As legal nurse consultants in support of our attorney clients, we have a vital role in ensuring that healthcare providers meet the standards of care for patients, especially in cases involving sepsis and pressure injuries. The Centers for Disease Control and Prevention’s (CDC) recently issued Sepsis Care Guidelines for hospitals, highlighting the urgent need for improved sepsis management. In this blog post, I will discuss the significance of these guidelines, the challenges of sepsis diagnosis and treatment, and how we can make a difference in patient outcomes.
Sepsis: A Life-Threatening Condition
According to the CDC, sepsis affects approximately 1.7 million adults in the United States annually, resulting in 350,000 deaths or hospice admissions. It is a complex and potentially life-threatening condition that can arise from various external and internal risk factors. Early recognition and prompt treatment are crucial in preventing severe organ damage and reducing mortality rates. Unfortunately, pressure injuries are a common complication of sepsis, posing additional risks to patients’ health and quality of life.
Hospital Sepsis Care Program: Seven Core Elements
The CDC’s Sepsis Care Guidelines emphasize the importance of a coordinated approach to sepsis management (Hospital Sepsis Program Core Elements (cdc.gov). The Hospital Sepsis Care Program consists of seven core elements: leadership, accountability, multi-professional expertise, action, tracking, reporting, education, and resources. These elements aim to promote recognition, awareness, prevention, and treatment of sepsis, ensuring that patients receive optimal care within the micro-environment of bedside care.
Nursing Process and Standardized Protocols
As nurses, we play a vital role in sepsis management. The nursing process, framed by authentic leadership and interprofessional expertise, is essential for delivering safe and effective care. Standardized protocols, such as checklists, can help streamline the process and ensure that all steps are taken to address sepsis. By establishing a baseline and benchmarking progress over time, we can measure the success of our efforts and continue improving patient outcomes. A recent retrospective, observational cohort study this month in JAMA (Melhammar et al., 2023), open access, shares epidemiological data linking population-based hospital databases with information with medical records to reveal the incidence of sepsis in Sweden. What makes this challenging is that Sepsis is often not documented as an explicit ICD code for sepsis, which impacts the sensitivity of measurement. This study does inform the burden that sepsis carries for public health.
Association of Sepsis and Pressure Injuries
Pressure injuries are a common consequence of sepsis, particularly when patients require prolonged hospital stays and invasive treatments. As legal nurse consultants, we must consider the relationship between sepsis and pressure injuries when analyzing medical malpractice cases. Avoidability of pressure injuries is a critical factor in determining whether the standard of care has been met. Patients with sepsis are vulnerable to pressure injuries due to their compromised circulatory system, which may necessitate the use of vasopressors and steroids. Pressure injuries never develop in isolation. Even with proper care, some patients may still develop pressure injuries, underscoring the importance of vigilant monitoring and taking the initiative in proactive treatment.
Raising Awareness and Educating Colleagues
This September, let us commit to reading and sharing articles, papers, or news items about sepsis. By doing so, we can educate ourselves and our colleagues, raising awareness about this critical issue. As legal nurse consultants and wound care experts, we are uniquely positioned to lead the way in connecting the dots between sepsis and pressure injuries. Together, we can advocate for better patient care and improved outcomes.
The updated Sepsis Care Guidelines serve as a reminder of the need for heightened attention to sepsis management. As legal nurse consultants, we must remain informed and proactive in promoting excellence in patient care. By embracing the seven core elements of the Hospital Sepsis Care Program and recognizing the link between sepsis and pressure injuries, we can make a meaningful difference in the lives of patients and their families. Let us collaborate to advance sepsis care and reduce the risk of pressure injuries, ultimately enhancing the quality of life for those affected by this life-threatening condition.
Mellhammar, Lisa, Erik Wollter, Jacob Dahlberg, Benjamin Donovan, Carl-Johan Olséen, Per Ola Wiking, Norman Rose, et al. “Estimating Sepsis Incidence Using Administrative Data and Clinical Medical Record Review.” JAMA Network Open 6, no. 8 (August 29, 2023): e2331168. https://doi.org/10.1001/jamanetworkopen.2023.31168.