Recognition and management of sepsis: the nurse's role

Sepsis can be defined as a life-threatening organ dysfunction that is caused by a dysregulated host response to infection (Singer et al, 2016). Despite notable improvements in our understanding of the pathophysiology of sepsis, innovations in haemodynamic monitoring and methods of resuscitation, as well as pharmacological and surgical interventions, it remains one of the major causes of morbidity and mortality in critically ill patients. The global incidence of this clinical syndrome has been placed at 30 million patients each year with up to 6 million deaths. In the UK, this translates to 200 000 cases, 70% of which arise in the community and an estimated 52 000 deaths (Daniels and Nutbeam, 2019:9). The annual economic burden may be as high as £2 billion and this may rise to £15.6 billion if the long-term effects on survivors is taken into account (Daniels and Nutbeam, 2019:10). Despite the significant morbidity, mortality and economic costs associated with sepsis, 10 000 deaths are thought to be preventable and the care improved in 2 out of 3 patients (NHS England, 2015). It is generally agreed that the crux of improving outcomes associated with sepsis is its early identification, coupled with prompt diagnostic testing, antimicrobial therapy and haemodynamic resuscitation (Wentowski et al, 2018). In essence, it is vital to recognise and act before significant organ failure has occurred. Early appropriate management saves lives. Delay costs lives. Sepsis is life-threatening and time-critical (Daniels and Nutbeam, 2019:53).