Increasing Septic Screening Compliance
Increasing Septic Screening Compliance
Abstract
There is a growing medical challenge within the confines of medical service facilities that if not addressed may lead to unnecessary loss of life. There has been a growing rate of sepsis infections, especially those who are admitted in the hospital. It is a baffling problem as one would image that the hospital is the last place where one’s sickness gets worse. Delving further into the probable causes of the increase of septic infection cases, once would discover that the methodologies that are being used to detect and address these infections are undependable. As such there is the need to revise and improve modes of screening not to forget detection processes. The solution needed here ought to also positively impact the medical profession positively. It ought to provide a means of educating nurses, improve interdepartmental information sharing, and optimize the solutions available for septic infections. The technological solution proposed in this paper enables the detection of septic infections through the analysis of clinical and demographic data. It has the capacity to seek through laboratory results, sieving out results that fit the Systemic Inflammatory Response Syndrome category. It then provides an alert once the combination of results fitting the criteria is analysed. The paper also encompasses the benefits of the system, chief among them the provision of critical knowledge to nurses on alternate means of detecting infections through analysis of patient data.
Introduction
Sepsis is a serious systemic inflammatory reaction to an infection that can be life-threatening if not properly addressed. Such infections can be caused by an unlimited number of pathogens and as such is experienced mostly by patients who are admitted to hospital. This is because the generic healthcare environment houses millions of germs, not to mention the delicacy of the type of treatments that need a patient to be admitted, such as surgeries. Sepsis infections are known to have one of the highest death rates in hospitals. Despite the various developments that have been done on improving hygiene in within the confines of medical institutions, the number of septic infections has strangely been increasing.
In retrospect, the cause of this increase is the laxity in the delivery of various medical services by medical staff or personnel. Some of these poor practices include late detection of infections, poor technical expertise on sepsis infections and delay in administering medicine. Due to the fragility of the state of sepsis patients, it is imperative that the detection of the illness be made in good time. Due to the manner with which nurses constantly interact with patients, they are the best positioned medical professionals to administer improved means of preventing and containing sepsis infections. In addition to their many medical duties, nurses ought to be equipped with the knowledgeable capacity to identify and intercept septic infections when they come up (Angus, 2001).
Background.
Among some of the solutions that have been provided by medical bodies such as The Surviving Sepsis Campaign, have proposed logistics on how each medical care center can come up with their independent means of screening and addressing infections. It stipulates that each hospital or clinic ought to have means of conducting screening tests that enable the identification of symptoms of Systemic Inflammatory response syndrome. The tool advised ought to include vital information that is relevant to detection of septic infections. Demographic information such as patient history and hospital frequency are vital. They enable medical professionals understand whether the infection is new, narrowing down its source. Such information goes as far as to indicate the areas of the healthcare facility that fall short of the hygiene’s standards. The tool applied needs to accommodate statistical information collected from laboratory examinations. Such information can provide a new approach to the detection of septic infections. Once a patient has an inflammatory reaction, there are certain chemical elements of the body that are altered from their regular measurements. The solution also needs to tell the difference and similarities between these chemical imbalances in order to provide the appropriate diagnosis. To put it into perspective, the solution ought to encompass information on hepatic and coagulation functions. The quantity of these functions ought to be carefully selected because the assimilation of SIRS entities characterised with lactate or hypotension are conventional in emergency rooms. Despite it being sourced from different geographical and physical conditions, once an inflammatory reaction grows into an infection, it is considered septic. Once this stage has commenced, it is vital that the patient is constantly monitored with a leaning towards indications of organ failure. If at least one dysfunction or hyper fusion is detected, the patient’s conditions are considered to have grown into severe sepsis. Not only that, there are now increased chances of the patient to suffer from septic shock. There are unique cases where severe sepsis is a result of refractory hypotension as well.
