Code sepsis nursing review

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Code sepsis nursing review

  1. 1. Code Sepsis Nursing Review
  2. 2. WHO is involved? <ul><li>eLink monitoring team </li></ul><ul><li>CCM Medical Team </li></ul><ul><li>ICU/ED/Floor nurses </li></ul><ul><li>Pharmacy </li></ul><ul><li>Lab </li></ul><ul><li>Other medical professionals </li></ul>
  3. 3. WHAT is the nurses role in code sepsis? <ul><li>Placement of IV lines </li></ul><ul><li>Administration of IV fluids, pressors, and IV antibiotics </li></ul><ul><li>Monitoring patient’s status </li></ul><ul><li>Ensuring labs are ordered and taken appropriately </li></ul><ul><li>Meeting specified goals within an appropriate amount of time </li></ul>…but most importantly overall patient safety & care…
  4. 4. STAT Within 1 hour of patient ID (3 hours to ID and initiate for ED pts) <ul><li>Blood Cultures </li></ul><ul><li>Antibiotic administration </li></ul>
  5. 5. Sepsis Resuscitation Bundle Within 6 hours of patient identification <ul><li>SBP > 100mmHg </li></ul><ul><li>MAP > 65 mmHg </li></ul><ul><li>CVP 8-12 mmHg </li></ul><ul><li>CI > 2.5 L/min/m 2 </li></ul><ul><li>PCWP 8-12 mmHg </li></ul><ul><li>Urine Output > 0.5mL/kg/hr </li></ul><ul><li>ScVO 2 > 70% </li></ul>
  6. 6. Sepsis Management Bundle Within 24 hours of patient identification <ul><li>Administer low-dose steroids (if applicable) </li></ul><ul><li>Maintain glucose levels <180mg/dL </li></ul><ul><li>Maintain IPP <30cm H 2 O for mechanically ventilated patients </li></ul>
  7. 7. HOW should antibiotics be administered? <ul><li>Within 1 hour of patient identification for non-ED patients and 3 hours to identify septic patients and administer antibiotics in the ED setting </li></ul><ul><li>Compatibilities should be checked – more antibiotics are compatible than you may realize </li></ul><ul><li>A broad spectrum of antibiotic should always be administered first </li></ul>
  8. 8. Spectrum of Activity for Selected Antimicrobial Agents <ul><li>Gram (+) Antibiotics (+/- Anaerobes) </li></ul><ul><li>Vancomycin (Vancocin®), Linezolid (Zyvox®), Daptomycin (Cubicin®), Clindamycin (Cleocin®) </li></ul><ul><li>Gram (-) Antibiotics (+/- Anaerobes ) </li></ul><ul><li>Gentamicin, Tobramycin, Aztreonam (Azactam®) </li></ul><ul><li>Antifungal </li></ul><ul><li>Fluconazole (Diflucan®), Caspofungin (Cancidas®), Micafungin (Mycamine®), Amphotericin B </li></ul>
  9. 9. Broad Spectrum Antibiotics <ul><li>Penicillins </li></ul><ul><li>Piperacillin/Tazobactam (Zosyn®), Ampicillin/Sublactam (Unasyn®) </li></ul><ul><li>Cephalosporins </li></ul><ul><li>Ceftriazone (Rocephin®), Ceftazidine (Fortaz®), Cefipime (Maxipime®) </li></ul><ul><li>Fluoroquinolones </li></ul><ul><li>Ciprofloxin (Cipro®), Moxifloxacin (Avelox®), Levofloxacin (Levaquin®) </li></ul><ul><li>Carbapenem </li></ul><ul><li>Imipenem/Cilastin (Primaxin®), Meropenem (Merrem®) </li></ul>
  10. 10. WHY does this matter? <ul><li>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 </li></ul><ul><li>Sepsis kills approximately 1,400 people worldwide every day and is a leading cause of death in ICU patients </li></ul><ul><li>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 </li></ul><ul><li>Nurses play a huge role in patient care and ensuring that antibiotics are given correctly and in a timely manner </li></ul>
  11. 11. That’s all for now! <ul><li>Now you can take the post test and see what you have learned. </li></ul><ul><li>Information provided by Elizabeth Jennings Martin, PharmD </li></ul><ul><li>Email: [email_address] with any questions or comments </li></ul>

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