There are 18 million cases of sepsis annually throughout the world. An estimated 75,000 maternal deaths worldwide are associated to sepsis.  The rate in the developed countries are lower, but sepsis is among the leading causes of preventable maternal mortality. The Surviving Sepsis Campaign is a national program focused on reducing sepsis related mobidity and mortality.This program will review the physiology of sepsis and how it affects the Perinatal patient. Early recognition and evidence based management are key in reducing morbidity and mortality.  Implementation of a screening and management program for the perinatal patient will improve outcomes as it has in the non perinatal population nation wide.

Proposed change:

Implementation of  a standardized sepsis screening tool that includes the unique physiology of pregnancy.  Implementation of the Surviving Sepsis management bundle.

Implementation, outcomes and evaluation:

Sepsis screening and standard management was initially implemented for the adult non OB population throughout the Sutter Healthcare System.  Reduction in overall mortality has been associated with this program.  It soon became obvious that the Perinatal population would benefit from this progrm. We adopted the Surviving Sepsis bundle elements, but made changes to the screening tool to account for the changes in physiology in the pregnant and postpartum population.  Implementation of this program required a multidisciplinary team of OB and ICU MDs, OB, ICU, ED RNs, rapid response team, laboratory and pharmacy.  Patients are screened on admission and then every shift.  If a sepsis screen is positive, the rapid response nurse is called to immediately evaluate the patient.  The standard, evidence based order set is initiated.  This process has improved the collaboration between the Perinatal and Intensive Care teams.  There has been an increase in admissions to the ICU.  Compared to our ICU admissions before the screening, the ICU days are shorter.

Implications for nursing practice:

There is an increased awareness of sepsis and how it presents in the Perinatal patient. 

Keywords: Sepsis, Perinatal