Introduction

Healthcare professionals have an important role to play in saving lives or enhancing longevity of lives of patients. One of their key roles is to make early intervention and carry out effective monitoring to deteriorating patients (Odell, Victor & Oliver, 2009; Dresser, 2012). Early intervention and monitoring of deteriorating patients enhances chances of their survival and ultimately, it reduces deaths of patients admitted in critical care units. A good example is the case of Janet, a 69 year old woman who has been diagnosed with septic shock and her health condition is worsening every day. Septic shock is a health complication that results from the presence of toxins in the whole body, leading to inflammation that affects vital body organs. The condition is fatal, especially among patients with other body complications admitted in critical care units (Aitken et al., 2011). Despite this, nurses have a chance to rescue such people if they intervene to the condition as early as possible, offer effective treatment and afterwards, carry out effective monitoring (Australian Commission on Safety and Quality in Health Care, 2010; Levett-Jones et al., 2010; Ashcraft & Owen, 2014). In short, this paper uses the case of Janet to demonstrate why early intervention and effective assessment of deteriorating patients is important in reducing deaths caused by critical illnesses. Prior to that, the paper explores previous studies in order to explain the importance of timely intervention and effective monitoring to deteriorating patients.

Importance of Nursing Early Assessment and Intervention

There are numerous previous studies that have paid attention to the importance of early assessments and interventions to patients. The studies, in general, have emphasized on the importance of early intervention and effective monitoring in reduced chances of death among patients. While some have focused on the importance of early intervention and assessment to all patients in general, others have focused on the importance of the approach to patients with critical illnesses. DeVita et al. (2010) gathered evidence-based data that explains the importance of early assessment and intervention to patients who are admitted in hospitals. The results of data analysis indicated that early assessment and intervention increases chances of survival among patients. Although the researcher emphasized on the important of installing assessment equipments and systems that are effective, the study also pointed out that healthcare professionals in hospitals should focus on recognizing, assessing and intervening to patients’ illnesses as early as possible. DeVita et al. (2010) noted that rapid response plays a vital role in preventing deaths that could have been avoided through adopting early intervention strategies.

Hopkins Spuhler & Thomsen (2007) carried out a study that aimed at determining the importance of a mobility culture in healthcare facilities that facilitates early intervention and assessment of patients with critical illnesses. The researcher took an approach that involved gathering evidence from previous studies. After gathering the evidence, the researcher noted that it was vital for healthcare facilities to adopt cultures that enhance early intervention and assessment. The researcher recognized the importance of doing so in increasing chances of survival among patients with critical illnesses.

There are also numerous studies that have focused on the importance of early intervention and monitoring to patients with septic shock. The studies have emphasized on the importance of early intervention and assessment to patients with septic shock. For instance, Vandijck et al. (2008) analyzed previous studies that focused on determining the effectiveness of early assessment and intervention on patients with severe septic shock. The results of the analysis indicated that previous studies have found a reduction in the number of deaths of people with septic shock admitted in critical care units when early assessment and intervention strategies are adopted. As well, Minton et al. (2008) carried out a study that aimed at determining whether early recognition and application of assessment and intervention strategies leads to an improvement in the management of septic shock. The results of the study indicated that early assessment and intervention significantly improves the management of septic shock and reduces the risk of death among patients. Aitken et al. (2011) focused on collecting nursing evidence from clinicians and scholars and used it to offer recommendations regarding the intervention and assessment approaches that health professionals should adopt in order to reduce deaths of people with septic shock in healthcare facilities. Although numerous recommendations were made for the intervention, the most dominant recommendation was early and effective response to the condition. The strategies that were recommended in order to achieve that goal were early and effective assessment, intervention and monitoring. An empirical study carried out by Yokoe et al. (2008) found similar findings. In short, there is enough evidence to prove the importance of the use of early assessments and intervention strategies play a vital role in reducing chances of deaths among patients.

The case of Janet

Although Janet was diagnosed with septic shock recently, advanced cervix cancer is the illnesses that led her to be admitted to critical care unit. She was diagnosed with cervical cancer three years ago. She has been receiving treatment for the cancer throughout the period. By the time she realized that she had the illness, the cancer was at the advanced level. As a result, she has been receiving different forms of treatment that are offered to people with advanced cancer over the last three years, such as chemotherapy. Initially, her condition was not very severe and thus, she was not admitted to stay in a healthcare facility. However, the cervical cancer became severe two months ago, leading healthcare professionals to admit her in a hospital. Despite receiving treatment in the hospital since then, her condition deteriorated one week ago to the extent that she had to be admitted to a critical care unit in the hospital. After assessing her closely, nurses realized that she had developed septic shock. Close assessment and diagnosis indicated that the septic shock was not yet severe.

