Nursing care for the critically ill with sepsis: continuous quality improvement project
DOI:
https://doi.org/10.29352/mill0220e.40799Keywords:
nursing care; sepsis; septic shockAbstract
Introduction: Sepsis affects around 49 million people every year. Nurses work to prevent and identify sepsis, as they are the closest members of the team, preventing it from developing into shock. Multidisciplinary protocols and team training have been shown to facilitate the recognition and effective treatment of sepsis.
Objective: To evaluate the usefulness and feasibility of implementing an action protocol in the practice of nursing care for critically ill people with sepsis.
Methods: This was a quantitative and descriptive action-research study. The sample consisted of nurses from an Intermediate Care Unit of a Local Health Unit in the Centre of Portugal. All the ethical and legal assumptions intrinsic to the research were complied with.
Results: The nurses point to the inadequate nurse/patient ratio and the management of the therapeutic protocol as the main difficulties in providing care to critically ill people with sepsis and consider it important to carry out training on the subject, with improved knowledge afterwards. The creation of a work instruction is seen as an asset in the provision of care to these patients.
Conclusion: The implementation of the work instruction on nursing care for the critically ill person with sepsis allows for an improvement in quality care, but its application is difficult due to the lack of necessary materials and human resources.
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Aldhafeeri, Y., Alshammari, J., ALdhafeeri, M., Alenezi, R., Aldhafeeri, A., & Aldhafeeri, H. (2024). Examining the impact of implementing a nurse-drive sepsis protocol on early identification and management of sepsis in the crtitical care setting: An article review. Journal of International Crisis and Risk Communication Research, 7, 475.. https://jicrcr.com/index.php/jicrcr/article/view/475
Almeida, A. (2020). Abordagem ao cliente com sepse: Do pré-hospitalar à unidade de terapia intensiva. In Secad Artmed/ Artmed Panamericana Editora (Ed.), “Programa de Atualização em Enfermagem – Terapia Intensiva (pp. 117-163). Secad Artmed / Artmed Panamericana Editora”.
Bilro, M., Leite, L., & Marques, M. (2021). Specialized interventions on critically ill person with septic shock: A systematic review of the literature. Revista Ibero-Americana de Saúde e Envelhecimento, 7 (3), 438 - 459. https://doi.org/10.24902/r.riase.2021.7(3).538.438-459
Boechat, A., & Boechat, N. (2010). Sepse: diagnóstico e tratamento. Revista Brasileira Clinica Médica, 8(5), 420 - 427. http://files.bvs.br/upload/S/1679-1010/2010/v8n5/010.pdf
Branco,M., Lucas, A., Marques, R., & Sousa, P. (2019). The role of the nurse in caring for the critical patient with sepsis. Revista Brasileira de Enfermagem, 73(4), e20190031. https://doi.org/10.1590/0034-7167-2019-0031
Direção-Geral da Saúde (2017). Via Verde Sépsis no Adulto. Ministério da Saúde. https://normas.dgs.min-saude.pt/2016/09/30/via-verde-sepsis-no-adulto/
Drahnak, D., Hravnak, M., Ren, D., Haines, A., & Tuite, P. (2016). Scripting nurse communication to improve sepsis care. MedSurg Nursing, 25(4), 239. https://abrir.link/QzBCw
Escola Superior de Saúde de Leiria (2018). Guia de Elaboração de Trabalhos Académicos: Manual de referências técnicas para a elaboração de trabalhos académicos na ESSLei. Politécnico de Leiria. https://abrir.link/EpCML
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., … Levy, M. (2021). Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Intensive Care Medicine, 47(11), 1181–1247. https://doi.org/10.1007/s00134-021-06506-y
