A nurse holds hands with a senior nursing home resident
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The Centers for Disease Control and Prevention is urging long-term care clinicians and staff members to be on the lookout for signs of sepsis in residents.

Sepsis is an overwhelming response to infection that requires immediate intervention. It disproportionately affects frail seniors, including those living in nursing homes, but remains challenging to diagnose and treat in those settings, said Heather Jones, DNP, NP-C, a long-term care consultant with the CDC’s Division of Healthcare Quality Promotion.

The challenge of diagnosis

The intensive testing and monitoring needed to do so can be difficult to implement, and signs of sepsis, such as changes in cognition and function, can mimic those due to common chronic conditions, she wrote in a Sept. 13 blog post.

“The use of sepsis tools can also bring challenges. Some criteria typically used to support a sepsis diagnosis might not be as effective in older adults due to normal physiologic changes that occur with aging,” she explained.

To better detect and treat this condition in residents with known infections, direct care providers should team up with others who encounter residents daily, including other staff, family members and volunteers, to watch for key signs of sepsis and alert clinicians, Jones recommended. Signs may include sudden changes in baseline behavior and functioning, such as not recognizing a well-known staff member, trouble getting out of bed or loss of appetite.

Sepsis response plan

If the resident is developing sepsis, swift treatment, typically with intravenous fluids and antibiotics, is needed. Hospitalization is often required, she said.

In cases where a long-term care facility does not have a sepsis response plan, Jones encouraged staff members to approach their supervisors to recommend creating one. Plans should ensure that the residents’ goals of care are honored and related medical intervention documentation is at hand, she added.

“Sepsis develops quickly and can cause irreversible damage, including death, if not treated early,” Jones wrote. “With fast recognition and treatment, most residents survive.”

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