Sepsis: Research Proposal

The research proposal will analyze the efficacy of a sepsis prevention program within a hospital setting. Sepsis is a medical problem which can be fatal for patients who come down with the condition. Sepsis is caused by an infection which affects every vital organ in the body. If left untreated the condition can result in these vital organs shutting down which ends the life of the patient. Sepsis can occur in anyone regardless of race, ethnicity or gender. However, individuals with a weak immune system such as infants or the elderly are at an increased risk of contracting sepsis. The nurse can play a vital role in the diagnosis, informing the patient, treatment and prevention of sepsis. Due to this essential role a sepsis prevention program should be geared towards nurses in a hospital setting. 

Sepsis is an issue which is a cause of concern for any nurse as the condition can occur across multiple nursing fields. Septic shock is often lethal and can progress at an alarming rate, which is why the research needs to be targeted to nurses who are in a position to recognize sepsis before it progresses to this late stage. Sepsis often occurs with another condition such as cancer or alcoholism. The treatment of sepsis occurs with antibiotics and is dependent on the extent to which the sepsis has progressed within the patient. Nurses need to be educated and trained on sepsis in order to be able to treat the condition before it becomes fatal. The issue can also be seen as a cause of concern for policymakers as the fatality of sepsis can take away productive citizens as “the loss of productivity related to years of life lost” (Wheeler, 2011, p. 3) can be a high cost for societies who do not treat fatal conditions such as sepsis. The research proposal will add to the literature that exists on the topic and may set forth guidelines that can be used by many different facilities. 

The research proposal is designed to measure the effectiveness of the Surviving Sepsis Campaign (SSC), a program created by the Critical Care Society (2013), in hospital settings to improve the ability of nurses to treat the condition. The SSC’s guidelines allow clinicians to recognize sepsis in its early stages and treat the symptoms aggressively before sepsis progresses. The research proposal contributes to the current literature that exists on sepsis as it provides information on not just treating sepsis but also preventing the condition. The results of the research could be utilized in hospitals across the country to reduce the rates of the deadly condition occurring. The focus of the research proposal on nurses also add to the current literature as nurses in hospital setting can be influential in the implementation of the guidelines within their units. Nurses can also speak to the feasibility of the proposal on determining how they will or will not implement the guidelines within their units based on how reasonable the guidelines are.

The research proposal will analyze the efficacy of reducing rates of sepsis through the use of the Surviving Sepsis campaign. The research study will be conducted on two groups of nurses in a community-based teaching hospital. The study will occur in a nursing unit, such as intensive care, where sepsis is likely to occur. The researcher will inform the nurses who are participating in the study of the Surviving Sepsis Campaign (SSC) guidelines. The researcher will stress the use of data collection and bundles in order for the research study and the sepsis campaign to be effective. According to Kleinpell (2013), bundles are group of treatments within hospital settings which can reduce sepsis and are “(1) recommendations directly targeting the management of severe sepsis, (2) recommendations targeting high-priority general care considerations, and (3) pediatric considerations” (p. 214).  The researcher will go over SSC guidelines and bundles as well as recognizing the signs of sepsis. The participants will also be provided with material that they can use throughout their shifts through access to the Surviving Sepsis Campaign via its website. The website offers a multitude of resources and information, as well as recorded web-conferences, so it is both convenient and necessary. The researcher would then provide participants with the “Surviving Sepsis Campaign Declaration Letter” and ask them to sign it in order to emphasize the commitment to data collection in their units. The rates of sepsis within the hospital unit implementing the SSC guidelines will be compared to other similar hospital units to determine whether the campaign is effective in combatting sepsis for the patients within the hospital.

As a researcher who is familiar with the SSC, I will have an important role in stressing the importance of using the guidelines when working with the patients. I will need to be knowledgeable about the campaign in order to address any questions or concerns the participants may have. I would also need to be working closely with hospital administration to ensure that the SSC guidelines are not clashing with hospital policy. Becoming familiar with the campaign may increase my bias towards the effectiveness of the guidelines. While this may not impact the study itself, it may become a factor when analyzing the results. As a researcher I will have to be careful to address the bias and not overly attribute the reduced rates of sepsis to just the campaign. Other factors may impact the results such as the fact that the hospital is a teaching hospital and the group of nurses is willing to participate in the study. The study would also need to take into account factors that cannot be changed such as the patients who come in with the condition.  Levinson et al. (2011) emphasized patients’ health backgrounds may contribute to their susceptibility to sepsis. The patients are a factor that cannot be changed within the study and must be accounted for in the results. However, being aware of these biases will improve the research as I will be able to account for these factors early on in the study rather than after the results have been gathered.