The solution predominantly lies in the hands of the nursing staff. On the site that is worked from, nurses are the dominating figure within the premises of the hospital. They come in contact with many patients regardless of which department, room or role in which they have been allocated to. The core problem was the efficiency in the detection of the infections as well as timely delivery of medication to the patients. In addition to that, there were instances where some of the medical staff did not realize the cause of the infections and settled on simply managing the patient’s conditions despite the latter’s discomfort. The solution, therefore, ought to improve the technical know-how of the nurses, improve sepsis infection detection methodologies as well as optimize the delivery of prescribed medicines. The areas that I noted that needed much improvement was the organization of information, inclusive of the creation and management of patient charts. Other challenges were detection methodologies concerning septic infections and overall knowledge on septic inflammatory reactions.
The proposed solution is to replace the patient information management software from the t-system to Cerner as a means of improving the identification and communication of patient symptoms or conditions. The new system is an electronic medical clinical decision tool that provides a means of identifying patients with sepsis infections (Nelson, 2011). It has an improved automated sepsis identification entity that also works for outpatients and emergency cases. The Center FirstNet system enables the collection of clinical and demographic data of patients accessing medical services. It is inclusive of all the test results, as well as any and all doctor documentation about the patient. The sepsis detection system focuses on laboratory and clinical data.
With it, the system triggers an alert in the event several systemic inflammatory response syndrome types of criteria is identified. It is inclusive of temperatures that are equal or less than 36 degrees or greater than 38, a respiratory rate of fewer than 20 breaths per minute, a heart rate of less than or equal to 90 per minute, a white blood cell count of less than 4,000 or greater than 12,000 per millimeter cubic. Regarding shock symptoms, the system triggers an alert when systolic blood pressure is less than 90 mm Hg or a posting of lactic acid that is less than 2mg/dL (Padberg, 2009). These alerts are generation as services continue in the hospital, by an asynchronous assessment of data elements and a combination of recordings at different points in time to justify an alert. Any sepsis criteria that comes up will be added to the identification criteria and repeat the alert.
Implications for Nursing Practice
It is a system that comes with numerous advantages, chief among them being its accuracy. The quantity of false positive cases was considered as not clinically excess. The use of a computer solution is due to the complex means of identifying septic cases (Goldstein, 2005). It involves the acquisition and analysis of laboratory, physiologic and clinical information. Many of the nurses complained that early detection of such infections poses a challenge and are mostly noticed when a patient complains of discomfort that is not reacting to current medicine or when the condition becomes physical through organ failure.
The use of the system depends on the clinical results of the patient from the tests done in the laboratory, providing an early means of detection through the analysis of cellular composition and status. The system also incorporates laboratory values like hepatic function and coagulation panels. It provides a means of analyzing medical information, without needing further elaboration regarding terminologies and data types. It enables the nurses understood and interpreted the results more comprehensively.
Additionally, it includes lactate and hypotension as new methodologies with which sepsis detection can be successfully done. It is a recognized paradigm in energy medicine practices at a global scale. It further adds on to the amount of information and expertise that can be accessed by the nurses. The inclusion of developing detection criteria improves the knowledge on the subject of sepsis infections that the nurses use. It is a two-way advantage as not only does it improve the means by which infections are detected but act as a means of improving the knowledge of the relevant medical personnel within the hospital. As much as it is a formidable system that will be in place for decades to come, it is not without its disadvantages. The information processed in the system needs to be entered by the medical personnel in charge, most likely it being the laboratory specialists and emergency attendees. If the information entered in the system is inaccurate, the competency of the septic infection detection entity is compromised.
Conclusion
It also has a limit, somewhat, to the scope it focuses on as a means of detecting infections. A large quantity of the information sourced from outpatients or pediatric cases will simply occupy space in the computer as the majority of the septic infection cases involve patients who have been addicted. Not only that, the system is sophisticated and requires a quantifiable sum of resources to acquire it. It limits the number of areas sin which it can be applied. As such, investment in such a system is not ideal for a small scale medical center or clinic (Angus, 2001).
References
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Angus DC, L.-Z. W. (2001). Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Critical Care Medicine. , 1303-1310.
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Nelson JL, S. B. (2011). Prospective trial of real-time electronic surveillance to expedite the early care of severe sepsis. Annals of Emergency Medicine., 500-504.
Padberg FT, J. H. (2009). Screening for abdominal aortic aneurysm with electronic clinical reminders. American Journal of Surgery, 670-674.
