|
Current Key Challenges in Managing Maternal Sepsis - Sepsis resulting from maternal infection is the second lead- ing cause of pregnancy-related death. Although screening and initial care of a septic nonpregnant patient is standard- ized in nonpregnant adults, many challenges exist for early recognition and management of sepsis and septic shockin the obstetric population. Because most sepsis research excludes pregnant patients, there are many challenges that contribute to a lack of standardized approach to maternal sepsis. These challenges include inconsistent early warning sign criteria, lack of validated screening tools, adaptationof bundle components for maternal physiology, delivery considerations, and knowing when to transfer the patient to a higher level of care. To overcome these challenges, reduce variation in care, and improve patient outcomes, it is important for clinicians to plan, practice, and implement a maternal sepsis bundle.
Quality Improvement Opportunities Identified Through Case Review of
Pregnancy-Related Deaths From Sepsis
Objective: To analyze quality improvement opportunities (QIOs) identified through review of cases of maternal death
Results: Women’s delay in seeking care was the central theme in the Readiness domain. In the Recognition domain, health care providers missed the signs and symptoms of sepsis, including elevated temperature, elevated white blood cell count, increased heart rate, decreased blood pressure, mottled skin, preterm labor, headache, and pain. For Response, late antibiotic administration was a central theme; multiple emergent themes included administration of the wrong antibiotics, failure to investigate women’s complaints of pain, lack of nurse/provider communication, and lack of follow-up care after hospital discharge.
Conclusion: To reverse the contribution of sepsis to the rising rate of maternal mortality in the United States, health care facilities and providers need to reduce barriers for women who seek care, recognize early symptoms, and respond with appropriate treatment. This could be achieved by implementation of the Maternal Early Warning Criteria, standardized guidelines such as those from the Surviving Sepsis campaign, and comprehensive discharge education.
| 
