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Introduction to Sepsis

Sepsis occurs when chemicals released in the bloodstream to fight an infection trigger inflammation throughout the body. This can cause a cascade of changes that damage multiple organ systems, leading them to fail, sometimes even resulting in death. Learn about Sepsis with this starter Qstream microlearning course.

Category: Health and Wellbeing

Industry: Healthcare

Questions: 13

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Introduction to Sepsis

Navigate through the Qstream questions below to preview. Each challenge is designed following Qstream’s best practices for maximum knowledge reinforcement and engagement. This Qstream is free for clients to use as a starting point.

1. What is Sepsis? >
2. Can Sepsis Spread to Others? >
3. Those at High Risk >
4. U.S. Sepsis Rates >
5. Reducing risks >
6. Seeking Medical Attention >
7. Sepsis Symptoms >
8. Sepsis Testing >
9. Adult Sepsis Events >
10. Obtaining Data on Sepsis Rates >
11. Blood Culture Review >
12. Blood Culture Window Period >
13. QAD >

Follow the interactions on each screen to answer Qstream questions as a Participant.

Sepsis is the body’s ___________ to an infection.

Answer explanation:
Sepsis is the body’s extreme response to an infection and is a life-threatening emergency that can lead to other complications. It requires prompt medical attention. Sepsis can be caused by almost any infection, and most often start in the lung, urinary tract, skin, or gastrointestinal tract.

Joseph’s father Marco just received a diagnosis of sepsis at the local hospital during his treatment from a fall last week. While Joseph and his mother are at home, Joseph’s mother expressed concern that they shouldn’t visit Marco because they might contract sepsis from him.

Joseph should advise his mother that they ______________.

Answer explanation:
Sepsis happens when an infection you already have (typically bacterial or viral) triggers a chain reaction throughout your body. While you can’t spread sepsis to other people, the infection that caused the sepsis CAN spread. In this case, although Joseph and his mother can visit Marco, they need to take precautions to protect themselves from the infection Marco has, not his sepsis.

Categories of people at a higher risk of getting an infection that can lead to sepsis include which of the following?

Answer explanation:
People who are older than 65 years typically have deteriorating immune systems due to aging. Babies younger than one year old have immune systems that are not fully developed. This puts both of these groups at higher risk of getting an infection that can lead to sepsis. Also, people are at greater risk if they have weakened immune systems, previously had sepsis, and/or have chronic medical conditions such as diabetes, kidney disease, lung disease, or cancer.

Caleb is listening to an interview on the radio with a doctor who is talking about what happens to some people when they go to the hospital. Before the commercial break, the doctor says that an alarming number of people get a severe response to the infection that originally brought them into the hospital.

After the break, the doctor elaborates that every year, _______ adults in the United States develop sepsis.

Answer explanation:
The doctor on the radio show shares that according to the Center for Disease Control (CDC), each year, at least 1.7 million people develop sepsis, and out of that number, over 270,000 die as a result of sepsis. One out of every three people who die in a hospital has sepsis.

During her annual medical checkup, Julia listens to some advice from Dr. Bailey, her primary care provider. Dr. Bailey explains that since Julia is now 65, and also a diabetic, she needs to take extra precautions to ensure that any future infections don’t turn into more serious complications, such as sepsis.

To reduce Julia's sepsis risk, Dr. Bailey's recommendations include which of the following?

Answer explanation:
Dr. Bailey is following the guidance of the Center for Disease Control (CDC) by recommending to Julia that she:

• Prevent infections by taking good care of her diabetes
• Take all doctor-recommended vaccines
• Practice good hygiene by regularly washing her hands
• Keep any cuts clean and covered until healed

Avoiding physical activities and wearing latex gloves when going outside are not needed.

Jordan is looking at a scrape on his 7-year-old daughter’s elbow. She scraped it three days ago and, despite his best efforts to keep it clean and bandaged, it keeps getting dirty and damp. Jordan is very concerned as his daughter now has new symptoms: she is shivering and disoriented.

In light of his daughter's new symptoms, Jordan's next actions should be which of the following?