The sampling method that will be utilized in the study will be one of a nonprobability sampling as the population needed is very specific in that they need to be nurses. The study will utilize quota sampling to gather enough participants who have a wide range of experience with sepsis and with the treatments. This sampling method is needed as a variety of nurses are needed in the study. If all the nurses have no experience of treating sepsis, they may not be able to provide quality data collection. Conversely if all the nurses who participate are experienced with sepsis, they may not follow the SSC guidelines due to being entrenched in their way of doing things. Having a mix of experienced and inexperienced nurses can enhance the study. This population can be obtained through quota sampling. The nurses will then implement the guidelines as a group because research has found that when nurses work together in groups, they offer optimal results. 

The participants within the study are critical care nurses who work within the setting of a teaching hospital. The nurses will have wide ranges of experiences with sepsis from never having worked a case to being very familiar with the condition. They will also have wide ranging experiences with the treatments that are being used to treat sepsis. The number of participants in the study will be 10 nurses. They must all have completed a BSN program in nursing. Master educated nurses will not be included in the study as all the nurses need to have the same level of education. The nurses are important to the research as they will be directly implementing the guidelines in their practice. However, the audience of the study is also beneficial as they are the ones who will make the decisions on whether the SSC guidelines will be adopted as a standard throughout the hospital. The audience for the study will be hospital administrators and doctors who can make an impact on decisions within the hospital. If the study can demonstrate to these individuals that the SSC is effective in reducing rates of sepsis the campaign can be implemented throughout the hospital and eventually can become a nationwide campaign that is utilized in numerous hospitals. 

The audience can also include the American Association of Critical Care Nurses (AACN) who can make policy changes for nurses across the nation. The study would need to demonstrate to the AACN that the campaign is effective. Without the contribution of the AACN hospitals may be reluctant to change guidelines within their hospitals. As the AACN (2010) is in the midst of updating their guidelines regarding treating severe sepsis the study would occur at an opportune time to make a difference in the way in which sepsis is treated and recognized within not only critical care units but across hospital settings as a whole. The impact of the study can be wide ranging and are heavily dependent on the results that will be gathered from the completion of the study.

After completing the study and gathering the results I would hypothesize that the study would reveal the SSC guidelines to be effective in reducing rates of sepsis. The results would demonstrate that by working together as a team and implementing the bundles nurses would see a significant drop in patients who either come in with sepsis or contract sepsis through their hospital stay. The results would need to account for the factors discussed earlier, such as the teaching hospital setting and nurse participants, in order to rule out any biases that may be in the study. Accounting for these factors will strengthen the reliability of the hypothesis and results that are gathered. These results would hopefully result in implementation of the guidelines in a number of different hospital settings, especially in the intensive care units where sepsis is most likely to occur. The research study would contribute to the literature on sepsis and further the understanding on how to effectively treat the fatal condition which affects millions of patients globally. 

References

AACN Practice Alert. (2010). Severe sepsis: Initial recognition and resuscitation. American Association of Critical Care Nurses.

Kleinpell, R., Aitkel, L., &Achorr, C.A. (2013). Implications of the new international sepsis guidelines for nursing care. American Journal of Critical Care, 22(3), 212-222.

Levinson, A., T., Casserly, B.P., & Levy, M. M. (2011). Reducing mortality in severe sepsis septic shock. Seminars in respiratory and critical care medicine, 32(20).

Society of Critical Care Medicine. (2013). Implement and Improve. Surviving Sepsis Campaign. Retrieved from http://www.survivingsepsis.org/Improvement/Pages/ default. aspx Wheeler, D.S. (2011). Pediatric sepsis: Markers, mechanisms, and management. The Open

Inflammation journal. (Suppl 1-M1), 1-3.