Introduction
Over the past decades, the world community’s interest in the sepsis problem has increased significantly. Despite the achievements of modern fundamental and clinical medicine, sepsis is still characterized by a significant prevalence and high mortality. Every year, it causes more than a million deaths worldwide, with a fatality rate of about one in four. The development of evidence-based intensive care and surgery at the beginning of the 21st century has successfully made treating patients with severe sepsis possible. However, sepsis is still a potentially fatal disease among people.
Sources of Evidence
The core sources of evidence used for this study include mainly primary research evidence obtained from relevant scholarly articles and the associated academic resources, as well as state authorities’ reports on the subject matter. The described approach to data collection has allowed for an accurate representation of the use of sepsis bundles as tools for addressing instances of sepsis in adults. Specifically, sepsis bundles as sets of tools and resources for addressing the immediate needs of patients with sepsis were centered in the studies in question, which has allowed for the collection of accurate and trustworthy data (Divatia & Khan, 2010; Martin et al., 2022). The specified range of information sources has allowed for an accurate representation of the issue, the identification of core concerns, and the opportunity to suggest several viable solutions.
Evidence of Findings
Prior to identifying the core evidence regarding the use of sepsis bundles, one must consider the manner in which they function and the opportunities that they provide. Specifically, in adults, sepsis bundles allow for minimizing the inflammation and the resulting coagulation of a patient’s blood, minimizing the threats associated with sepsis shock and preventing fatal outcomes from taking place, as Barbash et al. (2019) warn. Specifically, the systemic inflammatory response syndrome caused by the development of sepsis in adults is managed successfully with the help of sepsis bundles (“Safer Care Victoria,” 2020). The described goal is achieved by drawing the relevant blood cultures and measuring lactate levels in patients to determine the threat of fluid-responsive hypoperfusion as the key prerequisite to sepsis shock and the associated processes (Barbash et al., 2019). Namely, the specified tools allow for restoring the patient’s homeostasis in the clinical context by introducing opportunities for managing the fluid levels and, therefore, preventing hypotension from taking place. Therefore, sepsis bundles are utilized primarily to mitigate immediate premises for the development of sepsis and ensure that appropriate long-term measures are taken.
In turn, the available evidence proves that the effectiveness of sepsis bundles in adults varies from case to case. For instance, according to Barbash et al. (2019), the existing framework for sepsis bundle application for adults can be considered an important missed opportunity. Additionally, one should keep in mind that the range of sepsis bundles is quite large, with the time of their application varying significantly (Hotchkiss et al., 2016). Specifically, one-, three-, and six-hour sepsis bundles are currently used in clinical settings (Barbash et al., 2019). The integration of the specified bundles has been reported to deliver quite positive results in addressing the development of sepsis in patients (Craft et al., 2018; Marik, 2015). Finally, the existing taxonomy of sepsis bundles suggests that the specified tools provide extensive flexibility for addressing complex cases and, therefore, need to be incorporated into the clinical context as essential factors in preventing and addressing sepsis in patients and mitigating the adverse effects thereof. Specifically, the presence of the lactate collection bundle, the collection of blood cultures, administration of antibiotics, and fluid resuscitation bundles must be seen as core types of sepsis bundles (Mohr et al., 2021).
Analysis of Findings
The provided evidence has offered substantial food for thought. Specifically, the findings of the studies under analysis indicate that the current frameworks for using sepsis bundles in adult patients is mostly beneficial, which is why the failure to deploy them accordingly represents a major missed opportunity (Barbash et al., 2019). Examining the specified statement further, one will recognize the issue of the lack of homogeneity in applying sepsis bundles across hospitals in the U.S., which prevents the integration of sepsis bundles and their coherent update on a nationwide level (Lee et al., 2022). Thus, given the reported efficacy of the specified tool, policies allowing for a coherent approach to deploying sepsis bundles in the clinical context are needed (Morton & Fontaine, 2017). With the help of the specified initiative, an established standard in integrating sepsis bundles into the clinical context can be set, leading to improved care and a better opportunity for controlling the outcomes.
At the same time, the existing variety in sepsis bundles should not be mistaken for their lack of homogeneity. Specifically, the uses for one-, three-, and six-hour sepsis bundles are quite different, being applied to specific cases. For instance, Kalantari and Rezaie (2019) report that three-hour bundles are more effective in patients who have not developed septic shock. Therefore, the variety in the existing range of sepsis bundles and the relevant toolkits must be considered a substantial advantage that supports the idea of their significance in the clinical environment. Overall, it is highly recommended to introduce the specified bundles into the general framework for managing and preventing sepsis in hospitals across the state to minimize the risk of fatal outcomes in patients and create a safer environment for them. Based on the studies considered above, the contents of the existing sepsis bundles need to be tweaked slightly to ensure that the issue is diagnosed accurately and that a proper bundle is selected as a reasonable solution. Specifically, the quality of hemodynamics in a patient must be evaluated as a critical part of a sepsis bundle to enhance the efficacy of the following intervention. Afterward, the choice of an intravenous medication for counteracting the factors causing sepsis must be made with the help of a sepsis bundle. Finally, tools for administering the intervention and further controlling the patient’s health status must be considered vital components of a sepsis bundle.
Conclusion
An analysis of scientific data shows that the study of epidemiological indicators and risk factors that contribute to the development of sepsis are the most critical areas of work for world health to develop a strategy for the prevention of sepsis. In recent years, there has been an increase in the incidence of sepsis and an increase in the percentage of deaths from septic shock. In this regard, the cost of treating patients with sepsis is significant for the health care of any country. In addition, special attention should be paid to the spread of sepsis in adults since the disease phenotype changes depending on various factors.
Recommendations
- Further assessment of the patient’s hemodynamics to determine the type of shock in the case, when the clinical picture does not lead to a precise diagnosis;
- Establish a program in hospitals to improve the quality of care for sepsis, which would include its screening in patients with severe illness and patients at high risk;
- In patients with sepsis/septic shock, the specific anatomical source of infection should be identified and scanned, and all necessary decontamination of that source must be undertaken once the diagnosis is made;
- Intravenous antimicrobials should be started as soon as the pathogen is identified;
- In the case of septic shock, initial empiric combination antibiotic therapy should target the more likely spectrum of pathogens.
- Addressing the levels of hypotension by managing fluid-responsive evaluation as an aspect of the disease’s pathogenesis should be considered a critical opportunity to use with the help of sepsis bundles.
References
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Craft, J., Gordon, C., Huether, S.E., McCance, K., Brashers, V.L., & Rote, N.S. (2018). Understanding pathophysiology: Australia and New Zealand edition (3rd ed.). Elsevier Australia.
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Martin, G., Brunkhorst, F. M., Janes, J. M., Reinhart, K., Sundin, D. P., Garnett, K., & Beale, R. (2022). The International Progress Registry of patients with severe sepsis: Drotrecogin Alfa (activated) use and patient outcomes. Critical Care, 13(3), 1-14. Web.
Mohr, N. M., Campbell, K. D., Swanson, M. B., Ullrich, F., Merchant, K. A., & Ward, M. M. (2021). Provider-to-provider telemedicine improves adherence to sepsis bundle care in community emergency departments. Journal of Telemedicine and Telecare, 27(8), 518-526. Web.
Morton, P.G., & Fontaine, D.K. (2017). Critical care nursing: A holistic approach (11th ed.). Wolters Kluwer Health.
Safer care Victoria. (2020). Web.