Answer explanation:
Jordan’s daughter’s worsening condition with symptoms of shivering and disorientation are signs of sepsis. Jordan must act fast and get medical care immediately for his daughter either in person or through telehealth services.

Jordan can ask his healthcare professional if his daughter’s infection could be leading to sepsis and if he should take her to the Emergency Department (ED) for a medical assessment.

Which of the following are signs and symptoms of sepsis?

Answer explanation:
Although a medical assessment is needed to confirm a sepsis diagnosis, sepsis may present itself through one or more of the following symptoms:

• Rapid heart rate or low blood pressure
• Fever or shivering
• Confusion or disorientation
• Shortness of breath
• Extreme pain or discomfort
• Clammy or sweaty skin

Questions written for this Qstream are based on content from: https://www.cdc.gov/sepsis/education/index.html

A sepsis diagnosis requires clinical judgment based on evidence of infection and organ dysfunction because _________.

Answer explanation:
According to the U.S. Department of Health and Human Services (HHS), “Because there is no confirmatory diagnostic test, the diagnosis of sepsis requires clinical judgment based on evidence of infection and organ dysfunction.” Since 1991, when the clinical definition of sepsis was first established, it has been revised twice and is now referred to as Sepsis-3. It is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.

Learn More
Sepsis Surveillance Toolkit (32-page PDF)
Read all of the details in this comprehensive toolkit from the Center for Disease Control (CDC).
https://www.cdc.gov/sepsis/pdfs/Sepsis-Surveillance-Toolkit-Aug-2018_508.pdf

A clinical administrative team has assigned Nurse Henry to validate how many patients in their hospital have been accurately diagnosed with sepsis over the last 24 months.

To do so, Nurse Henry will perform Adult Sepsis Event (ASE) surveillance. This requires him to access which of the following types of records?

Answer explanation:
There are multiple sepsis event definitions Nurse Henry could use. The clinical team has decided to use Adult Sepsis Event (ASE) because it captures the widest variety of sepsis patients.

Nurse Henry will need to view multiple records of provider-initiated interventions such as ordering blood cultures, antimicrobials, laboratory tests, vasopressors, as well as medication administration and administrative coding data.

Three clinicians are discussing how they should obtain data on sepsis rates within the seven hospitals within their network.

To use a definition that measures with a high degree of accuracy, the clinicians agree on which of the following?

Answer explanation:
The three clinicians should use Bacteremia/Fungemia Shock Event (BSE) as their measure. It is a simplified definition that tracks a narrower sub-population of patients with much higher mortality. This sepsis definition is based on positive blood cultures (which almost always reflect true infections) and vasopressors (which almost always reflect clinically important hypotension).

BSE can be determined using only microbiology and medication administration records. Further, BSE has shown to have a positive predictive value of 100% when using Sepsis-3 criteria as the reference standard.

Chris and Maria are reviewing the blood cultures of all the patients in their department over the past six months to determine sepsis rates.

Maria advises Chris that they need to include which of the following cultures in their review?

Answer explanation:
When determining the prevalence of sepsis, Chris and Maria only need to use qualifying blood cultures including bacterial (aerobic and/or anaerobic), acid-fast bacilli (AFB), and fungal cultures. Blood cultures for specific viruses (e.g., cytomegalovirus) should be excluded.

For ASE (Adult Sepsis Event), blood cultures need to have been drawn, regardless of the result to be included. For BSE (Bacteremia/Fungemia Shock Event), blood cultures or other bacteremia or fungemia testing of blood must have yielded a recognized pathogen to be included in their analysis.

The date the blood culture is obtained is the center of a window period extending ___ day(s) before and after the blood culture.

Answer explanation:
For both ASE (Adult Sepsis Event) and BSE (Bacteremia/Fungemia Shock Event), a window period is calculated by determining the time two days before and two days after a blood culture is drawn. Also, there may be instances where there are multiple window periods during a patient’s hospitalization. They may even overlap if multiple blood cultures are obtained in a short period.

