Optimizing Sepsis care in the Emergency Department: Integrating Nursing, Pharmacy, and Laboratory Sciences
Main Article Content
Keywords
nursing, pharmacy, laboratory, optimizing, sepsis, care, emergency, department.
Abstract
Sepsis often prompts patients to seek immediate medical attention in the emergency room and then be admitted to the hospital. Given its frequency, it is accountable for a substantial number of deaths annually. The Surviving Sepsis Campaign has improved the results of sepsis by advocating for enhanced standards of identification and treatment.
Aim of work: To explore the role of integrating nursing, pharmacy, and laboratory in optimizing sepsis care in the emergency department.
Methods: We conducted a comprehensive search in the MEDLINE database's electronic literature using the following search terms: nursing, pharmacy, laboratory, optimizing, sepsis, care, emergency, and department. The search was restricted to publications from 2016 to 2024 in order to locate relevant content. I performed a search on Google Scholar to locate and examine academic papers that pertain to my subject matter. The selection of articles was impacted by certain criteria for inclusion.
Results: The publications analyzed in this study encompassed from 2016 to 2024. The study was structured into various sections with specific headings in the discussion section.
Conclusion: Research indicates that implementing treatments for sepsis can improve adherence to protocols and outcomes. However, determining the most beneficial interventions is challenging. A systematic and protocol-driven strategy is needed to manage sepsis patients in emergency departments. Artificial intelligence and machine learning are emerging in sepsis treatments, aiding in the detection of patients and developing appropriate treatment regimens. Future studies should employ randomized designs, incorporating process and patient outcome parameters, and have a long follow-up period. Cost-benefit evaluations are crucial, as the implementation and maintenance of these treatments require significant healthcare commitment. Treatments must demonstrate long-term viability and expand to other hospitals
References
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Abe, T., Ogura, H., Shiraishi, A., Kushimoto, S., Saitoh, D., Fujishima, S., ... & Gando, S. (2018). Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study. Critical Care, 22, 1-12.
Afshar, M., Arain, E., Ye, C., Gilbert, E., Xie, M., Lee, J., ... & Joyce, C. (2019). Patient outcomes and cost-effectiveness of a sepsis care quality improvement program in a health system. Critical care medicine, 47(10), 1371-1379.
Austrian, J. S., Jamin, C. T., Doty, G. R., & Blecker, S. (2018). Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay. Journal of the American Medical Informatics Association, 25(5), 523-529.
Brink, A., Alsma, J., Verdonschot, R. J. C. G., Rood, P. P. M., Zietse, R., Lingsma, H. F., & Schuit, S. C. E. (2019). Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PloS one, 14(1), e0211133.
Burrell, A. R., McLaws, M. L., Fullick, M., Sullivan, R. B., & Sindhusake, D. (2016). SEPSIS KILLS: early intervention saves lives. Medical Journal of Australia, 204(2), 73-73.
Caraballo, C., & Jaimes, F. (2019). Focus: Death: Organ dysfunction in sepsis: An ominous trajectory from infection to death. The Yale journal of biology and medicine, 92(4), 629.
Cecconi, M., Evans, L., Levy, M., & Rhodes, A. (2018). Sepsis and septic shock. The Lancet, 392(10141), 75-87.
Custo, R. T., & Trapani, J. (2020). The impact of rapid response systems on mortality and cardiac arrests–A literature review. Intensive and Critical Care Nursing, 59, 102848.
De Backer, D., & Dorman, T. (2017). Surviving sepsis guidelines: a continuous move toward better care of patients with sepsis. Jama, 317(8), 807-808.
Delawder, J. M., & Hulton, L. (2020). An interdisciplinary code sepsis team to improve sepsis-bundle compliance: a quality improvement project. Journal of Emergency Nursing, 46(1), 91-98.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., ... & Levy, M. (2021). Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Critical care medicine, 49(11), e1063-e1143.
Fernando, S. M., Rochwerg, B., & Seely, A. J. (2018). Clinical implications of the third international consensus definitions for sepsis and septic shock (Sepsis-3). Cmaj, 190(36), E1058-E1059.
Freund, Y., Khoury, A., Möckel, M., Karamercan, M., Dodt, C., Leach, R., ... & Garcia-Castrillo, L. (2019). European Society of Emergency Medicine position paper on the 1-hour sepsis bundle of the Surviving Sepsis Campaign: expression of concern. European Journal of Emergency Medicine, 26(4), 232-233.
