It Takes a Village - Atypical Presentation Warrants Teamwork for Sepsis Care

Sepsis is the body’s overwhelming response to infection that can lead to tissue damage, organ failure, and death. Sepsis, disproportionately, affects older adults due to an aging immune system and chronic illness. Older adults present atypically delaying diagnosis and intervention. This delay has been associated with increased morbidity and mortality. However, with early detection and rapid treatment there can be a reduction in poor outcomes. It is key, that clinicians practice collaboration and communication when diagnosing & treating patients that may have a different presentation. Early detection, monitoring, and intervention are crucial to survival of the older septic patient. The Continuous Monitoring Unit (CMU) consists of RNs, who monitor telemetry, video, and the Sepsis BPA/Checklist 24 hours/7 days a week. These nurses evaluate all active ED and acute care BPA data points. With their specific training, they dismiss the irrelevant and align the significant data while looking for possible notes of infection. They do not act upon the BPA unless the patient meets criteria. If there is confirmation of the BPA, the nurse collaborates with the primary provider to initiate recommended sepsis care. Since the beginning of August 2021, the CMU RN is utilizing the Sepsis Checklist, a customized tool built into the EMR that allows the CMU nurse to monitor the key elements of the Sepsis Bundle and intervene concurrently to complete the CMS SEP1 recommendations. Recommendations are based on the Surviving Sepsis Campaign.