{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:11:26Z","timestamp":1790039486884,"version":"4.0.1"},"reference-count":17,"publisher":"AACN Publishing","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Fluid responsiveness should be assessed in patients with septic shock because only 50% of patients are fluid responsive. Dynamic measures of fluid responsiveness, like pulse pressure variation measured after a passive leg raise maneuver, are recommended to guide fluid administration in patients with sepsis after initial fluid resuscitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Local Problem<\/jats:title>\n                  <jats:p>The purpose of the project was to evaluate outcomes after implementing a nurse-driven fluid responsiveness evaluation using passive leg raise and pulse pressure variation measurement in patients with septic shock.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The project included 30 adult patients with septic shock in a 24-bed medical-surgical intensive care unit at a community hospital. A new nursing process was initiated for bedside fluid responsiveness evaluation (pulse pressure variation measurement after passive leg raise). Staff members received in-person individual training sessions. Preintervention and 20-week postintervention patient outcomes data were collected to estimate the project\u2019s impact on incidence of fluid overload and acute kidney injury, duration of mechanical ventilation, and intensive care unit length of stay. Preintervention and postintervention staff satisfaction surveys assessed nurses\u2019 perception of the project\u2019s value.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Before intervention, 24 of 37 patients (65%) met criteria of fluid overload. The project resulted in a 28% decrease in the incidence of fluid overload. Staff satisfaction surveys revealed a significant increase in nurses\u2019 feelings of empowerment to positively affect patient outcomes; all nurses agreed that the new process was efficient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The results indicate that the project had a positive impact on patient outcomes and nurse autonomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ccn2024984","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:11:35Z","timestamp":1706746295000},"page":"13-20","source":"Crossref","is-referenced-by-count":5,"title":["Nurse-Driven Fluid Responsiveness Evaluation in Patients With Septic Shock: A Quality Improvement Initiative"],"prefix":"10.4037","volume":"44","author":[{"given":"Yana","family":"Dilman","sequence":"first","affiliation":[{"name":"Yana Dilman is a critical care nurse practitioner in the medical-surgical intensive care unit at University of Pittsburgh Medical Center (UPMC), Mechanicsburg, Pennsylvania, and an adjunct clinical faculty member at Herzing University, Milwaukee, Wisconsin."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Bethel","sequence":"additional","affiliation":[{"name":"Claire Bethel is a Magnet Director at UPMC Community Osteopathic Hospital, Harrisburg, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navitha","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Navitha Ramesh is an intensive care unit medical director at UPMC Community Osteopathic Hospital and the President of the Pennsylvania Chapter of the Society of Critical Care Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene","family":"Myers","sequence":"additional","affiliation":[{"name":"Charlene Myers is an associate professor and coordinator of the adult-gerontology acute care nurse practitioner track for master of science in nursing and doctor of nursing practice programs at the University of South Alabama College of Nursing, Mobile, Alabama."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"9","key":"2024020100113105200_b1-0440013","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.1097\/CCM.0000000000002554","article-title":"Incorporating dynamic assessment of fluid responsiveness into goal-directed therapy: a systematic review and meta-analysis","volume":"45","author":"Bednarczyk","year":"2017","journal-title":"Crit Care Med"},{"issue":"4","key":"2024020100113105200_b2-0440013","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1016\/j.chest.2020.04.025","article-title":"Fluid response evaluation in sepsis hypotension and shock: a randomized clinical 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