sepsis protocol

[heather in ohio]

I am looking for a Sepsis Protocol or 'bundle' in my hospital- do most hospitals already have this in place? Or some sort of early detection/ screening tool?

Thanks!

[MunoRN, RN]

Surviving Sepsis Campaign | Bundles

[Sun0408, ASN, RN]

We have a bundle to follow if sepsis is an admitting DX. As for detection, once they are admitted or have been inpatient for some time; we do a sepsis screening for each pt during our assessment that is built into our computer system. If they trigger in 2 areas, the pt is watched, if they are flagged with 3 or more triggers we notify the MD and we go from there.

[artisticmind]

Ditto to Sun0408. I work on a PCU and our hospital does a sepsis screen in ER (which nearly every admit on our floor screens positive for because they have increased respirs, HR, and temp but by the time they get to the floor they've had Tylenol, breathing tx, and are calmed down so their HR is down) but we still have our own sepsis screen that we do on the floor. It basically looks for extremely low/high temp, increased respirs and HR, change in LOC, and recent elevated labs (WBC and bglu). If 2 of those come up positive it goes into a secondary screen that looks at additional labs and considerations and asks whether we've called the doc or if they are already aware of the pt's condition.

[Guest 360983]

New York City Severe Sepsis Project

I'm assuming you are in the ICU based on previous posts?

I used this site to help revamp our ER sepsis screening protocol. Definitely check out the Surviving Sepsis campaign. Also, check out the recently publishef ProCESS study, which showed that the Rivers bundle isn't superior to aggressive non - invasive management. Be careful because "usual care" in the ProCESS study isn't universal--my hospital even now doesn't routinely do all those things (even the initial 2 L can be a stretch) so there is still definitely a place for good protocols. We just don't necessarily need CVPs on everyone.

[emtb2rn, BSN, RN, EMT-B]

Surviving Sepsis Campaign | Bundles

We aggressively use the bundles too. ER.

[anon456, BSN, RN]

This is a good question to ask your nurse educator. I'm sure they can point you to the one at your facility.

We have a protocol that all nurses on all floors use to screen patients. If they meet those warning signs (mostly based on vitals) the MD has to be called they need to come to bedside and examine the patient and order tests. In peds sepsis is so scary- the kids compensate for a long time and then suddenly die.