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Keywords:

  • sepsis;
  • perinatal

Poster Presentation

  1. Top of page
  2. Poster Presentation

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.

Proposed Change

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.