González Del Castillo, J., Julian-Jiménez, A., González-Martínez, F., Álvarez-Manzanares, J., Piñera, P., Navarro-Bustos, C., ... & representing the Infectious Disease Group of the Spanish Emergency Medicine Society (see addendum). (2017). Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department. European Journal of Clinical Microbiology & Infectious Diseases, 36, 2361-2369.
Goulden, R., Hoyle, M. C., Monis, J., Railton, D., Riley, V., Martin, P., ... & Nsutebu, E. (2018). qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis. Emergency Medicine Journal, 35(6), 345-349.
Grek, A., Booth, S., Festic, E., Maniaci, M., Shirazi, E., Thompson, K., ... & Moreno Franco, P. (2017). Sepsis and shock response team: impact of a multidisciplinary approach to implementing surviving sepsis campaign guidelines and surviving the process. American Journal of Medical Quality, 32(5), 500-507.
Harrison, A. M., Gajic, O., Pickering, B. W., & Herasevich, V. (2016). Development and implementation of sepsis alert systems. Clinics in chest medicine, 37(2), 219-229.
Hernández, G., Ospina-Tascón, G. A., Damiani, L. P., Estenssoro, E., Dubin, A., Hurtado, J., ... & Bakker, J. (2019). Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK randomized clinical trial. Jama, 321(7), 654-664.
Ju, T., Al-Mashat, M., Rivas, L., & Sarani, B. (2018). Sepsis rapid response teams. Critical care clinics, 34(2), 253-258.
Levin, A., & Constas, A. (2020). Rapid response systems across multisite locations of a pediatric hospital system: Patient characteristics matter most. Hospital Pediatrics, 10(7), 628-630.
Levy, M. M., Evans, L. E., & Rhodes, A. (2018). The surviving sepsis campaign bundle: 2018 update. Intensive care medicine, 44, 925-928.
McDonald, C. M., West, S., Dushenski, D., Lapinsky, S. E., Soong, C., Van den Broek, K., ... & Morris, A. (2018). Sepsis now a priority: a quality improvement initiative for early sepsis recognition and care. International Journal for Quality in Health Care, 30(10), 802-809.
Napolitano, L. M. (2018). Sepsis 2018: definitions and guideline changes. Surgical infections, 19(2), 117-125.
Pepper, D. J., Jaswal, D., Sun, J., Welsh, J., Natanson, C., & Eichacker, P. Q. (2018). Evidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1) A Systematic Review. Annals of internal medicine, 168(8), 558-568.
Prasad, P. A., Fang, M. C., Abe-Jones, Y., Calfee, C. S., Matthay, M. A., & Kangelaris, K. N. (2020). Time to recognition of sepsis in the emergency department using electronic health record data: a comparative analysis of systemic inflammatory response syndrome, sequential organ failure assessment, and quick sequential organ failure assessment. Critical care medicine, 48(2), 200-209.
Quinten, V. M., van Meurs, M., Wolffensperger, A. E., Ter Maaten, J. C., & Ligtenberg, J. J. (2018). Sepsis patients in the emergency department: stratification using the Clinical Impression Score, Predisposition, Infection, Response and Organ dysfunction score or quick Sequential Organ Failure Assessment score?. European Journal of Emergency Medicine, 25(5), 328-334.
Rhee, C., Jones, T. M., Hamad, Y., Pande, A., Varon, J., O’Brien, C., ... & Klompas, M. (2019). Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals. JAMA network open, 2(2), e187571-e187571.
Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., ... & Dellinger, R. P. (2017). Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive care medicine, 43, 304-377.
Serafim, R., Gomes, J. A., Salluh, J., & Póvoa, P. (2018). A comparison of the quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis. Chest, 153(3), 646-655.
Sherwin, R., Winters, M. E., Vilke, G. M., & Wardi, G. (2017). Does early and appropriate antibiotic administration improve mortality in emergency department patients with severe sepsis or septic shock?. The Journal of emergency medicine, 53(4), 588-595.
Uffen, J. W., Oosterheert, J. J., Schweitzer, V. A., Thursky, K., Kaasjager, H. A. H., & Ekkelenkamp, M. B. (2021). Interventions for rapid recognition and treatment of sepsis in the emergency department: a narrative review. Clinical Microbiology and Infection, 27(2), 192-203.
Umberger, R., Indranoi, C. Y., Simpson, M., Jensen, R., Shamiyeh, J., & Yende, S. (2019). Enhanced screening and research data collection via automated EHR data capture and early identification of sepsis. SAGE Open Nursing, 5, 2377960819850972.
