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Code sepsis nursing review
 

Code sepsis nursing review

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    Code sepsis nursing review Code sepsis nursing review Presentation Transcript

    • Code Sepsis Nursing Review
    • WHO is involved?
      • eLink monitoring team
      • CCM Medical Team
      • ICU/ED/Floor nurses
      • Pharmacy
      • Lab
      • Other medical professionals
    • WHAT is the nurses role in code sepsis?
      • Placement of IV lines
      • Administration of IV fluids, pressors, and IV antibiotics
      • Monitoring patient’s status
      • Ensuring labs are ordered and taken appropriately
      • Meeting specified goals within an appropriate amount of time
      …but most importantly overall patient safety & care…
    • STAT Within 1 hour of patient ID (3 hours to ID and initiate for ED pts)
      • Blood Cultures
      • Antibiotic administration
    • Sepsis Resuscitation Bundle Within 6 hours of patient identification
      • SBP > 100mmHg
      • MAP > 65 mmHg
      • CVP 8-12 mmHg
      • CI > 2.5 L/min/m 2
      • PCWP 8-12 mmHg
      • Urine Output > 0.5mL/kg/hr
      • ScVO 2 > 70%
    • Sepsis Management Bundle Within 24 hours of patient identification
      • Administer low-dose steroids (if applicable)
      • Maintain glucose levels <180mg/dL
      • Maintain IPP <30cm H 2 O for mechanically ventilated patients
    • HOW should antibiotics be administered?
      • Within 1 hour of patient identification for non-ED patients and 3 hours to identify septic patients and administer antibiotics in the ED setting
      • Compatibilities should be checked – more antibiotics are compatible than you may realize
      • A broad spectrum of antibiotic should always be administered first
    • Spectrum of Activity for Selected Antimicrobial Agents
      • Gram (+) Antibiotics (+/- Anaerobes)
      • Vancomycin (Vancocin®), Linezolid (Zyvox®), Daptomycin (Cubicin®), Clindamycin (Cleocin®)
      • Gram (-) Antibiotics (+/- Anaerobes )
      • Gentamicin, Tobramycin, Aztreonam (Azactam®)
      • Antifungal
      • Fluconazole (Diflucan®), Caspofungin (Cancidas®), Micafungin (Mycamine®), Amphotericin B
    • Broad Spectrum Antibiotics
      • Penicillins
      • Piperacillin/Tazobactam (Zosyn®), Ampicillin/Sublactam (Unasyn®)
      • Cephalosporins
      • Ceftriazone (Rocephin®), Ceftazidine (Fortaz®), Cefipime (Maxipime®)
      • Fluoroquinolones
      • Ciprofloxin (Cipro®), Moxifloxacin (Avelox®), Levofloxacin (Levaquin®)
      • Carbapenem
      • Imipenem/Cilastin (Primaxin®), Meropenem (Merrem®)
    • WHY does this matter?
      • Sepsis is a range of clinical conditions caused by the body’s systemic response to an infection, which can be accompanied by single or multiple organ dysfunction or failure, leading to death
      • Sepsis kills approximately 1,400 people worldwide every day and is a leading cause of death in ICU patients
      • Patients who do not receive prompt antibiotic therapy have a 10-15% increased risk of mortality – therefore early administration of antibiotics have proven to improve mortality
      • Nurses play a huge role in patient care and ensuring that antibiotics are given correctly and in a timely manner
    • That’s all for now!
      • Now you can take the post test and see what you have learned.
      • Information provided by Elizabeth Jennings Martin, PharmD
      • Email: [email_address] with any questions or comments