Spot sepsis, stop sepsis: Early detection and fast action save lives
Improving outcomes for patients with sepsis is a priority at Michigan Medicine, and a great deal of work is being done to provide care teams with the information and tools they need to spot sepsis early in order to prevent severe illness, irreversible organ damage and death.
Sepsis is a time-sensitive, life-threatening medical emergency, like a heart attack or stroke, and it affects at least 1.7 million adults in America each year, according to the Centers for Disease Control and Prevention (CDC).
“In the U.S., someone dies every two minutes of sepsis,” said Pat Posa, M.S.A., B.S.N., R.N., CCRN-K, FAAN, quality and patient safety program manager for University Hospital and Frankel Cardiovascular Center. “It is one of the leading causes of deaths in hospitals.”
In fact, the CDC reports that one of every three people who die in a hospital have sepsis.
What is sepsis?
“Sepsis is caused by the body’s overwhelming response to an infection, which can lead to tissue damage, organ failure and death,” said Winne Wood, R.N., M.S.N., ACNS-BC, clinical nurse specialist. “It should be treated with the same urgency as other medical emergencies.”
According to Jessie King, M.D., Ph.D., associate professor of internal medicine and medical director of sepsis initiatives at Michigan Medicine, the morbidity and mortality rates for sepsis are similar to heart attack and stroke, but it’s not as easy to identify.
“We need to be vigilant in looking for sepsis because it doesn’t always present in the same way,” said King. “For every hour that antibiotic therapy is delayed, the patient’s risk of mortality increases by approximately eight percent.”
Improving outcomes for patient with sepsis
“Early recognition and rapid initiation of treatment are key to improving outcomes and increasing survival,” said Posa. “Here at Michigan Medicine, we’re doing a lot of different things to help spot and stop sepsis quickly.”
In the last year, early recognition tools have been launched in the emergency room and inpatient units to help care teams identify sepsis so intervention can take place at the earliest possible stage of the disease.
Nurse sepsis screenings are required every 12 hours for all patients in the adult and children’s hospitals, best practice alerts and order sets that outline treatment recommendations have been put in place, and a sepsis navigator in the electronic medical record helps physicians and nurses understand a patient’s course of sepsis.
In addition to these tools, it’s critical for nurses and providers to be on the lookout for signs and symptoms of sepsis.
“Providers need to ask with every patient they see, ‘could this patient have sepsis?’” said King. “If the answer is yes, treat with SEP-1 guidelines.”
SEP-1 guidelines are an established bundle of tests and treatments to be implemented within three hours of a patient being suspected or confirmed as having sepsis.
“Timely intervention with the bundle elements, especially antibiotics and fluid, are essential for saving lives,” Posa said.
Awareness is key
A new “Spot Sepsis, Stop Sepsis” campaign aims to bring awareness to the condition and urge care teams to be on the lookout for sepsis. Digital signs, reminder ads, flyers and other materials have been created to encourage care teams to act fast and save lives.
King and her team are also in the process of developing educational materials for providers.
“As a provider,” said King, “if sepsis isn’t on your radar, you’re going to miss important signs and delay treatment.”
“We need to be proactive rather than reactive to sepsis so we can prevent irreversible organ dysfunction or death,” said Wood. “We are asking nurses to assist in this work by recognizing signs and symptoms of sepsis and understanding the treatment.”
Working together to save lives
“It’s important for nurses to complete sepsis screens at the beginning of each shift and complete prompt screens in MiChart as soon as possible,” Wood said. “If there is a positive sepsis screen or suspected sepsis, we ask that nurses utilize their HRO skills and partner with providers to discuss implementing the three-hour bundle.”
Teamwork, communication and vigilance are crucial for protecting patients. Nurses and providers should be on the lookout for sepsis and work together to take immediate action when a patient is at risk.
“We know that, at Michigan Medicine, we have an opportunity to improve outcomes,” said Posa. “Through early recognition and management of our patients with sepsis, we can save lives.”