Evidence Based Practice Guideline/Position Statement Paper Lakin S. Cooley University of South Alabama NU608: Evidence Based Practice and Quality Improvement in Healthcare Systems

Sepsis, a six-letter word that involves the body fighting against infection. The diagnosis of sepsis affects millions yearly and is amongst the primary reason for increasing health care cost, hospital readmission, and mortality in the United States. Annually, the health care system spends roughly three hundred and eighty-one billion dollars on health related cost linked to sepsis (Danna, 2018). Understanding the above leads to the focus of this paper. The author will dive into the significance of the current clinical practice guideline provided by the Surviving Sepsis Campaign in 2016, as well as evaluate and understand the implementation process that this campaign provides in respects to a thorough initial assessment and patient-based management of fluid resuscitation in septic patients in the acute hospital setting. Phenomenon of Interest Significance One might ask, what is the Advanced Practice Nurse’s (APN) role in evidence-based practice? The main goal for all APNs should be implementing the best research and applying it to individualize care and improve outcomes for all patients (Polit & Beck, 2018). Sepsis, the leading cause of death in critically ill patients, requires multiple medical care professionals at hand in order to reduce the mortality rate that tags along with this diagnosis (Howell & Davis, 2017). Not only does sepsis tag a high mortality rate, but the cost of care for these patients is well over three hundred billion dollars annually and takes the lead for costliest health care in the United States (Paoli et al., 2018). First and foremost, it is vital to correctly conclude that a patient is septic in order to move forward and provide the proper care. APNs play a crucial role in this process. It is at the hands of the practitioner to correctly assess the patient and then implement a plan that will in fact provide the patient with the best outcome. Along with assessing the patient for a correct diagnosis and implementing the best research available, it is just as utterly important for the practitioner to evaluate the outcome. Implementing new sepsis guidelines, where the goal of care is patient based using the practitioner’s keen assessment skills for a rapid recognition of sepsis is the start of the significance that applies to the practitioner and treatment of these patients. Allowing the individual’s body to lead the care all while considering fluid resuscitation and further treatment based on the initial assessment including vital signs and comorbidities allows for more holistic care and provides the practitioner with guidance that is patient-based rather than guidance that is set in stone and used on every patient. In retrospection, the guidance is task oriented and not patient tailored. By implementing these new guidelines there will be a decrease in mortality associated with the diagnosis of sepsis along with sharp decline in health care cost related to this diagnosis. PICO and Clinical Question P: Patient supposed of sepsis in the acute hospital care setting I: Use of a speedy physical assessment, including vital signs and a thorough look into past medical history, followed by a patient-based initial fluid resuscitation within the first three hours while recurrently reassessing the patient and involving passive leg raises and fluid encounters to regulate the need for additional fluid. C: Use of a fixed fluid resuscitation strategy within the first three hours for all patient with the supposed diagnosis of sepsis, and adding additional fluid based on central venous pressures and oxygen saturation. O: Decrease the amount of money the healthcare system puts forth all while decreasing the mortality rate associated with sepsis. Clinical Question: In patients supposed of being septic in the acute hospital care setting is the use of a speedy physical assessment, including vital signs and a thorough look into past medical history followed by a patient-based initial fluid resuscitation within the first three hours while

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