It is evident from the previous research that sepsis is an intense of to toxic reaction to an infection. The new definition according to Society of Critical Care Medicine states that sepsis is an overwhelming response to an infection. Others tend to be more prone to the reaction than others because of their compromised level of immune system. As such, correct medication is needed to help immune system fight the infection. The knowledge I got from past perspective also include knowing where sepsis in history originated from the Greek word “SIPI” which means to make rotten and was first identified during the times of Hippocrates as a medical condition. Knowledge in the current perspective involves knowing that Sepsis is a medical condition in pursuit whose existence and effects in terms of infections in the body is recognized. This current view was of sepsis was given by Ignaz Semmelweis between 1818 and 1865. Ignaz Semmelweis introduced measures of hygiene such as washing hands and use of gloves among others as an attempt to control high mortality rate. It has the highest rate of mortality annually. The current perspective according to CDC also shows that approximately 7 sepsis victims out of 10 use healthcare service and needs frequent medical care. Over 1500000 individuals in United States have been reported to get sepsis. The symptoms which many cannot detect at early stage include confusion or disorientation, shortness of breath, high heart rate, rapid breathing, and fever above 11.4 or than 96.8, extreme pain sweaty skin, reduced output of urine, confusion, increased bleeding, change of skin color, low blood pressure as well as oxygen deficiency. Tools for early detection include sepsis screening, nursing and physician resources among other resources for care purposes. Management practices of sepsis include vaccination, hand and oral hygiene, conducting education and awareness and early intervention.
Having collected knowledge on past and current perspective, the creation of two slide presentation will come next on past and current knowledge of sepsis by week 2. The presentation will be a summary of collected. The interactive PowerPoint templates will also acts as a blue print on how the rest of the presentation on the entire project will be created for presentation to the audience in the course of the project.
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The local perspective on sepsis shows that more than 1500000 people get sepsis with the evaluation of CDC showing that about 7 out of 10 sepsis victims uses healthcare service and hence require constant medical care. It is the main cause of death internationally if not treated well. In addition, sepsis is the second leading cause of death in United States with 75 percent of deaths being victims of septicemia and ESRD but the third leading cause of death at international level. The total number of patients at international level amounts to 258000, implying that other nations are affected by 108000 cases of sepsis. The United States remains to be the most affected nation with Sepsis. However, the same high case of sepsis is till the second leading cause of death in the nation.
The collection of pamphlets and handouts from sepsis will be done in week 3. The handouts and pamphlets will touch on sepsis alliance or associations by various nations globally. This will help in further understanding of sepsis case in other nations in comparison with the local impacts. The pamphlets and handouts will also be significant in providing all the relevant information ranging from the history, past and current knowledge of sepsis for enhanced understanding of the most suitable control measures that ought to be adopted.
The draft outline will contain a number of questions for assessment while interacting with the audience. The assessment questions will include the following: What is the origin of sepsis? What is the meaning of sepsis? What are some of the body organs that can be infected by sepsis? How can you compare local and international sepsis epidemics? What are some of the common specific sepsis cases? What are some of the pregnancy cases of sepsis? What is the annual international rate of sepsis associated mortality? What is the local rate of sepsis associated mortality? How can sepsis be controlled? These questions will help in further learning by interacting with the audience. The responses to the questions by the audience will help in the assessment of their understanding of sepsis.
The structure of conversation will be used to interact with the audience. In this case, questions will be presented to the audience who will in turn raise their hands to respond to the question. The audience will also be given time to formulate and ask their questions. More time will be given to the audience to formulate their questions to allow non-native English speakers to participate equally. Once the question is responded to by one member from the audience, one of two more people will be allowed to comment on the response and if possible to provide a better answer to the question (s). Questions will also be asked directly to members of the audience who appear to show non-verbal indications of having question (s) to ask as a way of ensuring that all members participate in the interaction process.
Standard Operating procedure
| Title | Sepsis |
| Version | 5 |
| Associated documents | E.g SOP invasive pressure checking, SOP Inotropic care |
| Author | Indicate author name her |
| Reviewer | Indicate reviewer name here |
Aims: To make sure there is suitable resuscitation and patient’s transfer
Background: Campaign for surviving sepsis has generated evidence oriented guidelines on the control of severe cases.
Application: May include EMRS clinical staff, Abulance paramedics for SAS Air and remote plus rural health experts.
