Introduction
Sepsis remains a global public health problem that has not lost its relevance throughout the entire period of the project of this pathological condition. One of the primary goals of nursing care is to minimize the risks associated with complications, such as bacterial infections. In the case of sepsis, it can cause a severe immune response and even death. Therefore, it is important to design and develop effective preventative measures in order to ensure that the septic shocks and related fatalities are reduced by implementing improved evidence-based interventions and protocols by identifying major risk factors.
Purpose and Rationale
The given scholarly project will primarily focus on the lower sepsis mortality rates. The key purpose of the project is to assess and analyze the mortality rate due to sepsis and develop and design measures on the basis of recent interventions, such as EGDT, vasopressin therapy, SOFA with its variations, and biomarker analysis, to prevent, predict, and reduce the severity of the issue. The problem is highly significant in the nursing community since nursing specialists are the main sources of care provision for patients with sepsis, and thus, any form of sepsis-related death reduction strategies cannot be properly implemented without the invaluable input of nursing professionals.
The key benefit of the project will be manifested in the fact that there will be improved outcomes among patients with sepsis in terms of mortality rates, and key risk factors will be identified in order to achieve the overall objective of reduction. The PICOT question: Among older individuals aged 60 and older, how does the use of novel intervention protocols, such as EGDT, vasopressin therapy, SOFA, and its variations, and biomarker analysis, compared to traditional approaches influence the sepsis mortality rates over the course of the disease over 30 days? The scope of the project will aim to cover the selected age group through databases and death certificate information alongside treatment procedures revolving around EGDT, vasopressin therapy, SOFA and its variations, and biomarker analysis in order to determine whether there are critical risk factors, which need to be considered in order to improve the clinical outcomes. The resources required for the project will be mainly allocated for data analysis efforts and data acquisition through various official sources.
It should be noted that the key rationale for the assessment is manifested in the fact that it will benefit in regards to the implementation of best and most effective practice as an intervention to reduce risks associated with septic shock, which will subsequently improve the overall awareness about the problem. The proposed interventions will be focused on recent evidence-based intervention protocols, which include EGDT, vasopressin therapy, SOFA, and its variations, and biomarker analysis. It is important to assess and analyze as well as understand the intricacies of the lower sepsis mortality rates due to the evidence of epidemiological data on the basis of randomized control trials. Research suggests that RCT data analysis demonstrates a gradual decline in septic shock mortality rates for the past two decades, but no major improvements were made when controlling for severity of inclusion in studies (Luhr et al., 2019). In other words, the most accurate and reliable sources of primary data are indicative of the fact that mortality rates did not decline significantly despite all the advancements made in the field of medicine and healthcare in the past decades. Therefore, the lack of improvements in regards to sepsis and related issues serves as a basis and rationale for findings and developing measures to lower the overall mortality rates for sepsis.
Background On the Problem and Population of Interest
The incidence of sepsis in the world is growing every year (Neri, 2020). The increase is facilitated by increasing resistance to antimicrobial drugs, the widespread introduction of new medical technologies, the expansion of indications for cytostatic and immunosuppressive therapy, the development of transplantology and prosthetics. It is important to note that significant progress has been achieved in understanding the general biological mechanisms of the body’s response to bacterial aggression and the alteration associated with the responses. Sepsis is based on the formation of a generalized inflammation reaction initiated by an infectious agent, in response to which there is an uncontrolled release of endogenous inflammatory mediators, a lack of mechanisms limiting their damaging effect is formed, which ultimately are the causes of organ-systemic disorders. Although the current understanding of biological mechanisms behind sepsis and inflammatory responses is significant, the knowledge is not entirely improving the practical aspect of healthcare in regards to timely treatment and diagnosis (Luhr et al., 2019). In addition, the world continues to discuss the definition, diagnosis, and treatment of sepsis, severe sepsis, and septic shock.
