Development and implementation of a multidisciplinary sepsis protocol.

CRITICALCARENURSE Vol 26, No. 3, JUNE 2006 43 sion of the bloodstream by micro organisms. However, a subset of critically ill patients have features characteristic of sepsis despite blood cultures that are repeatedly negative for microorganisms and no identified source of bacterial, fungal, or viral infection. Trauma, surgery, burns, and illnesses such as cancer and pneumonia can trigger the onset of sepsis. In 1991, the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference outlined definitions for systemic inflammatory response syndrome, sepsis, severe sepsis, septic shock, and multiple organ dysfunction syndrome (Table 1). These definitions have been widely adopted. They have allowed greater consistency in diagnosis and treatment and in tracking statistics on the incidence and occurrence of sepsis. Patients vulnerable to sepsis may have a number of risk factors (Table 2). Despite the wide variety of patients who initially have systemic inflammatory response syndrome, if Kathy M. Picard, RN, MS, CCRN Sharon C. O’Donoghue, RN, MS Duane A. Young-Kershaw, RN, BSN Kristin J. Russell, RN, BSN