Lesson 1Pathophysiology of sepsis and septic shock: host response, organ dysfunction, and progressionExplains the host response to infection, including inflammatory and immune pathways, microcirculatory failure, and cellular dysfunction. Links these mechanisms to organ failure, shock progression, and clinical signs nurses monitor in real time.
Host immune response to infection in sepsisEndothelial injury and capillary leakMicrocirculatory and mitochondrial dysfunctionFrom sepsis to septic shock: key transitionsOrgan dysfunction patterns and SOFA conceptsClinical correlates of underlying pathophysiologyLesson 2Fluid therapy specifics: crystalloid selection, bolus strategies, and recognition of fluid overloadCovers crystalloid selection, bolus volumes, and rates in early sepsis resuscitation. Emphasizes dynamic assessment of fluid responsiveness, bedside recognition of fluid overload, and nursing strategies to balance perfusion with avoidance of harm.
Balanced versus normal saline selectionInitial bolus strategies and reassessment timingStatic and dynamic fluid responsiveness toolsClinical signs of fluid overload at the bedsideDocumentation of fluid balance and net statusCollaboration on de-resuscitation strategiesLesson 3Patient safety and sepsis-related complications: acute kidney injury, coagulopathy, and need for organ supportAddresses common sepsis-related complications, including acute kidney injury, coagulopathy, respiratory failure, and need for organ support. Emphasizes early recognition, prevention strategies, and nursing care for renal, respiratory, and hematologic support.
Recognition and staging of acute kidney injuryCoagulopathy, DIC, and bleeding riskRespiratory failure and ventilatory supportHemodynamic support beyond vasopressorsNursing care for renal replacement therapyPrevention and early detection of complicationsLesson 4Documentation and communication: recording bundle elements, escalation triggers, and handover of sepsis careDetails accurate documentation of sepsis bundles, vital trends, and interventions, along with clear communication of escalation triggers. Emphasizes structured handovers, closed-loop communication, and use of checklists to maintain continuity of care.
Recording sepsis bundle elements and timingDocumenting hemodynamics and lactate trendsEscalation triggers and rapid response criteriaStructured handover tools for sepsis patientsInterdisciplinary communication best practicesLegal and quality implications of documentationLesson 5Antimicrobial stewardship and timing: empirical therapy selection, de-escalation, and culture stewardshipFocuses on timely empirical antimicrobial selection, dosing, and administration in sepsis. Reviews obtaining cultures, reassessing therapy with new data, de-escalation strategies, and nursing roles in antimicrobial stewardship and monitoring toxicity.
Timing of first-dose antibiotics in sepsisEmpirical regimen selection and local antibiogramsObtaining cultures without delaying therapyDe-escalation and duration of therapyMonitoring for antimicrobial adverse effectsNursing contributions to stewardship roundsLesson 6Vasopressors and inotropes: indications, dosing targets, titration, adverse effects, and common nurse-driven protocols for norepinephrineReviews norepinephrine as first-line vasopressor in septic shock, focusing on indications, starting doses, titration strategies, monitoring targets, adverse effects, and common nurse-driven protocols, including safety checks and central line considerations.
Indications for norepinephrine in septic shockStarting doses, concentration, and titration stepsMAP targets and hemodynamic monitoringRecognition and management of adverse effectsCentral line use, patency, and extravasation careNurse-driven vasopressor titration protocolsLesson 7Current international sepsis guidelines and bundles (Surviving Sepsis Campaign): 1‑hour and 3‑hour elementsSummarizes current Surviving Sepsis Campaign guidelines and bundles, emphasizing 1-hour and 3-hour elements. Highlights time-sensitive nursing actions, local protocol adaptation, and audit-feedback processes to improve adherence and patient outcomes.
Core principles of Surviving Sepsis CampaignOne-hour bundle elements and nurse actionsThree-hour bundle elements and sequencingIntegrating bundles into unit workflowsMeasuring compliance and feedback loopsAdapting guidelines to local resourcesLesson 8Hemodynamic goals in sepsis: MAP targets, lactate-guided resuscitation, and fluid responsiveness assessmentDefines hemodynamic goals in sepsis, including MAP targets, lactate clearance, and markers of perfusion. Reviews bedside assessment of fluid responsiveness and integration of dynamic indices, ultrasound, and clinical judgment in resuscitation decisions.
MAP targets and individualized blood pressure goalsLactate trends and perfusion-guided resuscitationCapillary refill and peripheral perfusion markersDynamic indices for fluid responsivenessRole of bedside ultrasound in volume assessmentBalancing fluids, vasopressors, and inotropesLesson 9Monitoring response to sepsis treatment: serial lactates, urine output, end-organ perfusion markers, and bedside clinical toolsDescribes how to monitor response to sepsis treatment using serial lactates, urine output, mental status, and other end-organ markers. Covers bedside tools, frequency of reassessment, and documentation to guide ongoing resuscitation and de-escalation.
Serial lactate measurement and interpretationUrine output targets and renal perfusionNeurologic status and delirium screeningSkin, temperature, and perfusion assessmentFrequency and structure of reassessment roundsTrend-based documentation and care adjustmentsLesson 10Infection source control: principles, timelines, and nursing coordination for procedures and diagnosticsOutlines principles of infection source control, including timing, coordination of imaging and procedures, and communication with the multidisciplinary team. Highlights nursing roles in preparation, transport, consent support, and postprocedure monitoring.
Identifying likely infection sources earlyTiming and urgency of source control actionsCoordinating imaging and bedside proceduresPreprocedure preparation and safety checksPostprocedure monitoring and complication signsNursing role in multidisciplinary planning
