Patient journey 2 Assessment Answers

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Question 1: Discussion about Sepsis

Definition

Sepsis is known as an infection that is bacterial in nature and enters into the bloodstream responsible for causing systemic infection along with an email response. Sepsis is also considered to be as life threatening and therefore requires early intervention for preventing septic shock that might lead towards organ failure as well as death.

Patient journey 2 Assessment Answers

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Christian Wise 7 Years | PhD

Pathophysiology

In pathophysiology of sepsis the role of coagulation and inflammation is high. Sepsis occurs when infections triggers localised implemented reactions and their after spills over for causing systemic "symptoms of fever", tachycardia, tachypnea or hypothermia (Arina, and Singer, 2021). Clinical symptoms of sepsis are known to be as "systemic inflammatory response syndrome". Severe sepsis is known to be as dysfunction of unexplained metabolic acidosis and measure organ systems. Therefore, release of cytokines such as interleukins, tumour necrosis factor Alpha as well as prostaglandins from macrophages and neutrophils.

Epidemiology

Sepsis is known to be one of the most frequent causes behind death worldwide and there are challenges in the collection of reliable amounts of data at population level. In 2020, around 48.9 million cases as well as 11 million sepsis related deaths were found worldwide that represents about 20% of global death (Who.int, 2024). Sepsis is responsible for affecting individuals worldwide having regional disparities within incidents as well as morality that exist with the highest rate within lower middle income Nations. Among 1000 hospital patients an estimation of around 15 patients might develop sepsis as a complication of healthcare that is received by them (Who.int, 2024). Sepsis is also considered to be a costly aspect and the average cost of sepsis hospital-wide is estimated to be high for each patient within high income countries.

Risk factors or possible causes responsible for cause of sepsis

Different factors that are responsible for occurrence of sepsis among individuals such as Mr Clarke are failure in treating or recognising infection and exercising proper preventive measures. Individuals also suffer from sepsis due to different causes that include compromising immune system, actual or relative hypervolemia, minimization of arterial blood flow, vascular occlusion intimal damage, selective vasoconstriction, microemboli, and altered oxygen supply (Nhs.uk, 2024). Most common causes behind the occurrence of sepsis are urinary tract infection and respiratory tract that is followed by soft tissue and abdominal infection. On the other hand, there are other risk factors that because an increase in the risk of sepsis at our age over 65, longer hospital stays, compromised immune system and use of corticosteroid. Usability of intravascular devices is considered to be the reason behind hospital acquired sepsis. Etiology of sepsis is considered to be as diverse whereas clinical clues towards various organ systems help in appropriate diagnosis and workup (Hincu et al. 2020). Finally sepsis might also occur due to obvious infection, injury or complicated etiology that includes rupture, compromise and perforation of pelvic or intra-abdominal structure.

Way sepsis deteriorates health conditions if left untreated

Sepsis needs to be treated in hospital as it might get worse at a quick rate. Finally if the sepsis is not treated at an early stage it might result in septic shock that may cause failure of organs resulting in life threatening.

Question 2: Evidence best decision making through using systematic approach for treating sepsis

Evidence-based sepsis program within nursing care

Under the auspices of surviving sepsis campaign experts prefer developing "evidence based management strategies" for sepsis. Proper application of clinical practices that is based on evidence is responsible for addressing major challenges that patients with sepsis face. On the other hand, evidence-based therapies that are applicable for patients able to gain proper medication include appropriate antibiotics, strict glycaemic control, early fluid resuscitation, as well as lung protective ventilation (Chivukula et al. 2021). Many healthcare centres and healthcare providers responsible for treating patients with sepsis prefer developing sepsis programs that are based on evidence based sepsis bundles. Therefore, introduction of healthcare programs within the healthcare sector dedicated towards sepsis is responsible for improving adherence towards evidence based recommendation.

