase, the participants will be helped to appreciate the intensity of the harm associated with sepsis in patients. The second phase will include training on the signs and symptoms of the infection in the formative stages. The third phase will compromise detailed studies on the current and effective interventions to be introduced to patients immediately the infection is detected. The last phase of the project will seek to ensure that the participants retain high levels of the knowledge acquired through the training. 

Barriers to implementation 

After completion of the project outline, some challenges may be encountered in the implementation. One major limitation of the evidence-based education training program for sepsis is the level of knowledge retention by the participants. Mainly, the successful implementation of the project is dependent on how well the nurses can understand and retain the training on the best ways through which sepsis in patients can be detected early. Another barrier to the implementation is the time allocated for the implementation that is two months. In an ideal situation, the training and implementation should spread to a minimum of six months, and this would make it possible for the nurses to practice and apply the knowledge gained. It would also allow for observations to be made to measure the outcome on patients. Another challenge that could be encountered in the implementation process is the time that it would take for the new strategies to be approved for use on patients especially due to the limited time that is available. 

References 

Bhattacharjee, P. (2017). Identifying Pateients With Sepsis on the Hospital Wards. Chest Journal , 898-907. 

Christ, M. (2014). How to Manage Sepsis in the Emergency Department Leading to a Decreased Mortality in ICU - the Critical care cascade. Infection & Sepsis , 1346-1364. 

Davis-Patrick, D. M. (2017). An RN Sepsis Training program That supports Registered Nurses in theEmergency Room Setting. Walden University Scholar Works , 559-571. 

Fairchild, K. D. (2013). Predictive monitoring for early detection of sepsis in neonatal ICU patients. Current opinion in pediatrics, 25(2), 172-179. 

Hermandez, G. (2015). Transformation and uality improvement Program. Texas Health Care , 116-128. 

Hooper, M. H., Weavind, L., Wheeler, A. P., Martin, J. B., Gowda, S. S., Semler, M. W., ... & Mathe, J. L. (2012). Randomized trial of automated, electronic monitoring to facilitate early detection of sepsis in the intensive care unit. Critical care medicine, 40(7), 2096. 

Kleinpell, R. (2017). Promoting early identification of sepsis in Hospitalized Patiets with Nurse-led Protocols. Critical care , 118-130. 

Movement, P. S. (2016). Early Detection & Treatment of Sepsis. Actionable Patient Safety Solution , 227-241. 

Perez, D. (2015). An Evidence based Approach to Sepsis: Education Program. University Libraries , 11-47. 

Sushma, S. (2016). Identifying and assessing Patient's Sepsis by Nurses in an Emergency Department. Centria University of Applied Sciences , 18-25.