Why Handwashing Makes Us Healthier – and Happier too!

handwashing.jpgAs nurses, we all know the importance of handwashing. We understand that germs can spread disease, and that hand hygiene can help defend against it. But still, 78 percent of all healthcare professionals tested in a recent study presented at a conference of the Association for Professionals in Infection Control and Epidemiology (APIC) didn’t wash up to the standards of the World Health Organization’s guidelines for reducing the risk of spreading infection to patients. So, why so many slackers?

Perhaps sinks or hand sanitizer dispensers aren’t always in the most convenient locations in hospitals. And if they are conveniently located, there might not always be soap or sanitizing gel in those dispensers. Or maybe it’s just that we’re rushing from one emergency or critical situation to the next, and taking time to stop and wash our hands consistently doesn’t get prioritized. Or simply because, given those same circumstances, we merely forget.

It seems so obvious, yet the importance of handwashing wasn’t always known. In 1847, a physician working in a Viennese maternity hospital with two separate clinics, one run by physicians and one run by midwives, discovered that babies delivered by physicians had nearly triple the infant mortality as babies delivered by midwives. The reason was that the doctors coming into the hospital to deliver babies had just finished up duties in the autopsy ward, thereby infecting mother and child with numerous germs acquired from their deceased patients. Once doctors were instructed to wash their hands with an antiseptic solution before delivering babies, the mortality rate plummeted.

Getting Nurses to Wash Their Hands
Solutions to promote more frequent handwashing can run the gamut for many hospitals. Implementing one of several newfangled, automated hand hygiene monitoring devices such as video-monitored direct observation systems, electronic dispenser counters, and automated hand hygiene monitoring networks can work for some. And while there is empirical proof that these types of monitoring systems work, with the budgetary constraints many hospitals face, adoption can be cost-prohibitive and therefore not an option.

While there is no universal solution, many hospitals have taken steps to further encourage handwashing by investing in alcohol-based hand rub solutions (significantly more efficient in reducing hand contamination than antiseptic soaps), both by installing wall-mounted dispensers and by providing individual containers for each healthcare worker. Changing posted messages around the hospital from, “Wash Your Hands to Protect Yourself” to “Wash Your Hands to Protect Your Patients" can be helpful, along with peer pressure and personal incentives like drawings for free monthly manicures (yes, we all know the toll that constant handwashing can have on our skin and nails).
New incentives
It’s apparent that handwashing keeps us healthier, but what isn’t noticeable is the additional, subtle psychological effect handwashing has on us all as well. The Dalai Lama tells us, “as human beings we all want to be happy and free from misery… and we have learned that the key to happiness is inner peace.” So, what if you could achieve inner peace and happiness through the simplest of daily activities – like handwashing?

A study from the University of Cologne in Germany examined how the act of washing one’s hands can positively affect us after a bad experience or stressful event while also making us feel more optimistic after recent failure. Earlier research from the University of Michigan also found that handwashing can be physically and emotionally cleansing, suggesting that this simple act can make us feel more comfortable about decisions we’ve made or actions we’ve taken.

Personally, when I finish a workout at the gym, the first thing I do is wash my hands. Somehow, this simple ritual of washing my hands afterwards provides a sense of finality and accomplishment. The workout ritual, however, is far more complex (at least for me).

The act of seeking cleanliness has two distinct meanings to us humans. The first is the obvious physical hygiene benefits. The second is more psychological in nature. Psychological studies have shown that the simple act of washing one’s hands can help you feel more optimistic, less doubtful, and even a bit morally superior – as “clean” people have been found to be more judgmental towards other people’s bad behavior. Think Lady Macbeth.

So, maybe now as we endeavor to wash our hands for the hundredth time today, recalling the Nightingale Pledge and our duty to protect our patients’ safety, we can also reflect on our own goals for self-improvement, including eating healthier, trying to exercise more, and being kinder to others and to our planet, knowing that this simple act of handwashing might be a more logical path to happiness and inner peace. Or, at least we can tell ourselves that. 
Brun-Buisson, C., Girou, E., Legrand, P., Loyeau, S., Oppein, F., (2002, August 17). Efficacy of
handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. Retrieved from NCBI, US National Library of Medicine National Institutes of Health  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC117885/
Johnson, N., Niles, M. (2016, June 2). Hawthorne Effect in Hand Hygiene Compliance Rates. American
Journal of Infection Control, Volume 44(Issue 6), S28-S29. Retrieved from AJIS
Kaspar, K. (2012, April 10). Washing One’s Hands After Failure Enhances Optimism but Hampers Future
Performance. Social Psychological and Personality Science, Volume 4(Issue 1), 69-73.
Retrieved from http://journals.sagepub.com/doi/full/10.1177/1948550612443267#articleCitationDownloadContainer
Psyblog (n.d.). 6 Purely Psychological Effects of Washing Your Hands. Retrieved from
Deborah Baldwin
Wolters Kluwer Health


