Copyright 2012, SLACK Incorporated. Conclusions: Nurses play a critical role in detecting early sepsis-related manifestations and improving adherence to implementation of early goal-directed therapy. J Contin Educ Nurs. The adjusted odds ratio for mortality improved the longer a site was in the Campaign, resulting in an adjusted absolute drop of 0.8% per quarter and 5.4% over 2 years (95% CI, 2.5-8.4%). 3. All rights reserved. 8600 Rockville Pike To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock, published in 2004. Aim: Nurses have an important role in early recognition of sepsis. A strong recommendation (1) indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost) or clearly do not. Se As a result, sepsis screening can be integrated as part of routine patient assessments and patient care rounds [ 1 ]. 2014 Mar;9(1):79-89. doi: 10.1111/opn.12027. 1. The analysis and results of the needs Definition Sepsis is a life-threatening condition that arises when the body's response to an infection damages its own tissues and organs. The Campaign was associated with sustained, continuous quality improvement in sepsis care. Compliance with the entire management bundle started at 18.4% in the first quarter and increased to 36.1% by the end of 2 years (P = 0.008). A validated survey was distributed to 122 critical care nurses at one 320-bed academic institution with a sepsis protocol advocating intravenous(IV) antibiotic initiation within 1hour of shock recognition. Methods: The RCN recognises the importance of the identification, management and prevention where possible of sepsis. By working with nursing management, these staff nurses expanded their professional skills and enhanced clinical practice at their institution. Reassess Over the course of the seven-year pre- to postintervention evaluation period, ED sepsis bundle adherence increased from 40.5% to 73.7% (P < 0.001), with a mean triage to antibiotic time of 80 minutes. In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B), targeting a blood glucose < 150 mg/dL after initial stabilization (2C); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). 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