Capillary Refill Time for Early Sepsis Recognition
Faculty Mentor
Patricia Nadraus
Area of Research
Nursing, Medical Sciences
Major
Nursing
Description
INTRODUCTION: Sepsis is a life-threatening condition requiring rapid identification and timely intervention to improve patient outcomes, particularly on medical-surgical units where early signs of deterioration may be subtle. Traditional vital signs may not adequately detect early alterations in tissue perfusion; therefore, capillary refill time (CRT), a simple and non-invasive bedside assessment, may enhance early recognition.
METHOD: This quasi-experimental study will employ a cohort trial design (Med Surg Unit 1 compared to Med Surg Unit 2) to evaluate whether incorporating CRT into routine nursing assessments on a medical-surgical unit improves time to sepsis identification. A convenience sample of 100 patients (n=100), aged 18 years and older, admitted to medical-surgical will be included, with the ability to provide written consent, and the ability to assess CRT without barriers. Exclusion criteria include patients with Raynaud’s disease, peripheral vascular disease, diabetes mellitus, amputations, artificial nails, those already diagnosed and treated for sepsis, and patients receiving vasopressors. Two comparison groups include a control group on one medical-surgical unit receiving standard vital sign monitoring without CRT and an intervention group on a separate unit receiving CRT assessments every 4 hours with routine vital signs. The independent variable is performing CRT every 4 hours along with standard of care, and the dependent variable is time to sepsis identification. Statistical analysis planning includes using the Kaplan-Meier survival analysis for each group to visualize probability of remaining without sepsis identification over time. A log-rank test will be used to compare the survival distribution between the two groups at a significance level of α = .05.
RESULTS: Previous literature findings suggest that incorporating CRT into routine assessments may support earlier recognition of impaired perfusion and early identification of sepsis, which can facilitate timely initiation of sepsis treatment protocols and ultimately improve patient outcomes.
DISCUSSION/CONCLUSION: Incorporating capillary refill time into routine nursing assessments may support earlier identification of sepsis by detecting subtle signs of poor perfusion that standard vital signs can miss. If effective, this simple, low-cost intervention could improve time to treatment and patient outcomes on medical-surgical units. Further research with larger, randomized samples is needed to confirm these findings and support broader implementation.
Capillary Refill Time for Early Sepsis Recognition
INTRODUCTION: Sepsis is a life-threatening condition requiring rapid identification and timely intervention to improve patient outcomes, particularly on medical-surgical units where early signs of deterioration may be subtle. Traditional vital signs may not adequately detect early alterations in tissue perfusion; therefore, capillary refill time (CRT), a simple and non-invasive bedside assessment, may enhance early recognition.
METHOD: This quasi-experimental study will employ a cohort trial design (Med Surg Unit 1 compared to Med Surg Unit 2) to evaluate whether incorporating CRT into routine nursing assessments on a medical-surgical unit improves time to sepsis identification. A convenience sample of 100 patients (n=100), aged 18 years and older, admitted to medical-surgical will be included, with the ability to provide written consent, and the ability to assess CRT without barriers. Exclusion criteria include patients with Raynaud’s disease, peripheral vascular disease, diabetes mellitus, amputations, artificial nails, those already diagnosed and treated for sepsis, and patients receiving vasopressors. Two comparison groups include a control group on one medical-surgical unit receiving standard vital sign monitoring without CRT and an intervention group on a separate unit receiving CRT assessments every 4 hours with routine vital signs. The independent variable is performing CRT every 4 hours along with standard of care, and the dependent variable is time to sepsis identification. Statistical analysis planning includes using the Kaplan-Meier survival analysis for each group to visualize probability of remaining without sepsis identification over time. A log-rank test will be used to compare the survival distribution between the two groups at a significance level of α = .05.
RESULTS: Previous literature findings suggest that incorporating CRT into routine assessments may support earlier recognition of impaired perfusion and early identification of sepsis, which can facilitate timely initiation of sepsis treatment protocols and ultimately improve patient outcomes.
DISCUSSION/CONCLUSION: Incorporating capillary refill time into routine nursing assessments may support earlier identification of sepsis by detecting subtle signs of poor perfusion that standard vital signs can miss. If effective, this simple, low-cost intervention could improve time to treatment and patient outcomes on medical-surgical units. Further research with larger, randomized samples is needed to confirm these findings and support broader implementation.