Nursing care process for people with septic shock in the emergency department

Keywords

Septic shock
Nursing Care Process
Critical care
Nursing diagnosis
NANDA
NOC
NIC

How to Cite

1.
Báez Escaza BV, Ortiz Martínez C, Cortes López E, Oria Saavedra M, Vargas Escamilla M del P. Nursing care process for people with septic shock in the emergency department. SAP Nursing Depths Series [Internet]. 2026 Jan. 1 [cited 2026 May 3];5:402. Available from: https://nds.southam.pub/index.php/nds/article/view/402

Abstract

Introduction: Septic shock is a medical emergency characterized by a systemic inflammatory response secondary to infection, leading to life-threatening hemodynamic instability. In this context, the Nursing Care Process allows for the scientific application of nursing knowledge to deliver safe and high-quality care.
Objective: To describe the application of the Nursing Care Process in people with septic shock in emergency and critical care settings using the updated NANDA, NOC, and NIC taxonomies.
Methods: A descriptive case study conducted in a hospital emergency service from March to June 2025. The Marjory Gordon functional health patterns model and an electronic clinical record system were used. The process included assessment, diagnosis, planning, implementation, and evaluation based on NANDA (2023–2026), NOC, and NIC.
Results: Priority diagnoses included ineffective tissue perfusion, risk for shock, and fluid volume imbalance. Nursing interventions focused on hemodynamic control, fluid therapy, and continuous monitoring achieved stabilization of vital signs and clinical improvement.
Conclusions: The application of the Nursing Care Process supported evidence-based clinical decision-making, contributing to patient recovery and reinforcing professional nursing practice in critical scenarios.

References

1. Organización Mundial de la Salud. Sepsis: un desafío mundial de salud pública. Ginebra: OMS; 2023. Disponible en: https://www.wwho.int/es/news-room/fact-sheets/detail/sepsis

2. Rodríguez-Pérez M, Díaz C. Aplicación del PAE en el manejo del paciente séptico en urgencias. Enferm Glob. 2024;23(1):45–57.

3. Marriner-Tomey A, Alligood MR. Modelos y teorías de enfermería. Barcelona: Elsevier; 2020.

4. Butcher HK, Bulechek GM, Dochterman JM, Wagner CM. Intervenciones de enfermería (NIC). 8.ª ed. Barcelona: Elsevier; 2023.

5. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–10.

6. Jiménez-García R, Hernández L, Rivas P. Cuidados de enfermería en pacientes críticos con shock séptico: revisión sistemática. Rev Iberoam Enferm Intensiva. 2022;35(2):121–34.

7. Secretaría de Salud (México). Informe epidemiológico de sepsis y shock séptico en unidades críticas. México: Dirección General de Epidemiología; 2024.

8. Sánchez-López F, Torres V, Ruiz M. Rol del profesional de enfermería en la prevención de la sepsis: revisión narrativa. Cienc Cuid. 2023;20(1):34–49.

9. Watson J. Teoría del cuidado humano: fundamentos para la práctica enfermera. Madrid: Springer; 2021.

10. NANDA International. Diagnósticos enfermeros: definiciones y clasificación 2023–2026. 12.ª ed. Barcelona: Elsevier; 2023.

11. Dellinger RP, Rhodes A, Evans L, Alhazzani W, Beale R, Jaeschke R, et al. Surviving Sepsis Campaign. Crit Care Med. 2023;51(4):431–44. https://doi.org/10.1097/CCM.0000000000005804

12. Santos JA, Rodríguez ML, Pérez RG, Hernández P. Surviving Sepsis Campaign: guía actualizada 2023. New York: Society of Critical Care Medicine; 2023. Disponible en: https://www.sccm.org/ssc

13. Consejo Internacional de Enfermeras. Código deontológico para enfermeras. Ginebra: CIE; 2021. Disponible en: https://www.icn.ch/

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2026 Brenda Vanesa Báez Escaza, Coralina Ortiz Martínez, Esmeralda Cortes López , Michel Oria Saavedra , María del Pilar Vargas Escamilla (Author)