Updated Hour One Sepsis Bundle - Nursing Considerations and Safe Practices

Abstract

Sepsis is the leading cause of morbidity and mortality among patients in critical care unit. Sepsis is a life threatening condition caused by the body's response to an infection that can lead to tissue damage, organ failure and ultimately end up with death. Untreated sepsis will progressed to septic shock a condition in which vital organs starve for oxygen due to peripheral vasoconstriction. World health Assembly and WHO made sepsis a global priority in 2017. Nearly 30 million annual cases and 6 million deaths was estimated globally. Sepsis is the prime reason for readmissions to the hospital with 19% of people hospitalized with sepsis needs readmission within 30 days. Bacterial and viral pathogenic organisms are responsible for majority of sepsis infection. Nurses play an imperative role in the early identification of sepsis through their constant patient interaction and assessment. Once a sepsis diagnosis is established, treatment focuses on early administration of fluids, antibiotics, respiratory therapies and hemodynamic management to clearly meet delineated needs (Dellinger et. al 2008). Surviving Sepsis campaign (SSC) focused to reduce sepsis and septic shock related mortality and morbidity issues world wide. SSC periodically publishes sepsis related guidelines which includes 3 hour bundle, 6 hour bundle .In 2018 SSC published its recent updated guideline named as Hour one sepsis bundle. Understanding qSOFA tool, Time zero concept and Hour one sepsis Bundle will help nurses to initiate an early recognition and prompt management thereby preventing the transition of sepsis in to septic shock. The purpose of this article is to update the clinical nurses to understand sepsis, etiology, warning signs, risk factors, stages, diagnostic studies, assessment criteria, steps in hour one bundle and nursing challenges in implementing sepsis bundle.