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The early diagnosis of sepsis in the acutely ill cancer patient. / Shelley Michelle Dolan

Swansea University Author: Shelley Michelle Dolan

Abstract

The sepsis syndrome is the systemic response of the body to infection. It develops from the earliest stage, Systemic Inflammatory Response Syndrome sepsis, to severe sepsis, septic shock and multi-organ dysfunction syndrome. The incidence of sepsis is growing and globally accounts for one in ten adm...

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Published: 2010
Institution: Swansea University
Degree level: Doctoral
Degree name: D.N.Sc
URI: https://cronfa.swan.ac.uk/Record/cronfa42440
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first_indexed 2018-08-02T18:54:42Z
last_indexed 2019-10-21T16:47:49Z
id cronfa42440
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spelling 2018-08-20T16:56:40.5182998 v2 42440 2018-08-02 The early diagnosis of sepsis in the acutely ill cancer patient. 19f04ba0ec76ca060ec7f56624627bc6 NULL Shelley Michelle Dolan Shelley Michelle Dolan true true 2018-08-02 The sepsis syndrome is the systemic response of the body to infection. It develops from the earliest stage, Systemic Inflammatory Response Syndrome sepsis, to severe sepsis, septic shock and multi-organ dysfunction syndrome. The incidence of sepsis is growing and globally accounts for one in ten admissions to Intensive Care Units. The mortality rate for severe sepsis ranges from 25% to 67%. People with cancer are ten times more likely to develop sepsis and having developed it have a higher mortality rate. Early recognition and treatment of sepsis has been demonstrated to improve outcomes. This study sought to improve early recognition of sepsis in cancer patients receiving acute treatment. Nurses and patient assessment were the focus of this study. The design was a prospective multi-method observational study with two interventions: a teaching session for 177 nurses; the introduction of a bedside test - Procalcitonin (PCT-Q), an immunological marker of sepsis. PCT has been shown to be a reliable marker of sepsis. The PCT-Q, has been used since the late 1990s but never by ward nurses. Methods used were: qualitative interviews of ten nurses and a questionnaire survey of 177 nurses pre and post intervention; and a patient database with the PCT-Q test being used 416 times in 320 patients to diagnose sepsis. The study showed that nurses and patients recognise the early changes of deterioration before their observations change. Nurses recognise these changes because they know their patients well. Nurses' knowledge improved in several areas during the study and they used PCT-Q appropriately, diagnosing sepsis at an early stage in 66% of cases. Ordinal multi-regression analysis demonstrated that PCT was more reliable than CRP and, used together with a low WBC and high lactate, accurately predicts sepsis. E-Thesis Nursing.;Medicine. 31 12 2010 2010-12-31 COLLEGE NANME Nursing COLLEGE CODE Swansea University Doctoral D.N.Sc 2018-08-20T16:56:40.5182998 2018-08-02T16:24:29.2597915 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Shelley Michelle Dolan NULL 1 0042440-02082018162454.pdf 10798148.pdf 2018-08-02T16:24:54.5800000 Output 16774357 application/pdf E-Thesis true 2018-08-02T16:24:54.5800000 false
title The early diagnosis of sepsis in the acutely ill cancer patient.
spellingShingle The early diagnosis of sepsis in the acutely ill cancer patient.
Shelley Michelle Dolan
title_short The early diagnosis of sepsis in the acutely ill cancer patient.
title_full The early diagnosis of sepsis in the acutely ill cancer patient.
title_fullStr The early diagnosis of sepsis in the acutely ill cancer patient.
title_full_unstemmed The early diagnosis of sepsis in the acutely ill cancer patient.
title_sort The early diagnosis of sepsis in the acutely ill cancer patient.
author_id_str_mv 19f04ba0ec76ca060ec7f56624627bc6
author_id_fullname_str_mv 19f04ba0ec76ca060ec7f56624627bc6_***_Shelley Michelle Dolan
author Shelley Michelle Dolan
author2 Shelley Michelle Dolan
format E-Thesis
publishDate 2010
institution Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
active_str 0
description The sepsis syndrome is the systemic response of the body to infection. It develops from the earliest stage, Systemic Inflammatory Response Syndrome sepsis, to severe sepsis, septic shock and multi-organ dysfunction syndrome. The incidence of sepsis is growing and globally accounts for one in ten admissions to Intensive Care Units. The mortality rate for severe sepsis ranges from 25% to 67%. People with cancer are ten times more likely to develop sepsis and having developed it have a higher mortality rate. Early recognition and treatment of sepsis has been demonstrated to improve outcomes. This study sought to improve early recognition of sepsis in cancer patients receiving acute treatment. Nurses and patient assessment were the focus of this study. The design was a prospective multi-method observational study with two interventions: a teaching session for 177 nurses; the introduction of a bedside test - Procalcitonin (PCT-Q), an immunological marker of sepsis. PCT has been shown to be a reliable marker of sepsis. The PCT-Q, has been used since the late 1990s but never by ward nurses. Methods used were: qualitative interviews of ten nurses and a questionnaire survey of 177 nurses pre and post intervention; and a patient database with the PCT-Q test being used 416 times in 320 patients to diagnose sepsis. The study showed that nurses and patients recognise the early changes of deterioration before their observations change. Nurses recognise these changes because they know their patients well. Nurses' knowledge improved in several areas during the study and they used PCT-Q appropriately, diagnosing sepsis at an early stage in 66% of cases. Ordinal multi-regression analysis demonstrated that PCT was more reliable than CRP and, used together with a low WBC and high lactate, accurately predicts sepsis.
published_date 2010-12-31T03:52:58Z
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score 11.014067

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