To meet the criteria for a presumed infection, a Qualifying Antimicrobial Day (QAD) is calculated by the _____ day in the window period extending two days before and two days after the patient receives a new antimicrobial.

Answer explanation:
For ASE (Adult Sepsis Event) events, the first QAD (Qualifying Antimicrobial Day) is the first day in the window period extending two days before and two days after the patient receives a new antimicrobial. A new antimicrobial is defined as an antimicrobial not previously administered in the prior two calendar days. Oral and intravenous formulations of the same antimicrobial are counted as the same antimicrobial EXCEPT for vancomycin.

Sepsis is the body’s ___________ to an infection.

Answer explanation:
Sepsis is the body’s extreme response to an infection and is a life-threatening emergency that can lead to other complications. It requires prompt medical attention. Sepsis can be caused by almost any infection, and most often start in the lung, urinary tract, skin, or gastrointestinal tract.

Joseph’s father Marco just received a diagnosis of sepsis at the local hospital during his treatment from a fall last week. While Joseph and his mother are at home, Joseph’s mother expressed concern that they shouldn’t visit Marco because they might contract sepsis from him.

Joseph should advise his mother that they ______________.

Answer explanation:
Sepsis happens when an infection you already have (typically bacterial or viral) triggers a chain reaction throughout your body. While you can’t spread sepsis to other people, the infection that caused the sepsis CAN spread. In this case, although Joseph and his mother can visit Marco, they need to take precautions to protect themselves from the infection Marco has, not his sepsis.

Categories of people at a higher risk of getting an infection that can lead to sepsis include which of the following?

Answer explanation:
People who are older than 65 years typically have deteriorating immune systems due to aging. Babies younger than one year old have immune systems that are not fully developed. This puts both of these groups at higher risk of getting an infection that can lead to sepsis. Also, people are at greater risk if they have weakened immune systems, previously had sepsis, and/or have chronic medical conditions such as diabetes, kidney disease, lung disease, or cancer.

Caleb is listening to an interview on the radio with a doctor who is talking about what happens to some people when they go to the hospital. Before the commercial break, the doctor says that an alarming number of people get a severe response to the infection that originally brought them into the hospital.

After the break, the doctor elaborates that every year, _______ adults in the United States develop sepsis.

Answer explanation:
The doctor on the radio show shares that according to the Center for Disease Control (CDC), each year, at least 1.7 million people develop sepsis, and out of that number, over 270,000 die as a result of sepsis. One out of every three people who die in a hospital has sepsis.

During her annual medical checkup, Julia listens to some advice from Dr. Bailey, her primary care provider. Dr. Bailey explains that since Julia is now 65, and also a diabetic, she needs to take extra precautions to ensure that any future infections don’t turn into more serious complications, such as sepsis.

To reduce Julia's sepsis risk, Dr. Bailey's recommendations include which of the following?

Answer explanation:
Dr. Bailey is following the guidance of the Center for Disease Control (CDC) by recommending to Julia that she:

• Prevent infections by taking good care of her diabetes
• Take all doctor-recommended vaccines
• Practice good hygiene by regularly washing her hands
• Keep any cuts clean and covered until healed

Avoiding physical activities and wearing latex gloves when going outside are not needed.

Jordan is looking at a scrape on his 7-year-old daughter’s elbow. She scraped it three days ago and, despite his best efforts to keep it clean and bandaged, it keeps getting dirty and damp. Jordan is very concerned as his daughter now has new symptoms: she is shivering and disoriented.

In light of his daughter's new symptoms, Jordan's next actions should be which of the following?

Answer explanation:
Jordan’s daughter’s worsening condition with symptoms of shivering and disorientation are signs of sepsis. Jordan must act fast and get medical care immediately for his daughter either in person or through telehealth services.

Jordan can ask his healthcare professional if his daughter’s infection could be leading to sepsis and if he should take her to the Emergency Department (ED) for a medical assessment.

Which of the following are signs and symptoms of sepsis?

