Sepsis Screening in the Perinatal Patient
Article first published online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, page S24, June 2012
How to Cite
Stephens-Hennessy, B. M. (2012), Sepsis Screening in the Perinatal Patient. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S24. doi: 10.1111/j.1552-6909.2012.01359_29.x
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
Purpose for the Program
There are 18 million cases of sepsis annually throughout the world. An estimated 75,000 maternal deaths worldwide are associated with sepsis. The rate of sepsis in developed countries is lower, but it is among the leading causes of preventable maternal mortality. The Surviving Sepsis Campaign is a national program focused on reducing sepsis-related morbidity and mortality. This program will review the physiology of sepsis and how it affects the perinatal patient. Early recognition and evidence-based management are keys to reducing morbidity and mortality. Implementation of a screening and management program for the perinatal patient will improve outcomes as it has in the nonperinatal population nationwide.
To implement a standardized sepsis screening tool that includes the unique physiology of pregnancy and to implement the Surviving Sepsis management bundle.
Implementation, Outcomes, and Evaluation
Sepsis screening and standard management was initially implemented for the adult non-obstetric population throughout the Sutter Healthcare System. Consequently, a reduction in overall mortality has been associated with this program at Sutter Healthcare System. It soon became obvious that the perinatal population would benefit from this program. We adopted the Surviving Sepsis bundle elements but made changes to the screening tool to account for the changes in physiology in the pregnant and postpartum population. Implementation of this program required a multidisciplinary team of obstetrician and intensive care unit physicians; obstetric, intensive care unit, and emergency department registered nurses; a rapid response team; a laboratory, and a pharmacy. Patients are screened on admission and then again on every shift. If a sepsis screening result is positive, the rapid response nurse is called to immediately evaluate the patient. The standard, evidence-based order set is initiated. This process has improved the collaboration between the perinatal and intensive care teams. There has been an increase in admissions to the intensive care unit; however, compared to our intensive care unit admissions before the screening, the duration of time spent in the intensive care unit is shorter.
Implications for Nursing Practice
There is an increased awareness of sepsis and how it presents in the perinatal patient.