Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper

School

School of Nursing

Department

Nursing

Date of Original Version

2019

Abstract

Septic shock is a complication that affects thousands of patients leading to high mortality rates and increased healthcare costs. One treatment in the attempt to decrease poor outcomes is corticosteroids. A systematic review was conducted to evaluate the impact of corticosteroids on mortality in adult patients with septic shock. Databases searched were CINAHL, PubMed, OVID, and Cochrane Library. A literature review was performed and pertinent data from each article was recorded in data collection tables. A total of six articles were critically analyzed. The Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and flow diagram were used to guide this systematic review. The Critical Appraisal Skills Programme (CASP) checklist assisted in assessing the quality of the articles selected. Cross study analysis was performed via the data collection tables developed by this author. This analysis revealed five of the six trials did not detect a decrease in mortality using corticosteroids in adult patients with septic shock; the sixth study did document a reduction in mortality rate. Four studies were underpowered which may affect the generalizability of their outcomes. Two studies were adequately powered with one demonstrating positive outcomes. Possible benefits were seen in the secondary outcomes such as faster resolution of shock and decreased vasopressor use. Advanced practice nurses are having an increased prominent role in patient care within healthcare. This role provides an opportunity for high quality evidence-based results to be applied to improve patient care. Results of this systematic review provide information to guide decision making by the advanced practice nurse as well as suggestions for further study.

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