Date of Award
Spring 5-14-2025
Document Type
Doctor of Nursing Practice Final Manuscript
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Razel Bacuetes Milo, PhD, DNP, APRN, FNP-C, AAOPM-BC
Abstract
Background: Sepsis is a life-threatening organ dysfunction caused by an infection. In the United States, treating sepsis costs approximately $23 billion annually, making it the most expensive condition treated in hospitals. Severe infections in nursing homes are estimated to occur in one to three million cases annually. Infections in nursing homes are on the rise, and the cost of hospitalization due to sepsis is increasing dramatically. Diagnosing sepsis is often delayed in nursing homes.
Purpose of the Project: This project aims to train nursing home nurses to use the SIRS screening tool to identify potential sepsis cases early and administer treatments. The objective is to provide safe care for select residents with sepsis within the nursing home rather than in a hospital setting.
Evidence-based Practice Model/Frameworks: This project was guided by the Johns Hopkins Nursing EBP Model, which uses three steps: a practice question, the evidence to guide the project, and the translation and application of the evidence.
Evidence-based Practice Change: This project implements evidence-based education on the signs and symptoms of early sepsis identification and use of SIRS criteria among nurses working in a nursing home setting. The training highlights the SIRS criteria as having any two of the following criteria: body temperature over 38 or under 36 degrees Celsius; heart rate greater than 90 beats/minute; respiratory rate greater than 20 breaths/minute; or leukocyte count greater than 12,000 or less than 4,000 per microliter. After identifying sepsis, the education focuses on the required evidence-based elements of the safe treatment of residents in the nursing home setting.
Project Outcome Evaluation: From October to December 2024, the facility completed 77 SIRS screening tools. Twenty-two residents met the definition of sepsis. Furthermore, sepsis-related hospitalizations dropped from 12 residents between July and September 2024 to five residents from October to December 2024. It represents a reduction of over 50% in sepsis-related hospitalizations during the implementation period.
Implications for Practice: This evidence-based project can improve the identification of sepsis diagnoses in nursing home residents by training nurses to use the SIRS criteria. Prevention and prompt intervention are pivotal in sepsis survival.
Conclusion: Future EBP projects may concentrate on improving practices for treating sepsis in nursing homes and/or transferring patients to acute hospitals. This transfer can be disruptive for residents with sepsis and is often unnecessary if an early sepsis assessment is initiated using the SIRS criteria, along with appropriate interventions for septic residents within the nursing home setting.
Keywords: Sepsis, SIRS, Nursing Home, Skilled Nursing Facility, Long-Term Care, Infection, Hospitalization
Digital USD Citation
Arceo, Edwin Tobbee Y. Jr, "The Use of Systemic Inflammatory Response Syndrome (SIRS) Criteria by Nurses in the Nursing Home Setting to Identify Sepsis" (2025). Doctor of Nursing Practice Final Manuscripts. 293.
https://digital.sandiego.edu/dnp/293
Copyright
Copyright held by the author