Nursing care plans

"Nursing care management" for patients suffering from sepsis States about monitoring vital signs, prompting assessment and fluid resuscitation along with intravenous fluids. As stated by Ranjit and Kissoon (2021), nursing care management for sepsis patients include administrative appropriate antibiotics timely, hemodynamic support together with vasoactive medication, ensuring respiratory support and adequate oxygenation. On the other hand, individualist care is considered to be a necessary aspect that is based on hospital protocols, severity and patient’s condition (Alfahmi, 2022). Care providers responsible for treating sepsis need to have proper knowledge about the way of implementation of infection control measures, providing psychological support, offering nutritional support as well as educating regarding symptoms and signs of sepsis that include discharge planning.

Initiating infection prevention and control

Patients with sepsis are considered to be at high risk for infection as they have compromised immune system and pathogenic microorganism’s presence. Systemic inflammatory responses also have the ability of damaging tissues of Mr Clarke that results in impaired hostess and increase of risk of infection. As stated by Ranjit and Kissoon (2021), responses of abnormal host immune might also in hand susceptibility towards severe disease as well as motability. Initiating infection prevention as well as control measures in "patients with sepsis" is of paramount importance for mitigating spread of infection as well as improving patient outcomes. On the other hand, implementation of strict "infection control practices" within the health care setting also plays a vital role in reduction of risk related to hospital acquired infections. Therefore, the initial step includes promptly identifying as well as isolating the source of infection that includes through diagnosis imaging or blood culture for guiding appropriate antimicrobial therapy.

Prevention of sepsis shock

Prompting recognition as well as intervention that include fluid resuscitation, antibiotic administration and vasopressor therapy are considered to be essential for treating or preventing septic shock. As mentioned by Muntner et al. (2020), by monitoring trends within blood pressure it is possible to prevent sepsis. Apart from that it is also better for care providers to monitor heart rate as increased heart rate at certain times persists in sepsis irrespective of fluid depletion. On the contrary, nurses taking care of sepsis patients need to have proper access to respiratory quality, depth as well as rate for understanding severity of sepsis. Therefore, it is also necessary for healthcare providers in nursing care to note down the strength and quality of peripheral pulses of patients with sepsis.

Increasing gas exchange as well as breathing pattern

Inflammatory mediators release in sepsis is the reason behind alveolar damage as well as capillary leakage in lungs that lead towards impaired gas exchange. According to Egbuta and Mason (2020), optimising breathing patterns and enhancing gas exchange within patients with sepsis is considered to be as critical in managing sepsis for preventing father complications. Enhancement of gas exchange along with breathing pattern in sepsis patients involves intervention that are mechanical ventilation, oxygen therapy and strategies for promoting optimal breathing pattern that includes deep breathing positioning and exercises. Contrastingly, Egbuta and Mason (2020) asserted that the aim of interventions related to sepsis treatment are improving oxygenation, supporting respiratory function, removing carbon dioxide and contributing to patient recovery together with reducing risk of complications related with sepsis. Finally, different activities that nurses in nursing care for patients with sepsis need to perform include monitoring respiratory depth and rate, assessing changes within sensorium, monitoring pulse oximetry and reviewing serial chest X-rays. Managing fluid balance and fluid resuscitation Sepsis patients have a risk of deficient fluid volume as a result of fluid losses that occur due to diaphoresis, fever, vasodilation and increased respiratory rate. As opined by Dull, and Hahn (2023), fluid shifts from intravascular space into intracellular as well as interstitial spaces contribute towards hypervolemia. During augmentation of intravascular volume cardiac output is found to be evaluated. Main goal is achieving balance within fluid resuscitation as well as avoiding fluid overload. Intravenous fluids are also administered for the story circulation volume along with maintaining adequate amounts of blood pressure. On the other hand, Vignon (2020) mentioned that hemodynamic monitoring that includes cardiac output measurement and Central Venous pressure are responsible for helping patients with maintaining blood pressure. As a reason proper assessment related to fluid responsiveness along with adjusting fluid therapy is considered to be an essential aspect for curing patients with sepsis. Therefore, health care providers can take proper care of sepsis patients specially by recording and measuring urinary output, monitoring heart rate and blood pressure, palpating peripheral pulses and monitoring laboratory values.

