SEPSIS PREVENTION-PREVENTION-PREVENTION !!!

I think the best way to address sepsis conditions is to PREVENT IT! We as healthcare providers take many precautions for our patients, but we can take it to another level with sepsis prevention protocols. Mortality is HIGH in sepsis conditions, from 30%-60%, so prevention is crucial and can save lives. In researching sepsis prevention, I found the following points and interventions:

• Hand Hygiene and aseptic technique as per protocol
• Avoid trauma to mucosal surfaces that can be colonized by bacteria
• Use Prophylactic topicals and sprays to prevent nosocomial infections
• Attention to DVT
• Note: Protective environments for patients at risk have not been considered successful because most infections have endogenous origins.
• Prevention of ventilator-associated pneumonia:
  • Use sedation vacations and bundle protocols:
    • Elevate HOB
    • Peptic ulcer prophylaxis
    • Preventing oral-tracheal contamination
    • Use of continuous-suctioning endotracheal tube
    • Perform oral care every 2 hours
  • Prevention of venous catheter-related bloodstream infections (Central Line Bundle):
    • Use maximum barrier insertion precautions and daily review of line necessity/removal
  • Surgical site care:
    • Pts with surgical site infections are 60% more likely to be in ICU, spend 7+ more days in hospital and 2x mortality rate; avoid shaving and give prophylactic antibiotics 1 hr prior to procedures. Maintain aseptic technique when changing dressings; pay close attention to normothermia and blood glucose control.
  • Prevent UTIs:
    • 25%-40% of UTis occur in pts with foley > 7 days;
    • Maintain aseptic technique, dependent drainage, minimize manipulation of drainage system.

It is interesting to note that there is contradicting information regarding patient isolation and if it is beneficial to patients, as most infections are considered to have endogenous origins.

I remember a senior last year whose project included tallying healthcare workers as they entered/existed a patient’s room to see if they performed proper hand hygiene. The fact that she observed any percentage of non-compliance shows that the simplest preventions can be overlooked. If a nurse cannot remember protocols, a flow-chart or check list should be followed. Additionally, printed “bundle” protocols can usually be found in every facility.