Answer explanation:
Although a medical assessment is needed to confirm a sepsis diagnosis, sepsis may present itself through one or more of the following symptoms:

• Rapid heart rate or low blood pressure
• Fever or shivering
• Confusion or disorientation
• Shortness of breath
• Extreme pain or discomfort
• Clammy or sweaty skin

Questions written for this Qstream are based on content from: https://www.cdc.gov/sepsis/education/index.html

A sepsis diagnosis requires clinical judgment based on evidence of infection and organ dysfunction because _________.

Answer explanation:
According to the U.S. Department of Health and Human Services (HHS), “Because there is no confirmatory diagnostic test, the diagnosis of sepsis requires clinical judgment based on evidence of infection and organ dysfunction.” Since 1991, when the clinical definition of sepsis was first established, it has been revised twice and is now referred to as Sepsis-3. It is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.

Learn More
Sepsis Surveillance Toolkit (32-page PDF)
Read all of the details in this comprehensive toolkit from the Center for Disease Control (CDC).
https://www.cdc.gov/sepsis/pdfs/Sepsis-Surveillance-Toolkit-Aug-2018_508.pdf

A clinical administrative team has assigned Nurse Henry to validate how many patients in their hospital have been accurately diagnosed with sepsis over the last 24 months.

To do so, Nurse Henry will perform Adult Sepsis Event (ASE) surveillance. This requires him to access which of the following types of records?

Answer explanation:
There are multiple sepsis event definitions Nurse Henry could use. The clinical team has decided to use Adult Sepsis Event (ASE) because it captures the widest variety of sepsis patients.

Nurse Henry will need to view multiple records of provider-initiated interventions such as ordering blood cultures, antimicrobials, laboratory tests, vasopressors, as well as medication administration and administrative coding data.

Three clinicians are discussing how they should obtain data on sepsis rates within the seven hospitals within their network.

To use a definition that measures with a high degree of accuracy, the clinicians agree on which of the following?

Answer explanation:
The three clinicians should use Bacteremia/Fungemia Shock Event (BSE) as their measure. It is a simplified definition that tracks a narrower sub-population of patients with much higher mortality. This sepsis definition is based on positive blood cultures (which almost always reflect true infections) and vasopressors (which almost always reflect clinically important hypotension).

BSE can be determined using only microbiology and medication administration records. Further, BSE has shown to have a positive predictive value of 100% when using Sepsis-3 criteria as the reference standard.

Chris and Maria are reviewing the blood cultures of all the patients in their department over the past six months to determine sepsis rates.

Maria advises Chris that they need to include which of the following cultures in their review?

Answer explanation:
When determining the prevalence of sepsis, Chris and Maria only need to use qualifying blood cultures including bacterial (aerobic and/or anaerobic), acid-fast bacilli (AFB), and fungal cultures. Blood cultures for specific viruses (e.g., cytomegalovirus) should be excluded.

For ASE (Adult Sepsis Event), blood cultures need to have been drawn, regardless of the result to be included. For BSE (Bacteremia/Fungemia Shock Event), blood cultures or other bacteremia or fungemia testing of blood must have yielded a recognized pathogen to be included in their analysis.

The date the blood culture is obtained is the center of a window period extending ___ day(s) before and after the blood culture.

Answer explanation:
For both ASE (Adult Sepsis Event) and BSE (Bacteremia/Fungemia Shock Event), a window period is calculated by determining the time two days before and two days after a blood culture is drawn. Also, there may be instances where there are multiple window periods during a patient’s hospitalization. They may even overlap if multiple blood cultures are obtained in a short period.

To meet the criteria for a presumed infection, a Qualifying Antimicrobial Day (QAD) is calculated by the _____ day in the window period extending two days before and two days after the patient receives a new antimicrobial.

Answer explanation:
For ASE (Adult Sepsis Event) events, the first QAD (Qualifying Antimicrobial Day) is the first day in the window period extending two days before and two days after the patient receives a new antimicrobial. A new antimicrobial is defined as an antimicrobial not previously administered in the prior two calendar days. Oral and intravenous formulations of the same antimicrobial are counted as the same antimicrobial EXCEPT for vancomycin.

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