Young, R. (2021). Improving Patient Sepsis Outcomes Using Society of Critical Care Medicine Sepsis Bundle Guidelines to Improve Sepsis Mortality Rates (Doctoral dissertation, Grand Canyon University).
Abe, T., Ogura, H., Shiraishi, A., Kushimoto, S., Saitoh, D., Fujishima, S., ... & Gando, S. (2018). Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study. Critical Care, 22, 1-12.
Afshar, M., Arain, E., Ye, C., Gilbert, E., Xie, M., Lee, J., ... & Joyce, C. (2019). Patient outcomes and cost-effectiveness of a sepsis care quality improvement program in a health system. Critical care medicine, 47(10), 1371-1379.
Austrian, J. S., Jamin, C. T., Doty, G. R., & Blecker, S. (2018). Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay. Journal of the American Medical Informatics Association, 25(5), 523-529.
Brink, A., Alsma, J., Verdonschot, R. J. C. G., Rood, P. P. M., Zietse, R., Lingsma, H. F., & Schuit, S. C. E. (2019). Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PloS one, 14(1), e0211133.
Burrell, A. R., McLaws, M. L., Fullick, M., Sullivan, R. B., & Sindhusake, D. (2016). SEPSIS KILLS: early intervention saves lives. Medical Journal of Australia, 204(2), 73-73.
Caraballo, C., & Jaimes, F. (2019). Focus: Death: Organ dysfunction in sepsis: An ominous trajectory from infection to death. The Yale journal of biology and medicine, 92(4), 629.
Cecconi, M., Evans, L., Levy, M., & Rhodes, A. (2018). Sepsis and septic shock. The Lancet, 392(10141), 75-87.
Custo, R. T., & Trapani, J. (2020). The impact of rapid response systems on mortality and cardiac arrests–A literature review. Intensive and Critical Care Nursing, 59, 102848.
De Backer, D., & Dorman, T. (2017). Surviving sepsis guidelines: a continuous move toward better care of patients with sepsis. Jama, 317(8), 807-808.
Delawder, J. M., & Hulton, L. (2020). An interdisciplinary code sepsis team to improve sepsis-bundle compliance: a quality improvement project. Journal of Emergency Nursing, 46(1), 91-98.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., ... & Levy, M. (2021). Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Critical care medicine, 49(11), e1063-e1143.
Fernando, S. M., Rochwerg, B., & Seely, A. J. (2018). Clinical implications of the third international consensus definitions for sepsis and septic shock (Sepsis-3). Cmaj, 190(36), E1058-E1059.
Freund, Y., Khoury, A., Möckel, M., Karamercan, M., Dodt, C., Leach, R., ... & Garcia-Castrillo, L. (2019). European Society of Emergency Medicine position paper on the 1-hour sepsis bundle of the Surviving Sepsis Campaign: expression of concern. European Journal of Emergency Medicine, 26(4), 232-233.
González Del Castillo, J., Julian-Jiménez, A., González-Martínez, F., Álvarez-Manzanares, J., Piñera, P., Navarro-Bustos, C., ... & representing the Infectious Disease Group of the Spanish Emergency Medicine Society (see addendum). (2017). Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department. European Journal of Clinical Microbiology & Infectious Diseases, 36, 2361-2369.
Goulden, R., Hoyle, M. C., Monis, J., Railton, D., Riley, V., Martin, P., ... & Nsutebu, E. (2018). qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis. Emergency Medicine Journal, 35(6), 345-349.
Grek, A., Booth, S., Festic, E., Maniaci, M., Shirazi, E., Thompson, K., ... & Moreno Franco, P. (2017). Sepsis and shock response team: impact of a multidisciplinary approach to implementing surviving sepsis campaign guidelines and surviving the process. American Journal of Medical Quality, 32(5), 500-507.
Harrison, A. M., Gajic, O., Pickering, B. W., & Herasevich, V. (2016). Development and implementation of sepsis alert systems. Clinics in chest medicine, 37(2), 219-229.
Hernández, G., Ospina-Tascón, G. A., Damiani, L. P., Estenssoro, E., Dubin, A., Hurtado, J., ... & Bakker, J. (2019). Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK randomized clinical trial. Jama, 321(7), 654-664.
Ju, T., Al-Mashat, M., Rivas, L., & Sarani, B. (2018). Sepsis rapid response teams. Critical care clinics, 34(2), 253-258.
Levin, A., & Constas, A. (2020). Rapid response systems across multisite locations of a pediatric hospital system: Patient characteristics matter most. Hospital Pediatrics, 10(7), 628-630.
