Answer 3 for DNP 801 Describe your proposed practice site and a potential patient practice problem that you are interested in exploring for your project

Answer 3 for DNP 801 Describe your proposed practice site and a potential patient practice problem that you are interested in exploring for your project

I work in a small hospital in Fresno, California and we only serve our Veterans. My proposed practice site will be at Veterans Administration Central California Health Care System. My proposed DPI project that I chose is reducing mortality from severe sepsis and septic shock in inpatient setting. Sepsis, a syndrome of physiologic, pathologic, and biochemical abnormalities induced by infection, is a major public health concern, accounting for more than $20billion (5.2%) of total US hospital costs in 2011 (Signer et al, 2016). Septic shock is the most severe complication of sepsis that has a high mortality in any hospital setting. I would like to improve our educational intervention and implement better ways to identify early detection of severe sepsis and septic shock. At work, we don’t have enough established protocols and treatment guidelines that we practice. Patients that experience sepsis rapidly can develop severe sepsis and septic shock and becomes very ill and has little time to improve their condition. I’ve noticed in our institution there are significant delay patient outcomes after identifying of sepsis. Partly, because lack of standardization to the approach of septic patient, extended stay in the emergency department, no standardized protocol, no guidelines to follow and disagreement with health care providers.

Identifying early detection of sepsis can improve patient outcome and this will greatly help our care for our patients. Early recognition of septic patient combined with quick and proper treatment can improve morbidity and mortality that could reduce death. Compliance with all the health care providers has a great impact in providing right care for septic patients. I believe that choosing this project can improve our patient quality care in our medical center. It is important for clinicians to assess patient condition, laboratory tests, timely antibiotic treatment administration, vasopressors if needed and fluid resuscitation. The management of septic shock and severe sepsis is best acquired with interdisciplinary team uniting with each other.

After completing this DPI project I am hoping that it will help nurses to be proactive in recognizing early signs of sepsis. It will provide a clear link to improve knowledge, competence, critical thinking and skill performance for clinicians. With the classification of sepsis our facility will be able to train clinical providers in identifying early detection of sepsis. Early diagnosis and proper treatment management of sepsis are important to increase of survival.

References:

Elfeky S, Golabi P, Otgonsuren M, Djurkovic S, Schmidt ME, Younossi ZM. The epidemiologic characteristics, temporal trends, predictors of death, and discharge disposition in patients with a diagnosis of sepsis: A cross-sectional retrospective cohort study. J Crit Care. 2017 Jun;39:48-55. [PubMed]

Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management. British Medical Journal 2016.

Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., & … Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, (8), 801.

World Health Organization. WHO Report on the burden of endemic health care-associated infection worldwide. 2017-11-21 15:11:22 2011.