Award Date

5-1-2021

Degree Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Committee Member

Aaron Bellow Jr.

Second Committee Member

Paul Thomas Clements

Third Committee Member

Michelle Sotero

Number of Pages

64

Abstract

Morbidity and mortality related to sepsis management have been popular research topics for a significant part of the last two decades. The Surviving Sepsis Campaign was launched in 2002 with goals to develop medical management guidelines, improving diagnosis by building awareness, expanding healthcare provider education, and improving appropriate treatment (Society of Critical Care Medicine [SCCM], 2019). Professional organizations and governing bodies continuously revise guidelines for the early identification and treatment of sepsis. The latest treatment recommendations for the Hour-1 Bundle of sepsis management (SEP-1) include initiating vasopressors in conjunction with fluid resuscitation to reach the hemodynamic goal of maintaining a mean arterial pressure of 65 mmHg or higher (SCCM, 2019). The hemodynamic interventions for septic-shock treatment include fluid resuscitation and accurate assessment of volume status by cardiovascular ultrasound, fluid response testing, and a focused physical examination (Pepper et al., 2018). Septic shock is a time-sensitive disease process whereby prompt recognition and management improves morbidity and mortality (Mittal & Coopersmith, 2014). The rapid acquisition of needed central vascular access for hemodynamic measurement and vasopressor titration to achieve adequate organ perfusion leads to optimal patient outcomes (Mittal & Coppersmith, 2014). Acute Care Nurse Practitioners (ACNP) are Advanced Practice Resisted Nurses (APRN) that are board-certified in acute care and typically work in acute care settings such as Intensive Care Units (ICU). ACNPs manage patients with sepsis and septic shock. Despite the demonstrated safety and efficacy of ACNP practice, some institutions do not grant central venous catheter (CVC) insertion privileges to ACNPs working in the ICU. Procedure privileges are determined by individual hospital credentialing policies. This poses a significant problem for septic shock management and restricts ACNP practice.

Keywords

Acute Care Nurse Practitioners; Advanced Practice Registered Nurse; Central Line Access; Central Venous Catheter Delays; Sepsis Delays; Septic Shock

Disciplines

Nursing

File Format

pdf

File Size

1922 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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Nursing Commons

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