A systematic review on the role of nurses in the prevention and management of sepsis in critical care settings

Résumé fourni par la source

Sepsis is a life-threatening syndrome caused by a dysregulated host response to infection and remains one of the leading causes of mortality among critically ill patients worldwide. Despite significant advances in critical care medicine, sepsis continues to impose substantial clinical, economic and social burdens due to delayed diagnosis, rapid disease progression and the development of multiple organ dysfunction. Nurses constitute the largest group of healthcare professionals in intensive care units (ICUs) and are uniquely positioned to identify early signs of sepsis, initiate timely interventions and coordinate multidisciplinary management. Their continuous bedside presence enables frequent patient assessment, prompt recognition of physiological deterioration and adherence to evidence-based sepsis management protocols. Consequently, nurse-led interventions have become increasingly important in improving patient outcomes, reducing hospital length of stay and lowering sepsis-related mortality (Singer et al., 2016). The present systematic review aims to synthesise current evidence regarding the role of nurses in the prevention and management of sepsis in critical care settings. Electronic databases including PubMed, Scopus, Web of Science, CINAHL and Google Scholar were searched for relevant English-language studies published between 2015 and 2025. Studies evaluating nursing interventions related to early sepsis recognition, infection prevention, implementation of sepsis bundles, haemodynamic monitoring, antimicrobial stewardship and multidisciplinary collaboration were considered. Data extraction and qualitative synthesis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations (Page et al., 2021). The reviewed evidence consistently demonstrates that nurses play a pivotal role throughout the continuum of sepsis care. Early identification through systematic patient assessment, utilisation of validated screening tools and rapid escalation of care significantly improves clinical outcomes. Nurse-driven implementation of sepsis bundles facilitates timely administration of antibiotics, intravenous fluids, blood cultures and lactate measurement, all of which are associated with reduced mortality. Furthermore, strict adherence to infection prevention strategies, continuous haemodynamic monitoring and effective communication with multidisciplinary teams contribute substantially to improved patient safety (Evans et al., 2021). However, several barriers continue to hinder optimal nursing practice, including inadequate staffing, insufficient training, limited awareness of evolving sepsis guidelines and resource constraints in low- and middle-income countries. Addressing these challenges through structured education, protocol-driven practice and organisational support may enhance nurses' capacity to deliver high-quality sepsis care. Overall, the available evidence indicates that critical care nurses are central to both the prevention and management of sepsis. Strengthening nursing competencies, encouraging evidence-based practice and integrating nurse-led sepsis programmes into routine ICU care are likely to improve survival rates and healthcare quality worldwide.

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