Nursing role in the management and monitoring of patients with sepsis and septic shock in critical care units
DOI:
https://doi.org/10.70577/asce.v5i2.882Keywords:
sepsis, septic shock, critical care nursing, clinical monitoring, systematic reviewAbstract
This article analyzed the nursing role in the management and monitoring of patients with sepsis and septic shock in critical care units through a systematic review of recent scientific literature. The methodology was developed according to PRISMA 2020, with searches conducted in PubMed/MEDLINE, CINAHL, Scopus, and the Virtual Health Library, considering studies published between 2019 and 2025 in Spanish, English, and Portuguese. The results showed that nursing plays an essential role in the early detection of clinical deterioration, protocol activation, timely administration of antibiotics and fluid therapy, continuous monitoring of hypoperfusion signs, and coordination with the interdisciplinary team. It was also identified that the effectiveness of care was influenced by organizational factors such as staffing levels, the availability of standardized tools, and the quality of interprofessional communication. It was concluded that nursing constitutes a central axis in the response to sepsis, although research gaps remain regarding its participation in the advanced hemodynamic monitoring of septic shock in contemporary high-complexity intensive care units.
Downloads
References
Abdalhafith, O., Rababa, M., Hayajneh, A. A., Alharbi, T. A. F., Alhumaidi, B., & Alharbi, M. N. (2025). Critical care nurses’ knowledge, confidence, and clinical reasoning in sepsis management: A systematic review. BMC Nursing, 24, 424. https://doi.org/10.1186/s12912-025-02986-1 DOI: https://doi.org/10.1186/s12912-025-02986-1
Centers for Disease Control and Prevention. (2025, January 31). Hospital sepsis program core elements. https://www.cdc.gov/sepsis/hcp/core-elements/index.html
Chua, W. L., Teh, C. S., Basri, M. A. B. A., Ong, S. T., Phang, N. Q. Q., & Goh, E. L. (2023). Nurses’ knowledge and confidence in recognizing and managing patients with sepsis: A multi-site cross-sectional study. Journal of Advanced Nursing, 79(2), 616–629. https://doi.org/10.1111/jan.15435 DOI: https://doi.org/10.1111/jan.15435
Cimiotti, J. P., Becker, E. R., Li, Y., Sloane, D. M., Fridkin, S. K., West, A. B., & Aiken, L. H. (2022). Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis. JAMA Health Forum, 3(5), e221173. https://doi.org/10.1001/jamahealthforum.2022.1173 DOI: https://doi.org/10.1001/jamahealthforum.2022.1173
Dall’Ora, C., Saville, C., Rubbo, B., Turner, L., Jones, J., & Griffiths, P. (2022). Nurse staffing levels and patient outcomes: A systematic review of longitudinal studies. International Journal of Nursing Studies, 134, 104311. https://doi.org/10.1016/j.ijnurstu.2022.104311 DOI: https://doi.org/10.1016/j.ijnurstu.2022.104311
Deulkar, P., Singam, A., Mudiganti, V. N. K. S., & Jain, A. (2024). Lactate monitoring in intensive care: A comprehensive review of its utility and interpretation. Cureus, 16(8), e66356. https://doi.org/10.7759/cureus.66356 DOI: https://doi.org/10.7759/cureus.66356
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., McIntyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., ... Levy, M. (2021). Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Intensive Care Medicine, 47(11), 1181–1247. https://doi.org/10.1007/s00134-021-06506-y DOI: https://doi.org/10.1007/s00134-021-06506-y
Gustad, L. T., Bangstad, I.-L., Torsvik, M., & Rise, M. B. (2024). Nurses’ and physicians’ experiences after implementation of a quality improvement project to improve sepsis awareness in hospitals. Journal of Multidisciplinary Healthcare, 17, 29–41. https://doi.org/10.2147/JMDH.S439017 DOI: https://doi.org/10.2147/JMDH.S439017
Guarino, M., Perna, B., Cesaro, A. E., Maritati, M., Spampinato, M. D., Contini, C., & De Giorgio, R. (2023). 2023 update on sepsis and septic shock in adult patients: Management in the emergency department. Journal of Clinical Medicine, 12(9), 3188. https://doi.org/10.3390/jcm12093188 DOI: https://doi.org/10.3390/jcm12093188
Hamad, D. B., Rababa, M., Tanash, M. I., & Abuali, R. (2025). Barriers and facilitators affecting the implementation of the Sepsis Six protocol by nurses in acute care settings in Jordan: A cross-sectional study. SAGE Open Nursing, 11, 23779608251362276. https://doi.org/10.1177/23779608251362276 DOI: https://doi.org/10.1177/23779608251362276
Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2024). Cochrane handbook for systematic reviews of interventions (Version 6.5, updated August 2024). Cochrane. https://www.cochrane.org/handbook
Kim, H.-J., Ko, R.-E., Lim, S., Park, S., Suh, G. Y., & Lee, Y. J. (2024). Sepsis alert systems, mortality, and adherence in emergency departments: A systematic review and meta-analysis. JAMA Network Open, 7(7), e2422823. https://doi.org/10.1001/jamanetworkopen.2024.22823 DOI: https://doi.org/10.1001/jamanetworkopen.2024.22823
