| Sepsis Medications | SIRS Criteria/Infection | Organ Dysfunction | Sepsis Screening Tool | Miscellaneous |
|---|---|---|---|---|
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What is 30mL/kg IV fluid bolus?
In addition to lactate, repeat lactate, blood cultures and IV antibiotics, I am required for all patients with septic shock
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What is on daily prednisone, HIV positive?
An example of an immunocompromised patient.
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What is only measurable and recorded UOP of 0.5mL/kg/hr x2hrs?
UOP is only considered an organ dysfunction when it meets these criteria.
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What is 48 hours after the first was sent; don’t forget to advocate for TWO sets of blood cultures!
If a patient screens positive per Nursing Protocol but has already had 1 set of blood cultures sent, I am the time frame for sending two more.
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What is IVF bolus, antibiotics, vasopressors if needed, and perfusion assessment?
Physician responsibilities when a patient screens positive.
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What is administer antibiotics anyway, notify MD, and document?
These things should be done if the RN is unable to obtain blood cultures.
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What is infection?
I do not have to be confirmed in order for the RN to answer YES when considering whether or not I am present.
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What is home use of BiPap at night?
A chronic respiratory issue that is not considered new organ dysfunction.
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What is within 3 hours/as soon as the initial lactate results?
The window of time you have to send the repeat lactate when your initial result is >18.
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What is two sets of cultures; one peripheral & one central, or two different peripheral sites if no central access?
Protocol for drawing blood cultures on a sepsis positive patient.
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What is a vasopressor?
I should be given if the patient has persistent hypotension within the hour following administration of 30ml/kg IV fluid bolus.
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What is two or more?
Number of SIRS criteria required to advance to Sepsis.
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What is end stage renal disease on dialysis?
This is not a new renal system organ dysfunction.
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What is screen appropriately and comment that interventions already implemented at X date/time?
Action when your patient screens positive, but Sepsis bundle has already been within 48hrs.
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What is blood cultures x2, lactate & repeat lactate (as needed) ONLY WHEN patient screens positive via nursing screen?
Bundle elements within nursing scope of practice.
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What is screen patient positive and implement nursing bundle?
I am the action required if a patient is already on broad spectrum antibiotics and screens positive per nursing protocol
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What are examples of suspected or confirmed infections?
UTI, Pneumonia, and implantable device infection.
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What is clearly documented in the chart that organ dysfunction is chronic and not related to infection?
This must done within 24 hrs after the time of presentation if the provider feels the organ dysfunction is chronic rather than related to infection.
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What is check all SIRS that apply, whether acute or chronic? (EX: Even if patient is always tachycardic, must still check HR >90)
I must be clearly documented when screening for SIRS criteria, whether chronic or acute.
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What is notify the physician and request an order for repeat lactate? (Not the nurse if not implemented initially per nursing protocol! Nurse must notify MD – cannot place per protocol.)
This should be done if the provider orders the initial lactate, the result is > 18, and no repeat lactate has been drawn.
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What is 1 hour from time of presentation?
I am the time frame allotted to start broad spectrum antibiotics.
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What is blood pressure?
I am one of the most common vital signs that is mistaken for SIRS criteria.
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What is a creatinine that doubled overnight? (EX: 2.9 to 5.8 in 12 hrs) – Clarify with MD first.
Chronic condition that may qualify as organ dysfunction.
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What is at the beginning of your shift, admission/transfer, or change in patient condition?
Timeframe that sepsis screening should be completed.
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What is identify severe sepsis/septic shock early and implement the bundle timely?
This is the goal of the sepsis screening tool.
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