I'm often asked to review cases where sepsis is a factor. Many cases involve clients who have developed an infection which may have led to an extended hospital stay, loss of an extremity, multi organ shut-down or even death. Understanding the process of how sepsis occurs and the guidelines for treatment will help to enhance your ability to litigate your case.
Sepsis has become one of the leading causes of mortality in the US. The CDC noted a 7 in10 ratio of patients with sepsis had recently used health care services or had chronic illnesses requiring health care services.
As a Legal Nurse Consultant, I have been asked to review several cases where the client became septic from an infection contracted in the hospital or nursing home. Often these infections are found to start with a wound, urinary tract infection, pneumonia or surgery.
An infection is defined as the invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body. These microorganisms must have an avenue of entry into the body i.e.; respiratory system, blood, urinary tract, skin.
Sepsis is a complication caused by the body’s overwhelming and life-threatening response to infection. It can lead to tissue damage, organ failure, and death.
When reviewing a case where sepsis has occured, it is important to understand the guidelines which have been implemented and updated over the past 5 years. A great tool to reference is the Severe Sepsis and Septic Shock Change Package. Within this resource, you will find when treating sepsis, there are stages at which sepsis develops. There are guidelines or “care bundles” which have been developed and recommended for healthcare entities to follow for each stage. Having an understanding will help to isolate the possibility of a breach in the Standard of Care.
A frequent occurance and example of sepsis would be a client in the nursing home setting who has developed a pressure ulcer which has become infected. The elderly are at a higher risk for infection, leading to sepsis, especially when isolated in a long term care facility. Identifying the signs and symptoms of sepsis would first fall on the nurse’s assessment skills. Several questions a prudent nurse should ask themselves when assessing their patient in any setting for possible sepsis would be:
Is the patient currently being treated for an infection?
Are the vital signs within normal range?
What are the intake and output totals for the past 24 hours?
Has there been a change in the patient’s mental status?
These questions can lead to identifiers for a possible diagnosis of sepsis. Any changes within the patient’s baseline assessment should be reported to the physician.
Early diagnosis is imperative as the elderly patient will decompensate at a much faster rate than a patient who is younger and healthier, with no pre-existing medical conditions.
For healthcare workers,identifying the early signs of sepsis and following the recommended standards of care as well as the treating facilities policy and procedures, will aid in the prompt and effective treatment of sepsis lowering mortality rates.
If you have a case where sepsis was a factor or in question, we can help to identify the issues associated with the identification, treatment and future care of a sepsis occurance.
photo 1: Kon,Kateryna; stock.adobe.com
photo 2: designua;stock.adobe.com