Critical care nursing quarterly
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Neutropenic sepsis results as a post-cancer treatment complications and is considered an oncologic emergency. Neutropenic sepsis can result in mortality, especially if it is not identified at an early stage. Septic syndrome is the leading cause of nonrelapse mortality in patients with hematologic malignancies and solid tumors. ⋯ Each of these components plays a vital role in the patient's overall management following treatments with chemotherapy, radiation, and stem cell transplantation. The ICU nurse who encompasses this understanding will be able to identify neutropenic sepsis in a timely manner. The early identification of neutropenic sepsis will enable the ICU nurse to expeditiously implement preventive treatment and management to prevent mortality.
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Comparative Study
Reduction in time to first action as a result of electronic alerts for early sepsis recognition.
The use of an electronic alerting system to notify practitioners when a patient meets modified systemic inflammatory response syndrome criteria was hypothesized to decrease the time to goal-directed therapy initiation. This retrospective, before-and-after study analyzed adult patients identified with sepsis or septic shock and compared 30 patients prior to electronic alert initiation with 30 patients after initiation. ⋯ Using computerized medical records to create an electronic alerting system has the potential to identify high-risk patients and initiate interventions sooner. At our institution, the creation of an alerting system with real-time data has decreased the time it takes to begin sepsis workup and treatment.
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Over the last decade, hospitalizations for sepsis have more than doubled and the incidence of postsurgical sepsis tripled between 1997 and 2006. This upward trend is expected to continue for several reasons, including population-specific characteristics (e.g., age, chronic disease status) and health care-specific characteristics (eg, lack of understanding of sepsis, medical treatments that leave patients susceptible). Highly effective, focused, quality improvement teams need to be established in order to successfully manage this condition. ⋯ Hospitals have responded with not only corrective actions but also actions that improve quality despite a lack of noted deficiencies (i.e., taking quality from "good" to "better"). Key components of a successful quality improvement program have been identified, as have components of successful quality improvement teams. By applying these components to a physician-led sepsis quality improvement team, hospitals can successfully decrease sepsis mortality and increase compliance with the application of sepsis best practice in the emergency department, intensive care unit, or non-intensive care unit nursing units.