Harley, A., Johnston, A., Denny, K., Keijzers, G., Crilly, J., & Massey, D. (2019). Emergency nurses’ knowledge and understanding of their role in recognising and responding to patients with sepsis: A qualitative study. International Emergency Nursing, 43, 106–112. https://doi.org/10.1016/j.ienj.2019.01.005
Henkin, C., Coelho, J., Paganella, M., Siqueira, R., & Dias, F. (2009). Sepse: Uma visão atual. Scientia Medica, 19(3), 135–145. https://abrir.link/uCTts Levy, M., Evans, L., & Rhodes, A. (2018). The Surviving Sepsis Campaign Bundle: 2018 update. Intensive Care Medicine, 44(6), 925 – 928. https://doi.org/10.1007/s00134-018-5085-0
Neto, J., Almeida, A., Silva, L., Viana, R., & Nóbrega, M. (2019). Paciente grave com sepse: Conceções e atitudes de enfermeiros intensivistas. Enfermagem Brasil, 18(5), 650 – 657. https://doi.org/10.33233/eb.v18i5.2757
Ordem dos Enfermeiros. (2016). Classificação Internacional para a Prática de Enfermagem. CIPE versão 2. Ordem dos Enfermeiros. Organização Mundial da Saúde. (2020). Sépsis. https://www.who.int/news-room/fact-sheets/detail/sepsis
Peninck, P., & Machado, R. (2012). Implementation of sepsis algorithm by nurses in the intensive care unit. Revista RENE, 13(1). 187-199. https://abrir.link/nYKii
Politécnico de Leiria (2021). Guia para a Elaboração de Citações e Referências Bibliográficas: Normas APA 7ª Edição. https://www.ipleiria.pt/sdoc/wp-content/uploads/sites/10/2024/03/Guia_APA_7Ed_06MAR2024.pdf
Ramos, F., Lima, F., Macário, F., Silva, C., Paiva,M., Silva, R., Gomes, R., & Rocha, S. (2020). O conhecimento do enfermeiro na deteção precoce da sepse em pacientes críticos. Brazilian Journal of Development, 6(12), 99931-99943. https://doi.org/10.34117/bjdv6n12-675
Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0). (2015). SQUIRE. https://www.squire-statement.org/index.cfm?fuseaction=Page.ViewPage&PageID=471
Rios, E., & Breda, K. (2023). Time is survival: Continuing education on sepsis for neurosurgical critical care nurses. The Journal of Continuing Education in Nursing, 55(5), 224 – 230. https://doi.org/10.3928/00220124-20231211-01
Roberts, R., Alhammad, A., Crossley L., Anketell, E., Wood, L., Schumaker, G., Garpestad, E., & Devlin, J. (2017). A survey of critical care nurses' practices and perceptions surrounding early intravenous antibiotic initiation during septic shock. Intensive Crit Care Nursing, 41, 90 – 97. https://doi.org/10.1016/j.iccn.2017.02.002
Silva, A., & Souza, H. (2018). Sepse: Importância da identificação precoce pela enfermagem. Revista Pró-UniverSUS, 9(1), 97 – 100. https://abrir.link/ibQAb
Silveira, A., & Nascimento, C. (2021). A intervenção do enfermeiro na prevenção e deteção precoce da sépsis na pessoa em situação crítica: Uma revisão integrativa da literatura. Brazilian Journal of Health Review, 4(5). https://doi.org/10.34119/bjhrv4n5-144
Singer, M., Deutschman, C., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., … Hotchkiss, R.S. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8), 801–810. https://jamanetwork.com/journals/jama/article-abstract/2492881
Sousa, T., Filho, I., Silva, C., Macêdo, C., Sá, E., Pereira, M., Filha, F. & Luciano, C. (2021). Difficulties faced by nurses in the recognizing and managing sepsis. Journal of Nursing and Health, 11(3). https://buscaintegrada.pucsp.br/vufind/Record/doaj-art88ddb39a99db4647a498340195b1b1c3
Torsvik, M., Gustad, L., Mehl, A., Bangstad, I., Vinje, L., Damas, J. K., & Lydersen, S. (2016). Early identification of sepsis in hospital inpatients by ward nurses increases 30-day survival. Critical Care, 20, 244. https://doi.org/10.1186/s13054-016-1423-1
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