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How to Effectively Teach Interventions for Sepsis

Sepsis, the body’s extreme and life-threatening response to an infection, can lead to septic shock, multiple organ failure, and death if not recognized early and managed promptly.

Worldwide each year, sepsis affects more than 30 million people and causes as many as 6 million deaths.1 Those with the highest risk include:2
  • Adults older than 65 years of age
  • Children younger than 1 year of age
  • People with weakened immune systems
  • People with chronic medical conditions, such as diabetes, lung disease, cancer, and kidney disease
3 million newborns and 1.2 million children suffer from sepsis globally each year.3

Experts recommend using simulation training to train for high-acuity patient situations as it can enhance a learner’s know-how, build confidence, and provide a creative learning environment to boost retention.4 Simulation can prove highly effective when training healthcare professionals to detect and treat patients suspected of having sepsis.

Specifically, simulation can aid educators in the following areas:

Early Detection and Diagnosis of Sepsis

In simulations designed to teach sepsis interventions, providers use simulators to repeatedly practice both diagnostic and treatment procedures that can optimize clinical outcomes. Learners can "rehearse" identifying early symptoms of sepsis in real-world scenarios – particularly those that may not reflect a clear-cut, simple sepsis diagnosis.

Some organizations choose to follow a progression of three different sepsis cases:5

Standard sepsis

a non-complicated scenario that easily demonstrates the signs and symptoms of sepsis.

Differentiating Sepsis/pneumonia from the flu

teaches learners to maintain a high sensitivity for sepsis patients while limiting false positives.

Septic shock

provides the opportunity to aggressively treat and understand the nuances of septic shock.

With simulation learning, healthcare professionals have the opportunity to refine their skills using simulation technology – without putting patients at risk.

Laura Cunanan, RN, Vice President of Clinical, Bakersfield Heart Hospital*

Cross-functional Team Training

Often when healthcare professionals are provided with training, it is conducted in silos and sorted by discipline. But, cross-functional team training can positively impact a team's interactions during a high-stress, time-sensitive emergency case like severe sepsis.

Simulation can help members from different care teams, who play different roles, develop effective communication skills. With better communication and precautionary team behaviors in place, patients are more likely to receive safe care.

Dr. Arthur Childs at Cape Regional Medical Center credits simulation for the hospital’s decrease in the number of patients with septicemia or severe sepsis.6 Prior to his team’s training with a simulator, 72% of the hospital's sepsis patients led to major complications or comorbidities. After simulation training, that percentage lowered to 63% - a result suggesting that patients with sepsis are now identified earlier.7

When doctors were interviewed [after the simulation experience], they admitted they hadn’t known everything and that it was stimulating to train as part of a multidisciplinary team.

Arthur Childs, M.D., Director of Critical Care, Cape Regional Medical Center **

Sepsis Treatment Protocols

Training using simulation can reinforce the protocols that are known to be most successful in treating patients with sepsis. Research shows that learners correctly diagnose sepsis and administer antibiotics correctly when they participate in a simulation.8

And, performance scores for learners continue to improve with more than one chance to practice with simulation.9

In addition to supporting a learner’s training on protocols, simulation training offers exposure to how quickly a patient’s condition can deteriorate. Septic patient mortality increases an estimated 9% per hour when antibiotics are delayed after hypotension.10

Providing a low-risk environment to watch and treat a time-sensitive patient can teach learners the urgency required in a sepsis patient case. This understanding can then translate directly to the bedside, improving response times as well as patient outcomes.

References

  1. World Health Organization. (2018). Sepsis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/sepsis
  2. Centers for Disease Control and Prevention. (2019). What is sepsis? Retrieved from https://www.cdc.gov/sepsis/what-is-sepsis.html
  3. World Health Organization. (2018). See reference #1.
  4. Marin, K. (2014). Simulation as a tool in early recognition of sepsis. Journal of Emergency Nursing, 39(5), p. 427. DOI: https://doi.org/10.1016/j.jen.2013.03.021
  5. Dix, A. (2017). 3 scenarios to train for diagnosis, treatment of sepsis. EMS1.com. Retrieved from https://www.ems1.com/ems-products/capnography/articles/3-scenarios-to-train-for-diagnosis-treatment-of-sepsis-pYAoKGarKW6P3C09/
  6. Maguire, P. (2014). Hands-on learning improves sepsis outcomes. Today’s Hospitalist. Retrieved from https://www.todayshospitalist.com/hands-on-learning-improves-sepsis-outcomes/
  7. Ibid.
  8. Dugan, M.C., McCracken, C.E., & Hebbar, K.B. (2016). Does simulation improve recognition and management of pediatric septic shock, and if one simulation is good, is more simulation better? Pediatric Critical Care Medicine, 17(7), p. 605-614. DOI: 10.1097/PCC.0000000000000766
  9. Ibid.
  10. Dix, A. (2017). See reference #5.

* Zimmerman, B. (2016). 3 things to know about sepsis simulation training. Becker’s Clinical Leadership and Infection Control. Retrieved from https://www.beckershospitalreview.com/quality/3-things-to-know-about-sepsis-simulation-training.html

** Maguire, P. (2014). See reference #6.

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