The role of nurses in caring for older adults with sepsis in the intensive care unit.

Main Article Content

Nattanicha Singjan

Abstract

Sepsis is a life-threatening condition that requires care in the intensive care unit, especially in older adults who tend to have serious complications, a prolonged length of hospital stay, and a high mortality rate compared to younger patients. Along with factors related to the aging process, including the immune system weakening and the body’s systems deteriorating, and important characteristics of older adults with sepsis include atypical presentations such as hypothermia, acute confusion state, loss of appetite, and malaise, resulting in complex and serious health problems. Screening sepsis to ensure older adults receive proper and timely treatment can reduce multiple organ dysfunction and mortality rates. Therefore, nurses must have the knowledge, understanding, and ability to care for older adults with sepsis while being admitted to the intensive care unit, which requires expert nursing care to achieve rapid screening, accurate diagnosis, and standard treatment to ensure patient safety without serious complications.

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Academic articles

References

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-10. doi:10.1001/jama.2016.0287.

Kotfis K, Wittebole X, Jaschinski U, Solé-Violán J, Kashyap R, Leone M, et al. A worldwide perspective of sepsis epidemiology and survival according to age: Observational data from the ICON audit. J Crit Care. 2019;51:122-132.

Goodacre S, Fuller G, Conroy S, Hendrikse C. Diagnosis and management of sepsis in the older adult. BMJ. 2023;382:e075585. doi: 10.1136/bmj-2023-075585. PMID: 37451817.

Kingren MS, Starr ME, Saito H. Divergent sepsis pathophysiology in older adults. Antioxid Redox Signal. 2021;35(16):1358-75. doi:10.1089/ars.2021.0056.

Conner T, Thompson J, Tiplady S. Sepsis in the older person. NRC. 2021;23(8):1-7. doi: 10.12968/nrec. 2021.23.8.3.

Wan MS, Mat NM, Md RA. Sepsis and its impact on outcomes in elderly patients admitted to a malaysian intensive care unit. Malays J Med Sci. 2022 Jun;29(3): 145-150. doi: 10.21315/mjms2022.29.3.14.

Nieves AU, Love PJ, Estey AJ. Improving the Accuracy of Sepsis Screening by Nurses in Hospitalized Older Adults: A Pilot Interventional Study. J Gerontol Nurs. 2021 Jun;47(6):27-34. doi: 10.3928/ 00989134-20210510-01.

Singjan N, Sutti N, Monkong S. Perceptions of relatives about symptoms and signs in older adults with sepsis: A cross-sectional study. Pacific Rim Int J Nurs Res. 2023;27 (3):431-444

Centers for Disease Control and Prevention. What is sepsis? [Internet]; 2021 [cited 2023 October]. Available from: https://www.cdc.gov/sepsis/what-is-sepsis.html.

World Health Organization. Sepsis [Internet]; 2023 [cited 2024 March]. Available from: https://www.who.int/news-room/ fact-sheets/detail/sepsis

Brunker LB, Boncyk CS, Rengel KF, Hughes CG. Elderly patients and management in intensive Care Units (ICU): Clinical Challenges. Clin Interv Aging. 2023;18:93-112.

Yoshikawa TT, Reyes BJ, Ouslander JG. Sepsis in older adults in long-term care facilities: challenges in diagnosis and management. J Am Geriatr Soc. 2019; 67(11):2234-39. doi: 10.1111/jgs.16194. Epub 2019 Oct 16. PMID: 31617944.

Bunyaphatkun P, Sindhu S, Davidson PM, Utriyaprasit K, Viwatwongkasem C, Chartbunchachai W. Factors influencing clinical deterioration in persons with sepsis. Pacific Rim Int J Nurs Res. 2017; 21(2):135-47.

Limpawattana P, Phungoen P, Mitsungnern T, Laosuangkoon W, Tansangworn N. Atypical presentations of older adults at the emergency department and associated factors. Arch Gerontol Geriatr. 2016;62:97-102. doi: 10.1016/j.archger.2015.08.016.

Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181-247. doi: 10.1007/ s00134-021-06506-y.

Dugar S, Choudhary C, Duggal A. Sepsis and septic shock: Guideline-based management. Cleve Clin J Med. 2020;87(1):53-64. doi: 10.3949/ccjm.87a.18143.

Belleza M. Sepsis and Septic Shock [Internet]. 2023 [cited 2023 November]. Available from: https://nurseslabs.com/sepsis-and-septic-shock/