The problem of sepsis mortality due to sepsis has existed for a long time and still remains among the top causes of death both worldwide and in the United States. The main emphasis of the research project will be based on recent interventions in regards to sepsis outcome improvements. Evidence suggests that prompt treatment is critical, which can be implemented through early goal-directed therapy or EGDT, which is highly effective in 3 and 6-hour bundles (Lehman, 2019). Another important element of a protocol-based intervention is vasopressor therapy, where angiotensin II is administered through an intravenous infusion with a desired concentration being between 5000 to 10000 nanograms per milliliter (Lehman, 2019). In addition, the utilization of sequential organ failure assessment or SOFA can be highly useful in assessing and identifying the general disease progression in real-time with possible alternatives, such as qSOFA or eSOFA (Rhee et al., 2019). These intervention frameworks can also be used for biomarker monitoring and tracking since these factors serve as strong predictive indicators of sepsis, which also promotes prompt treatment (Lehman, 2019). Therefore, the evidence-based intervention protocol for sepsis EGDT, vasopressin therapy, SOFA and its variations, and biomarker analysis.
In addition, one should also be aware that there are a number of risk factors, which can be targeted throughout the project in order to derive the potential solutions to the sepsis mortality rates, including the lower sepsis. Therefore, the focus of the project will be specifically directed at assessing and implementing evidence-based protocols to reduce sepsis mortality in order to promote better methods of prevention, prediction, and reduction of the problem.
Significance of The Problem to Nursing and Healthcare
It is important to note nursing professionals play a major role in the process of sepsis treatment, which means that integrating novel nursing protocols of care after these patients might inevitably lead to reductions in mortality rates. The new data on the implementation of protocols centered around the use of EGDT, vasopressin therapy, SOFA, and its variations, and biomarker analysis as key interventions for sepsis intervention reduction can be highly effective for reducing the overall mortality rate (Lehman, 2019). The impact of sepsis should not be underestimated since the healthcare costs can be substantial on both healthcare facilities and patients.
Benefits of The Project to Nursing Practice
The key benefit of the project to nursing practice is rooted in the fact that there will be improved outcomes among patients with sepsis in terms of mortality rates, and key risk factors will be identified in order to achieve the overall objective of reduction. Nursing professionals will be able to provide better and more effective care on the basis of evidence in order to promote evidence-based practice, which is an essential framework in the field of nursing.
PICOT and Scope of the Project
Among older individuals aged 60 and older, how does the use of novel intervention protocols, such as EGDT, vasopressin therapy, SOFA with its variations, and biomarker analysis, compared to traditional approaches influence the sepsis mortality rates over the course of the disease over 30 days? The general scope of the project will attempt to assess the issue on the national level by accessing the official databases relevant to the aims of the project. The objective is to conduct a comprehensive data acquisition from reliable sources and analyze the data for potential risk factors, such as socioeconomic and possible nursing protocol improvements, such as supplementations, which will require resources for these tasks.
Conclusion
In conclusion, the purpose of the project is to assess and analyze the sepsis mortality rates in order to develop and design improved nursing care protocols, such as EGDT, vasopressin therapy, SOFA with its variations, and biomarker analysis, for the patients of interest with the goal of lowering the mortality rates from the condition. The presented evidence is strongly indicative of the fact that supplementation and risk factor identification can effectively improve the occurrence of the issues through improved prevention, prediction, and reduction of sepsis mortality rates.
References
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Lehman, K. D. (2019). Evidence-based updates to the 2016 Surviving Sepsis Guidelines and clinical implications. The Nurse Practitioner, 44(2), 26–33.
Luhr, R., Cao, Y., Söderquist, B., & Cajander, S. (2019). Trends in sepsis mortality over time in randomised sepsis trials: A systematic literature review and meta-analysis of mortality in the control arm, 2002–2016. Critical Care, 23(1), 1-9.
Rhee, C., Zhang, Z., Kadri, S. S., Murphy, D. J., Martin, G. S., Overton, E., Seymour, C. W., Angus, D. C., Dantes, R., Epstein, L., Fram, D., Schaaf, R., Wang, R., Klompas, M., & CDC Prevention Epicenters Program (2019). Sepsis surveillance using adult sepsis events simplified eSOFA criteria versus sepsis-3 sequential organ failure assessment criteria. Critical Care Medicine, 47(3), 307–314.