CNA SEPSIS EDUCATION 2017
WHAT CAUSES SEPSIS? Sepsis occurs when the body has a severe immune response to an infection Anyone who has an infection is at risk for developing sepsis Sepsis occurs when the chemicals released into the bloodstream to help fight an infection cause widespread inflammation. This inflammation may lead to blood clotting, leaky blood vessels, and impaired blood flow, which cause oxygen deprivation to organs and tissues, which ultimately causes organ failure and death, if not treated.
SOURCES OF INFECTION Common infections that lead to sepsis are: Pneumonia Urinary tract infection (UTI) Abdominal infections Bloodstream Catheter-related infections Infected pressure ulcers Skin infections Unknown source
WHO IS AT RISK FOR DEVELOPING SEPSIS? Anyone can develop sepsis, but certain populations are more at risk, such as: Elderly, infants and children People with weakened immune systems Patients with cancer, hospitalized with frequent infections, and frequent use of antibiotics and steroids People with chronic diseases Diabetes, heart failure, liver disease, AIDS Recent surgery Recent hospitalization, especially within the last 30 days Patients with Foley catheters, PICC lines, central lines
WHY IS IT IMPORTANT THAT I KNOW ABOUT SEPSIS? Sepsis remains the primary cause of death due to infection High mortality rates are associated with sepsis; anywhere from 28 percent to 50 percent of people who develop sepsis can die if not treated timely Every year, more than 1 million people are affected with sepsis in the U.S. Early identification and treatment can decrease sepsis-related morbidity and mortality (the number of people who suffer from sepsis-related conditions or die from sepsis) Oftentimes CNAs may be the first to recognize the signs and symptoms of sepsis
WHAT ARE THE SIGNS AND SYMPTOMS OF SEPSIS? Centers for Disease Control and Prevention [CDC], 2016
WHAT ARE THE SIGNS AND SYMPTOMS OF SEPSIS? Abnormal lab values may be a sign of sepsis, however there are signs we can look for that don t include lab work, such as: Altered mental status, confusion, depression, sleepiness or difficult to arouse Cold, shivering, fever, sweating, temperature >100.4 or <96.8 Pain or discomfort: Pain in the lower back can be caused by a UTI or kidney failure; pain in the stomach can be caused by a stomach infection; pain in the arm or leg without injury can be caused by a skin or bone infection Difficulty breathing or shortness of breath Oxygen saturation <90%, respiratory rate >20 Fast heart rate Heart rate >90 The patient doesn t look right or complains that they don t feel right Decreased urinary output
WHAT SHOULD I DO IF I THINK SOMEONE HAS SEPSIS? If you think a patient has sepsis or a change in condition, inform the nurse or charge nurse immediately Remember: Early identification and treatment can save someone s life Tell the nurse or charge nurse you think the patient has sepsis and why Mr. Smith has pneumonia and he seems more confused that yesterday. I think he might be septic. I think this patient may be septic. They have a UTI and they are having trouble breathing now. Don t be afraid to report your concerns to the nurse or charge nurse The nurse or charge will do further assessment and call the physician to obtain additional testing and/or treatment to confirm that the patient has sepsis
WHAT WILL MY ROLE BE IF THE PATIENT IS SEPTIC? The treatment for sepsis includes IV fluids and antibiotics, there may be additional support, such as: Lab work Frequent vitals signs Fall risk due to weakness or confusion Oxygen support Some patients may need surgical intervention Change in diet due to aspiration pneumonia or failed swallow evaluation Continue to work with the nurse to monitor the patient for any changes in condition
WHY IS EARLY RECOGNITION & TREATMENT SO IMPORTANT? Time to start Treatment Evidence shows the longer we delay treatment, we increase the chance for mortality (death) Chance of Survival Kumar A, et al. Crit Care Med. 2006; 34:1589-1596 (as cited in Uslan D, 2014)
HOW CAN I HELP PREVENT SEPSIS? Good handwashing is the key to stopping the spread of infection Wash hands before and after contact with patients or body fluids Assist patient with daily bathing Keeping the skin clean can decrease the chance for infection Get vaccinated to help stop the spread of infection
REMEMBER, SUCCESS DEPENDS ON: Increased awareness of the signs and symptoms of sepsis Know who may be at risk for developing sepsis If a patient has tubes or drains in, they are at risk for developing sepsis If a patient has difficulty swallowing or chokes on their food, they may develop aspiration pneumonia, which can lead to sepsis A patient who just had surgery is at risk for sepsis Anyone with an infection is at risk for developing sepsis Communication is the key to early diagnosis and treatment Notify your nurse or charge nurse if you think a patient may have sepsis Report abnormal vital signs to the nurse immediately (Temp <96.8 or >100.4, heart rate >90, resp rate > 20, or systolic BP <90) Tell the nurse if your patient has a low urine output, confusion, lethargy, shortness of breath, sharp pain
CONTACT, THE SEPSIS COORDINATOR, FOR ANY QUESTIONS
SPECIAL THANKS FOR THE DEVELOPMENT OF THIS EDUCATION MODULE TO: Marlena Gonzales, RN BSN HCA Sepsis Program Coordinator at MountainView