Levy, M. M., Evans, L. E., & Rhodes, A. (2018). The surviving sepsis campaign bundle: 2018 update. Intensive care medicine, 44, 925-928.
McDonald, C. M., West, S., Dushenski, D., Lapinsky, S. E., Soong, C., Van den Broek, K., ... & Morris, A. (2018). Sepsis now a priority: a quality improvement initiative for early sepsis recognition and care. International Journal for Quality in Health Care, 30(10), 802-809.
Napolitano, L. M. (2018). Sepsis 2018: definitions and guideline changes. Surgical infections, 19(2), 117-125.
Pepper, D. J., Jaswal, D., Sun, J., Welsh, J., Natanson, C., & Eichacker, P. Q. (2018). Evidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1) A Systematic Review. Annals of internal medicine, 168(8), 558-568.
Prasad, P. A., Fang, M. C., Abe-Jones, Y., Calfee, C. S., Matthay, M. A., & Kangelaris, K. N. (2020). Time to recognition of sepsis in the emergency department using electronic health record data: a comparative analysis of systemic inflammatory response syndrome, sequential organ failure assessment, and quick sequential organ failure assessment. Critical care medicine, 48(2), 200-209.
Quinten, V. M., van Meurs, M., Wolffensperger, A. E., Ter Maaten, J. C., & Ligtenberg, J. J. (2018). Sepsis patients in the emergency department: stratification using the Clinical Impression Score, Predisposition, Infection, Response and Organ dysfunction score or quick Sequential Organ Failure Assessment score?. European Journal of Emergency Medicine, 25(5), 328-334.
Rhee, C., Jones, T. M., Hamad, Y., Pande, A., Varon, J., O’Brien, C., ... & Klompas, M. (2019). Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals. JAMA network open, 2(2), e187571-e187571.
Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., ... & Dellinger, R. P. (2017). Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive care medicine, 43, 304-377.
Serafim, R., Gomes, J. A., Salluh, J., & Póvoa, P. (2018). A comparison of the quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis. Chest, 153(3), 646-655.
Sherwin, R., Winters, M. E., Vilke, G. M., & Wardi, G. (2017). Does early and appropriate antibiotic administration improve mortality in emergency department patients with severe sepsis or septic shock?. The Journal of emergency medicine, 53(4), 588-595.
Uffen, J. W., Oosterheert, J. J., Schweitzer, V. A., Thursky, K., Kaasjager, H. A. H., & Ekkelenkamp, M. B. (2021). Interventions for rapid recognition and treatment of sepsis in the emergency department: a narrative review. Clinical Microbiology and Infection, 27(2), 192-203.
Umberger, R., Indranoi, C. Y., Simpson, M., Jensen, R., Shamiyeh, J., & Yende, S. (2019). Enhanced screening and research data collection via automated EHR data capture and early identification of sepsis. SAGE Open Nursing, 5, 2377960819850972.
Young, R. (2021). Improving Patient Sepsis Outcomes Using Society of Critical Care Medicine Sepsis Bundle Guidelines to Improve Sepsis Mortality Rates (Doctoral dissertation, Grand Canyon University).
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Apr 23, 2022
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Ali Mohamed Abomughayedh7 Abdullah Ghanem Almutairi8 Ahmed Sulaiman Muaytiq Alotaibi9 Tariq Abdulaziz Alshehri10 Ahmed Ali Ali Mesfer Alalyani11 Salim Hassan Mohamed Sahari12, A. A. J. A. J. A. . M. A. S. I. A. M. B. 3 H. H. A. 4 Y. H. H. A. 5 M. A. A. A. 6. (2022). Optimizing Sepsis care in the Emergency Department: Integrating Nursing, Pharmacy, and Laboratory Sciences. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1266-1276. https://doi.org/10.53555/jptcp.v29i04.5790
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Ali Mohamed Abomughayedh7 Abdullah Ghanem Almutairi8 Ahmed Sulaiman Muaytiq Alotaibi9 Tariq Abdulaziz Alshehri10 Ahmed Ali Ali Mesfer Alalyani11 Salim Hassan Mohamed Sahari12, A. A. J. A. J. A. . M. A. S. I. A. M. B. 3 H. H. A. 4 Y. H. H. A. 5 M. A. A. A. 6. (2022). Optimizing Sepsis care in the Emergency Department: Integrating Nursing, Pharmacy, and Laboratory Sciences. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1266-1276. https://doi.org/10.53555/jptcp.v29i04.5790