Nursing considerations to complement the Surviving Sepsis Campaign guidelines

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Title Nursing considerations to complement the Surviving Sepsis Campaign guidelines
Author Aitken, Leanne Maree; Williams, Gerald; Harvey, Maurene; Blot, Stijn; Kleinpell, Ruth; Labeau, Sonia; Marshall, Andrea; Ray-Barruel, Gillian Anne; Moloney-Harmon, Patricia; Robson, Wayne; Johnson, Alexander P; Lan, Pang Nguk; Ahrens, Tom
Journal Name Critical Care Medicine
Editor Joseph E Parrillo
Year Published 2011
Place of publication United States
Publisher Lippincott Williams & Wilkins
Abstract Objectives: To provide a series of recommendations based on the best available evidence to guide clinicians providing nursing care to patients with severe sepsis., Design: Modified Delphi method involving international experts and key individuals in subgroup work and electronic-based discussion among the entire group to achieve consensus., Methods: We used the Surviving Sepsis Campaign guidelines as a framework to inform the structure and content of these guidelines. We used the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system to rate the quality of evidence from high (A) to very low (D) and to determine the strength of recommendations, with grade 1 indicating clear benefit in the septic population and grade 2 indicating less confidence in the benefits in the septic population. In areas without complete agreement between all authors, a process of electronic discussion of all evidence was undertaken until consensus was reached. This process was conducted independently of any funding., Results: Sixty-three recommendations relating to the nursing care of severe sepsis patients are made. Prevention recommendations relate to education, accountability, surveillance of nosocomial infections, hand hygiene, and prevention of respiratory, central line-related, surgical site, and urinary tract infections, whereas infection management recommendations related to both control of the infection source and transmission-based precautions. Recommendations related to initial resuscitation include improved recognition of the deteriorating patient, diagnosis of severe sepsis, seeking further assistance, and initiating early resuscitation measures. Important elements of hemodynamic support relate to improving both tissue oxygenation and macrocirculation. Recommendations related to supportive nursing care incorporate aspects of nutrition, mouth and eye care, and pressure ulcer prevention and management. Pediatric recommendations relate to the use of antibiotics, steroids, vasopressors and inotropes, fluid resuscitation, sedation and analgesia, and the role of therapeutic end points., Conclusion: Consensus was reached regarding many aspects of nursing care of the severe sepsis patient. Despite this, there is an urgent need for further evidence to better inform this area of critical care.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1097/CCM.0b013e31821867cc
Copyright Statement Copyright 2011 LWW. This is a non-final version of an article published in final form in Critical Care Medicine, Volume 39 - Issue 7 - pp 1800-1818. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.
Volume 39
Issue Number 7
Page from 1800
Page to 1818
ISSN 0090-3493
Date Accessioned 2011-07-20
Date Available 2012-09-14T00:50:54Z
Language en_US
Research Centre Griffith Health Institute; Centre for Health Practice Innovation
Faculty Griffith Health Faculty
Subject Clinical Nursing: Secondary (Acute Care)
URI http://hdl.handle.net/10072/41408
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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