Pharmaceutical as well as non-pharmaceutical intervention for improving health condition of Mr Clarke

Pharmaceutical intervention Different organisms that are responsible for causing infection that further turns into sepsis include fungi, bacteria or viruses but the main treatment is antibiotic as it is mainly caused by bacterial infection. As influenced by Ong et al. (2020), after doctors diagonalise sepsis patients are provided with antibiotics immediately even before gaining confirmation of the test about bacterial infection. Mr Clarke might have received antibiotics within 1 hour of diagnosis. Based on the type of bacteria antibiotics are provided to patients with sepsis but as it takes time in identifying bacteria it causes infection. Thus patients need to be provided with broad breakdown antibiotics for killing different kinds of bacteria after switching to more target antibiotics. On the contrary, Abushaheen et al. (2020) stated that antibiotic treatment mainly forces disease to vary based on the bacterium responsible for infecting the individual and the risk faced by that patient in regard to availability and resistance patterns. Hence, doctors responsible for treating patients with sepsis are well aware of the kind of bacteria that causes certain infections and do start with "broad spectrum antibiotics" for treating patients effectively. Medication alone cannot help individuals with sepsis in curing as there is a need of maintaining healthy blood pressure. Low blood pressure might occur with patients suffering from severe sepsis as well as septic shock (Reaven et al. 2022). In this context there is a need for patients with sepsis to gain intravenous fluid during admission in hospital. Fluid aids patients with sepsis in increasing volume of their blood along with preventing dehydration that are known to be factors behind low blood pressure. Different kinds of intravenous fluid that have capability of treating sepsis together with increasing volume of blood that include normal saline that consists of minerals such as sodium. Body of a patient with sepsis demands for more oxygen and needs to be placed on "mechanical ventilators" for giving body and lungs rest and capability of healing (Owodolu et al. 2021). Oxygen therapy is provided to patients with sepsis in different ways that include through nasal tube, mechanical ventilation or face mask. As a result, oxygen therapy assists in racing oxygen level received by lungs and thereafter delivers it to blood. Non-pharmaceutical intervention Physical exercise is considered to be a non pharmaceutical intervention that assists patients with sepsis in improving their health condition. As per the viewpoint of Mostel et al. (2020), physical exercise is responsible for making an impact on outcomes of sepsis. Regular exercise is responsible for altering morbidity of sepsis along with increasing survival rate. On the other hand, there is presence of association within susceptibility of sepsis and physical exercise preconditioning. Individuals who perform low physical exercise and watch television for a long period of time have higher mortality and morbidity of sepsis. Moreover, sepsis survivors also have significant minimisation in exercise capacity as well as physical activities. As influenced by Van et al. (2023), sepsis survivors have limited information about the impact of post hospital exercise on outcomes of sepsis in the long term. Although the impact of physical exercise is responsible for improving organ functionality of sepsis, it is different and based on the organ system. Finally physical exercise preconditioning might be considered to be a non pharmaceutical alternative as well as beneficial aspect for treating and preventing sepsis that is father considered to be suitable for individuals with sepsis.

Question 3: Important role of multidisciplinary team (MDT) in treating Mr Clarke a sepsis patient

Multidisciplinary team responsible for reviewing sepsis patient during admission and “prior to discharge”