Kissel, K. A., Krewulak, K. D., Poulin, T. G., Parhar, K. K. S., Niven, D. J., Doiron, V. M., & Fiest, K. M. (2025). Understanding ICU nursing knowledge, perceived barriers, and facilitators of sepsis recognition and management: A cross-sectional study. Critical Care Explorations, 7(1), e1200. https://doi.org/10.1097/CCE.0000000000001200 DOI: https://doi.org/10.1097/CCE.0000000000001200
Khallaf, H., Abu Ejheisheh, M., Malak, M. Z., Shehadeh, A., Ayed, A., Batran, A., & Farajallah, M. (2025). Nurses’ knowledge, attitudes, and decision-making related to sepsis assessment and management in Palestinian intensive care units. BMC Nursing, 24(1), 517. https://doi.org/10.1186/s12912-025-03341-0 DOI: https://doi.org/10.1186/s12912-025-03341-0
La Via, L., Sangiorgio, G., Stefani, S., Marino, A., Nunnari, G., Cocuzza, S., La Mantia, I., Cacopardo, B. S., Stracquadanio, S., Spampinato, S., Lavalle, S., & Maniaci, A. (2024). The global burden of sepsis and septic shock. Epidemiologia, 5(3), 456–478. https://doi.org/10.3390/epidemiologia5030032 DOI: https://doi.org/10.3390/epidemiologia5030032
Lasater, K. B., Sloane, D. M., McHugh, M. D., Cimiotti, J. P., Riman, K. A., Martin, B., Alexander, M., & Aiken, L. H. (2021). Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes. American Journal of Infection Control, 49(7), 868–873. https://doi.org/10.1016/j.ajic.2020.12.002 DOI: https://doi.org/10.1016/j.ajic.2020.12.002
LeBlanc, P., Kabbe, A., & Letvak, S. (2022). Nurses’ knowledge regarding nursing surveillance of the septic patient. Clinical Nurse Specialist, 36(6), 309–316. https://doi.org/10.1097/NUR.0000000000000704 DOI: https://doi.org/10.1097/NUR.0000000000000704
Lemoh, A. Y., Rashidzada, Z., Krishnasamy, M., Wilkinson, A., Blackwood, R., Rivalland, A., Ierano, C., Thursky, K. A., & Guccione, L. (2025). Roles and responsibilities of registered nurses in the early recognition and management of sepsis in acute hospital settings: A scoping review. BMJ Open Quality, 14(4), e003485. https://doi.org/10.1136/bmjoq-2025-003485 DOI: https://doi.org/10.1136/bmjoq-2025-003485
Martin-Loeches, I., Singer, M., & Leone, M. (2024). Sepsis: Key insights, future directions, and immediate goals. A review and expert opinion. Intensive Care Medicine, 50(12), 2043–2049. https://doi.org/10.1007/s00134-024-07694-z DOI: https://doi.org/10.1007/s00134-024-07694-z
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71 DOI: https://doi.org/10.1136/bmj.n71
Rababa, M., Bani Hamad, D., & Hayajneh, A. A. (2022). Sepsis assessment and management in critically ill adults: A systematic review. PLOS ONE, 17(7), e0270711. https://doi.org/10.1371/journal.pone.0270711 DOI: https://doi.org/10.1371/journal.pone.0270711
Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J., Koffel, J. B., & PRISMA-S Group. (2021). PRISMA-S: An extension to the PRISMA statement for reporting literature searches in systematic reviews. Journal of the Medical Library Association, 109(2), 174–200. https://doi.org/10.5195/jmla.2021.962 DOI: https://doi.org/10.5195/jmla.2021.962
Rossetti, S. C., Dykes, P. C., Knaplund, C., Cho, S., Withall, J., Lowenthal, G., Albers, D., Lee, R. Y., Jia, H., Bakken, S., Kang, M.-J., Chang, F. Y., Zhou, L., Bates, D. W., ... Cato, K. D. (2024). Multisite pragmatic cluster-randomized controlled trial of the CONCERN early warning system [Preprint]. medRxiv. https://doi.org/10.1101/2024.06.04.24308436 DOI: https://doi.org/10.1101/2024.06.04.24308436
Semanco, M., Wright, S., & Rich, R. L. (2022). Improving initial sepsis management through a nurse-driven rapid response team protocol. Critical Care Nurse, 42(5), 51–57. https://doi.org/10.4037/ccn2022608 DOI: https://doi.org/10.4037/ccn2022608
Wayland, J., Teixeira, J. P., & Nielsen, N. D. (2024). Sepsis in 2024: A review. Anaesthesia & Intensive Care Medicine, 25(10), 642–651. https://doi.org/10.1016/j.mpaic.2024.06.010 DOI: https://doi.org/10.1016/j.mpaic.2024.06.010
World Health Organization. (2024, May 3). Sepsis. https://www.who.int/news-room/fact-sheets/detail/sepsis
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jacqueline de los Ángeles Realpe Sandoval , José Luis Aguilar Mejía , Anderson Paul Cuasapaz Luna
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Eres libre de:
- Compartir : copiar y redistribuir el material en cualquier medio o formato
- Adaptar : remezclar, transformar y desarrollar el material
- El licenciante no puede revocar estas libertades siempre y cuando usted cumpla con los términos de la licencia.
En los siguientes términos:
- Atribución : Debe otorgar el crédito correspondiente , proporcionar un enlace a la licencia e indicar si se realizaron cambios . Puede hacerlo de cualquier manera razonable, pero no de ninguna manera que sugiera que el licenciante lo respalda a usted o a su uso.
- No comercial : no puede utilizar el material con fines comerciales .
- CompartirIgual — Si remezcla, transforma o construye sobre el material, debe distribuir sus contribuciones bajo la misma licencia que el original.
- Sin restricciones adicionales : no puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otros hacer algo que la licencia permite.