Suitable victims for activation of EMRS: Sepsis patients who need advanced resuscitation before and during transfer
Definitions
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=Response syndrome for systematic inflammation SIRS 2 or more of Respiratory rate >20bpm Temperature<36 O C or >38 O C Heart rate>90bpm White count<4000/ml or >12000/ml |
| Sepsis SIRS and the source of infection |
| Severe sepsis Sepsis plus organ dysfunction |
| Septic shock Septic plus low blood pressure<systolic.40mmHg or <90mmHg |
Advice to GP before arrival of the team: Evidence shows that delivery of ‘sepsis six’ after one hour of identification can reduce mortality by half.
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Sepsis six |
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Three to conduct diagnosis Perform blood cultures Check lactate plus FBC Check proper urine output per hour |
Three to offer treatment/therapy High oxygen flow Intravenous antibiotics Fluid resuscitation of intravenous therapy |
Draft a project resources requirement sheet to identify required resources for Workshop by week 1
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Workshop resources |
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| Resource | Purpose |
| Laptop computer | For organizing presentation in the form of PowerPoint slides |
| Projector | For projecting presentation from the PowerPoint to the audience |
| Education literature resources | For making reference when educating the audience |
| Medical professionals (doctors, nurses, clinicians and so on) | To provide further knowledge and advise to the audience |
| UCLA Education Training Module (physician resource) | To guide the audience on the recognition, diagnosis and correct treatment of sepsis and severe sepsis including the treatment of sepsis shock |
| Nursing resources ( e.g septic shock screening Tpsheet, ED Adult Screening Tool, elearning resources and so on) | To educate the audience on the general protocol of handling sepsis patients right from the screening stage. |
| General resources | For informing the audience on how to define the rage of sepsis disease, measure process map and so on. |
The standards and guidelines of education set by Sepsis Alliance were meant enhance the management, diagnosis as well as treatment of Sepsis. The standards and guidelines include the use of evidence based guidelines for the control of severe sepsis plus septic shock through resuscitation and sepsis management bundles. There is also guidelines plus instructions for implementation of education at medical facilities. Others include information for the general public, families and patients, information for healthcare professionals and opportunities for education. The ANA code of ethics through interpretative statements informs the making of decisions concerning ethical violations by nurses and the program for nursing education. The code of ethics is the ethical standard of practice for nursing profession and the nursing contract with the society.
This involves quality standard that covers identification, diagnosis and early management of sepsis for populations. This standard explains the high quality care in areas of priority for improvement. These can be broken in to standards and guideline for quality assessment of sepsis, standards and guidelines for senior review and antibiotic treatment, standards and guidelines for treatment using intravenous fluids, escalation of care where patients with sepsis in the environment of acute condition and who gets intravenous antibiotics or fluid bolus have to be seen by consultant in the case where their condition fails to respond within a period of one hour from treatment. There is also standard for informing people who are at low risk of severe infection of low risk of death. In this case, individuals who are suspected to have sepsis and who have been stratified at low risk of severe infection are provided with information concerning symptoms to help in monitoring and accessing medical care. Another standard and guideline involves that of educating healthcare professionals such as nurses, physicians, clinicians and so on about sepsis.
I will consult and acquire permission from the relevant authorities such as my project supervisor and the academic entire health science department in order to go ahead with the execution of this project by week 2. The permission for the execution will be based on the approval of this presentation
The relevant resources needed in will include clinical resources such as medical professionals, who will be responsible for promoting health, education resources such as e-learning resources for use by both medical professionals and the computer literate population segment in the society. Other clinical resources will include diagnostic instruments, screening instruments, printed publications that explain more about sepsis and its prevention or control. Recreational resources such common field/ground, pubs among others will also be part of resources needed to enhance exercise among population so as to promote their health through lifestyle of doing exercise on a daily basis.
I will really appreciate the attendance of the presentation session by Laura as the Sepsis coordinator. This is because she is also experienced in the field and hence her experience together with my supervisor and the rest of the health professionals from the nursing facility will provide sufficient approval through guidance for informed execution of the project. The Sepsis Alliance through its team works to produce as much information as possible in the form of educational material as a way of helping the general public to become informed of the frequent lethal condition of sepsis. The alliance also produces educational material for professionals to help the public learn more concerning sepsis when it comes. The material comprise of information available on the website, brochures and even in videos (Sepsis Alliance, 2018). This means that Laura, who is the coordinator ad an ambassador of the Sepsis Alliance, is more resourceful and thus will be helpful in terms of additional information when she attends the presentation.
