Sepsis: Diagnosis and Treatment - Special Academic Support

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Currently, the diagnosis and treatment of sepsis remain largely unresolved. This is due to the lack of study of many aspects related to this diagnosis, as well as the ineffectiveness of the already existing methods of division used in hospitals. Lethality from sepsis varies between 20 and 80 percent, which is an unfavorable indicator. Along with the lack of effectiveness of methods such as antibiotic therapy and transfusion intervention, the situation is complicated by the emergence of new bacterial strains.

Based on the above situation, it is necessary to develop a fundamentally new approach in the study, diagnosis and treatment of this diagnosis. The process of interaction with the patient and the organization of their therapy in the hospital should not be underestimated factors (Ortiz-Ruiz & Duenas-Castell, 2018). It is important to note that in modern medicine, all patients with this diagnosis are commonly divided into three groups. The first includes people in whom sepsis is a consequence of pathology related to the work of the immune system, the second group includes patients in whom this diagnosis is exclusively of genetic nature (Ortiz-Ruiz & Duenas-Castell, 2018). The third group combines the two above-mentioned situations. Scientists claim that a separate algorithm of action and approach is requireded for each of the patient segments (Ortiz-Ruiz & Duenas-Castell, 2018). This idea has been reflected in the work of medical scientists for many years, but in real practice this rule is not often observed.

The neglect by doctors of a detailed study of the mechanism of sepsis in individual patients leads to many problems. Firstly, there is the risk of complicating the course of treatment, increasing its duration and, in the extreme case, increasing the risk of lethality (Kanjee, 2020). Secondly, the psychological component remains unnoticed, since with this diagnosis it is important for the patient to receive complete and timely information about the treatment process and the causes of the disease (Kanjee, 2020). If doctors have not sufficiently investigated a particular case, the patient client of the clinic feels insufficiently confident and secure.

Moreover, from a psychological point of view, the consequences after sepsis treatment, called post-septic syndrome, are important. The latter is a relatively new term, not studied deeply enough. It is known that during and after severe sepsis, a person undergoes significant cognitive and behavioral changes (Stawicki, 2020). At the same time, physical symptomatology is not the end of the diagnosis itself and ideally should not be a reason to discontinue therapy (Ortiz-Ruiz & Duenas-Castell, 2018). This is not taken into account in the practice of many hospitals, consequently, patients leave the hospital with serious psychological consequences and do not understand how to deal with them (Kanjee, 2020). To improve the situation, strategies for psychological follow-up of patients with sepsis, regardless of severity, as well as the creation of educational programs on self-diagnosis and self-help, are needed.

From a technical point of view, many medical institutions have advanced electronic patient registration systems based on best practice guidelines. However, there is currently no evidence that mortality rates are decreasing (Ortiz-Ruiz & Duenas-Castell, 2018). Therefore, it is important to examine in depth the mechanisms of influence of these recommendations in electronic charting and to identify the reasons for inefficiencies. Based on the backdrop of the question studied, a research question was formulated.

PICO Question: In adult emergency department patients (P), what is the effect of sepsis best practice advisories (BPAs) within the electronic health record (EHR) (I) compared with no sepsis best practice advisories within the electronic health record (C) on patient length of stay and mortality rates (O)?

Working thesis: The use of best practice advisories (BPAs) within the electronic health record (EHR) in adult emergency department patients does not have a significant effect on patient mortality rates. Regarding patient length stay, algorithm-based sepsis best practice advisories do significantly reduce patient length of stay. However, SIRS-based sepsis best practice advisories do not significantly affect patient length of stay.

References

Ortiz-Ruiz, G., & Duenas-CastellC. (2018). Sepsis. Springer.

Stawicki, S. P. (2020). Clinical management of shock: The science and art of physiological restoration. Intechopen.

Zahir Kanjee. (2020). Cases in hospital medicine: An evidence-based approach. Wolters Kluwer.

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