There are several parameters that indicated that Janet had septic shock. Firstly, the nurses noted that she had patches of on her skin that were not of natural color. Secondly, she had lost alertness and was often confused. Further, she urinated less frequently than before and the amount of urination had reduced over time. The nurses noted that Janet had started experienced problems in breathing. The results of the assessment indicated that Janet had developed abnormal heart functions. Sometimes, the heart rate increased to an abnormal level. Also, she sometimes experienced palpitations. The nurses realized that she experienced chills sometimes. After close assessment, the nurses found that the chills were caused by falls in body temperature. Also, Janet’s body had become too weak to the extent that she had to be supported when going to toilet. She could not lift slightly heavy objects. The presence of those parameters indicated that the health status of Janet was deteriorating.

After noticing those parameters, the nurses invited a physiologist to carry out a physiological assessment of Janet. The results of the assessment indicated that Janet had an infection in her reproductive system that had spread to other parts of her body. In particular, the report of the physiologist showed that Janet had bacteria in her reproduction system and blood. Also, the physiologist found clotted blood in some parts of her body. In addition, she had a lot of waste products in her blood. The physiologist noted that Janet’s liver and kidney were not functioning properly. There was also evidence of lack of enough oxygen in her blood. The physician also carried out a test on her to determine the source of the problem. The test report indicated that the problem was caused by the continuous treatment of cervix cancer.

Actions for Assessing, Monitoring and Intervening in the Case

There are several key physiological changes that occur in the body of an individual when he or she acquires sepsis, leading to the emergence of the symptoms that were exhibited by Janet. Although other infections may lead to the illness, septic shock usually occurs as a result of bacterial infection. The bacteria enter into the body as a result of a wound or a serious infection such as meningitis, cancer, pneumonia or appendicitis (Martin, 2012). In the case of Janet, the bacteria entered through the wounds that were caused by cervical cancer and treatment methods such as chemotherapy. The bacteria release toxins that cause an infection to the body. The toxins are usually present in the body fluids. This explains why the doctor found toxins in the body fluids of Janet. The bacteria that cause infection are present in the blood, as noted in the issue of Janet. The body responses through releasing chemicals that are meant to fight the infection. However, the chemicals cause inflammation in different parts of the body where it passes. Severe inflammation causes damage to internal and external body organs (Dellinger et al., 2013). The patches that were on the skin of Janet were caused by the inflammation.

Also, the inflammation leads to blood clotting, which reduces blood flow to various internal organs and limbs. This explains why a reduction in the blood pressure was a significant symptom evident in Janet. Ultimately, different internal organs and limbs are deprived oxygen and nutrients, leading to a reduction in their functions. This explains why the test results indicated that the functioning of Janet’s kidney and liver were altered, leading to a reduction in the amount of urine that she released. Ultimately, low functioning of organs causes problems such as body weakness, reduction in body temperature and shivering (Dellinger et al., 2013). Elderly people, very young children and people with diseases that make the immune system weak have a high risk of acquiring the illness (Levinson, Casserly, & Levy, 2011). Janet had a high risk of acquiring sepsis due to her elderly age.

Health professionals have already carried out an assessment of Janet’s health status. They can save her life through early intervention through effective treatment. The health professionals should treat her with the most effective medications. For instance, they can treat her with antibiotics that are effective in fighting the infection caused by bacteria. They can also treat her with drugs that help to improve blood pressure and constrict blood vessels (Levinson et al., 2011). The problem of low blood pressure can be treated using IV fluids. The fluids are also essential in preventing dehydration. To enhance the stability of blood sugar, the health professionals can treat her using insulin. Inflammation can be treated using corticosteroids. In case the problem of breathing persists, the health professionals should provide her with a respirator. In case of need, surgery can be done on her to remove infected tissues (Levinson et al., 2011). After offering the treatment, the health professionals should make constant assessment of Janet’s status and help her manage the problem through following the doctor’s directives on how to use different types of drugs (Vandijck et al., 2008). The assessment should start immediately after the treatment and should continue even after Janet leaves the hospital, until she is fully healed.

Conclusion

Overall, it is quite imperative for health professionals to focus on early assessment and intervention to deteriorating patients. In doing so, they are they will contribute immensely in reducing the number of deaths that occur as a result of lack of timely recognition of critical illnesses. After successful early intervention, close assessment should be carried out frequently on the patient to ensure that he or she is responding well to treatment. Treatment strategy should be modified in case evidence of the need to do so emerges during the assessment process. The aforementioned strategies can be quite effective in reducing deaths that are caused by septic shock. The strategies should be applied in treating Janet.

 

 

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