The invitation of the director of nursing from the facility will be very important in helping to. This is because nursing director is part of clinical resources with vast knowledge about the management of sepsis. Nursing director is a senior position in the health facility. Because of that, the nursing director is more knowledgeable about the standards and guidelines as well as the ANA code of ethics which defines the ethical principles for the operation of nurses (ANA Bylaws and Codes of Ethics, 2016). He will therefore be very helpful as well in providing extra information concerning the ethical principles and standards of practice required when handling cases of sepsis. As such, the nursing director will also be part of the authority that I look forward to approving my project for execution. This means that the approval of this project through presentation attendance is going to be done by individuals from higher level of authorities at their respective health organizations.
I will consult with the appropriate quality and case management teams for presentation setup by week 3. The nursing director, the coordinator and ambassador for Sepsis Alliance as well as my supervisor comprise the quality and case management team. In this case, the issue of quality will touch on presentation that aims to achieve safety and privacy of patient including high recommended quality of sepsis care according to the laid down standards and guidelines. The consultation process will also be necessary because it will help in appropriate editing of the presentation to meet the required standard for educating the audience.
The number of presentation sessions will be subject to increase if the workshop is a success. The success of the workshop will be seen from the point of view of high level of participation whereby many questions are likely to arise from the audience, thus taking much time to respond. Asking more questions by the audience will mean high level of concentration and the need to learn from the presentation via responses from the questions asked. In such a case, I will plan to take the shortest time possible for my presentation so that much time is left for the audience to ask more questions for response.
The major resource to be assigned to various health professionals is time of serving the patient in terms of division of labor. Here, each health professional will be assigned responsibility according to his/her role and area of specialization. As an example, the physician/doctor will be responsible for the diagnosis, treatment through surgery and prescribing medication to the patients. The nurses will be responsible for collecting blood and performing blood cultures, conduct nursing intervention through education to patients, performing oxygen treatment and intravenous antibiotic treatment. The Fluid resuscitation of intravenous therapy can be conducted by consultant nurse. The lab technicians will conduct urinalysis, blood test, monitor lactate and FBC.
My fellow medical staff, I am very glad to take this opportunity to than all of you for the cooperation you have shown towards delivering quality health services to our sepsis patients. As we, all know that sepsis is an infection that now characterizes high number of deaths than other diseases; we have no option but to work as a team in our own respective areas of jurisdiction in order to provide high quality of healthcare to our patients. The fact that, sepsis is treatable if recognized as early as possible is an advantage to us, showing hope for many patients. However, even in the severe cases, it is still possible for us to rescue lives and hence reduce death rates associated with sepsis if we collaborate in our work. I believe that our patients will also have confidence in us a medical team of the health facility if they notice changes in the outcome of the services we offer through our commitment and concern to them. I look forward to seeing this kind of team work for better sepsis treatment and control. Thank you all.
Laura, the Sepsis coordinator will go through my project scope and provide comments in terms whether it is satisfactory or whether it is of narrow scope. The Coordinator will also comment on whether the project goals are smart, that is whether the goals are specific, measurable, achievable, and realistic and time bound. The sepsis coordinators will also find out whether my project is applicable in terms of sepsis patient’s care and management. I therefore expect that positive approval of the scope, goals and the application part after going through it by week 3 will largely contribute to the approval of the project for execution.
The expected total time for the execution of the project depends on the time that will be taken to accomplish each activity on a regular basis on every week throughout the project duration. I will ensure that I work closely with my supervisor and consult regularly as I continue to carry out the individual tasks of the project. In addition, I will ensue that the project duration is allocated adequate time in proportion to the available number of activities to be accomplished. As a result, all the nursing home staff in our hospital will have undergone training about sepsis recognition and intervention at the end of the project execution period. By so doing I will have contributed towards sepsis awareness so that the knowledge about early recognition of emergency change in condition can be spread.
References
Sepsis Alliance, (Online), What is Sepsis, Sepsis Alliance Website, retrieved March 11, 2018 from https://www.sepsis.org/
ANA Bylaws and Codes of Ethics.(2016). ASSOCIATION BYLAWS. Retrieved from https://www.money.org/uploads/pdfs/ANA%20Bylaws%20and%20Code%20of%20Ethics%206-13-16.pdf