Multidisciplinary team care refers to multiple health professionals from various different disciplines, patients and family members of patients. As inferred in the study of Zajac et al. (2021), healthcare professionals responsible for participating into multidisciplinary teams communicate, and collaborate together for addressing different aspects of patient care. In this context, Mr Clarke has individual journey and his condition circumstances and need might change over time therefore flexibility of multi disciplinary team care is valued and paramount. Main goal of multidisciplinary care team is providing comprehensive care possible and also at right time and place for each patient. Some of the values of an efficient multi disciplinary team includes solid implementation strategies, effective coordination and communication, transparency as well as respect as well as trust. According to the study of Clarke et al. (2020), the multidisciplinary team responsible for reviewing patients mainly prior to discharge and during admission need to function properly and for this there need to be clear about their roles. On the other hand comprehensive procedures, protocols, policies and systems are necessary for development of an efficient multidisciplinary team. Multidisciplinary team is for most and fast that is centered upon the needs of the patient. Professionals responsible for contributing in a multidisciplinary team are aligned health professionals, general practitioners, health educators, specialists as well as community and practice health nurses (Lucas et al. 2021). Effective working capability of the multidisciplinary team responsible for reviving Mr Clarke during getting admission in hospital as well as before being discharged could benefit him in different ways that includes improved health outcomes, use of resources in an efficient manner, improved time management and increased satisfaction level. Multidisciplinary team for Mr Clarke also needs to be consisting of clinical nurse specialist, psychiatrist, psychologist, mental health nurses, medical secretaries, occupational therapist and social workers. As per the study of Holmes et al. (2020), professionals from various areas of expertise need to combine together and form a multi-disciplinary team that would help in complicated as well as challenging mental health conditions. Professionals of a multidisciplinary team need to meet on a regular basis to discuss their work for each patient and have a proper care plan that would suit individual needs of patients. Main role of a psychiatrist is performing assessment by providing talking therapies, investigating physical illness and prescribing medicine based on the health condition of Mr Clarke. Apart from that, psychologists would also provide specialized therapy along with performing in-depth assessment of brain functionalities as well as behavior (Keefer et al. 2022). Finally it would be better to include psychiatrist, psychologist, clinical nurses and doctors for treating Mr Clarke suffering from sepsis.

Communication strategies used by Multidisciplinary team for ensuring effective professional working and way it would be documented accurately

Communication is considered to be an essential aspect for the multi disciplinary team responsible for reviewing Mr Clarke prayer to discharging from hospital as well as during admission. As inferred in the study of Zajac et al. (2021), professionals working in multidisciplinary teams face difficulties that include conflicting roles, expectations, values and perspective. Therefore, it is the core responsibility of all individuals of a multi-disciplinary team to use appropriate communication strategies for improving communication among themselves and with patients as well as their families.

Establishing clear roles and goals

First step that multidisciplinary needs to implement for ensuring effective communication is establishment of shared as well as clear roles and goals for the team. As asserted by Santos-Moreno et al. (2021), benefits that a multidisciplinary team would gain from establishment of clear goals as well as roles is avoiding confusion, gaps or duplication within service delivery and fostering a sense of common direction and purpose. In this context, a multi-disciplinary team can also use different tools which include agreements, charters or contracts for defining responsibilities, objectives, mission and vision of the entire team. Finally, by establishing shared goals as well as roles, a multi-disciplinary team is able to make proper decisions for resolving conflicts and communicating effectively with patient parties.

Using appropriate communication tools and channels

Multidisciplinary team is capable of ensuring effective communication by using suitable communication channels as well as tools based on team’s preferences and needs. As mentioned by Santos-Moreno et al. (2021), depending upon frequency, location and size of team it is a core responsibility of a multidisciplinary team to use a combination of phone, email, online platform or face to face for communicating with patients, their families and among themselves. For instance, in case of routine updates email can be used by a multidisciplinary team, online platform for documentation and collaboration as well as phone only for urgent matters. Therefore, multidisciplinary teams also need to consider the urgency, type and purpose of information that is needed to be shared by choosing the most reliable and suitable channel along with tools for conveying it within a short period of time.

Communicating respectfully and clearly

Multidisciplinary team working for safety patients can ensure effective communication through communicating clearly as well as respectfully with team members, patients as well as their families. As inferred in the study of Lucas et al. (2021), multidisciplinary teams need to use accurate, clear and concise language for avoiding acronyms, technical or jargon terms that might not be well understood by others. Apart from that, multidisciplinary teams also need to utilize active listening skills that include asking questions, summarizing, giving feedback and paraphrasing for showing that they pay attention as well as interest towards the welfare of patients. On the other hand, multi-disciplinary teams need to express their needs and opinions assertively along with respecting necessity as well as opinions of others even while disagreeing with them (Keefer et al., 2022). As a result, multi-disciplinary teams need to be careful about using constructive as well as respectful language in order to avoid judging others, criticizing or blaming and focus on solutions, feelings and facts. This analysis is particularly useful for students seeking assignment help in healthcare communication, emphasizing core principles for improving teamwork and patient safety in multidisciplinary settings.

References

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