Posted: 12/3/2017 10:52:56 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Patient Safety

Inspired Nurses Calendar 2017: It’s My Pleasure

Lippincott NursingCenter.com is partnering with Lippincott Solutions to bring you an inspired nurse’s story every month. Here is November’s nurse story, “It’s My Pleasure.”
it-s-my-pleasure-November-2017.jpgIt’s My Pleasure
Katie Fadell-Mann, RN
Ebenezer Lake City Care Center
My Dad was a double lung transplant recipient in 2006. What inspired me to be a nurse was seeing the difference his nurse made in his care. His nurse, Sara literally did not leave his side for the first two days after his surgery. When I asked where I could send a gift to for her to thank her for all she had done, she said, "There's no need, it's my pleasure to take care of your Dad."
I started going to school for nursing a few months later.


Posted: 11/30/2017 9:52:16 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Happy Nurse Practitioner Week!

NP-week.pngMany of you know I still practice on the weekends as a nurse practitioner for Penn Medicine Chester County Hospital and I’m adjunct faculty for Drexel University in Philadelphia. I am currently teaching a course on using evidence in practice and this week is focused on using change theory to implement evidence. Change – one of the hardest things for us to do. We become stuck in doing things the way they have always been done. All you have to do is look at your current practice setting and see others who resist change. Courage and perseverance are the necessary ingredients to implement change. How many of us really have the so-called “right stuff” to make changes in our own practice settings? 

As I look back on our nurse practitioner profession, I am amazed at the courage and perseverance it took for Drs. Loretta Ford and Henry Silver to step out of the so-called “healthcare norm” and decide there needed to be a better way to provide care. A nurse and a physician worked together to change practice. They did not do this for recognition. Rather, they did it to improve access to quality care for those who were in need. They implemented change in a healthcare system by using courage and perseverance.

Why did you become a nurse? Why have many of you gone on to be advanced practice nurses? Were you afraid of making a change? When I think about why I became a nurse practitioner, it was because I saw an opportunity to connect the art and science of nursing and medicine in my own practice to improve patient care. I am sure many of you have a similar story.

This is Nurse Practitioner Week and I want to thank each of my NP colleagues for the work you do each day. You emulate what Drs. Ford and Silver did over 50 years ago; you meet each day with courage and perseverance to implement change and improve patient outcomes one patient at a time.
Chief Nurse, Wolters Kluwer, Health Learning, Research & Practice
Adjunct Faculty, Drexel University
Nurse Practitioner, Penn Medicine Chester County Hospital
Posted: 11/13/2017 2:05:21 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

The Opioid Epidemic: Are Women Most Vulnerable?

The opioid epidemic is a serious public health problem that impacts us professionally, as well as many of us personally. Asking about drug use is something we were taught while in nursing school. Assessing and managing pain has always been a big part of our training too. Now, as the United States is in the midst of an opioid epidemic, our assessment and communication skills must reach a new level. Those of us who are advanced practice nurses who are also prescribers, have even more to consider when it comes to pain management.

women-and-opioids.pngAs a women’s health nurse practitioner, new research on age and gender trends related to the opioid epidemic caught my eye. Findings revealed excessive opioid prescribing with persistent use among women. This new report, conducted by the QuintilesIMS Institute, states that “middle-aged women are prescribed more opioids than any other group – twice as many as middle-aged men – making them particularly vulnerable to opioid use.” The research report, The United States for Non-Dependence: An Analysis of the Impact of Opioid Overprescribing in America, shows individuals undergoing surgery are at particular risk, due to the prescribing of opioids to manage postsurgical pain.

Here are some interesting facts from the report that you should know:
  • Patients receive an average of 85 pills following surgery.
  • Overprescribing leads to 3.3 billion pills left unused-leaving them available for misuse.  
  • In 2016, three million surgical patients became persistent opioid users.
  • The majority of opioid addictions start with prescription medications.
  • Surgery is an unintentional gateway to the opioid crisis.
  • 40% more women than men become persistent opioid users after surgery.
  • Women ages 40-59 are prescribed more opioids than any other age group and have the highest death rates from misuse.
Another report from the Office on Women’s Health demonstrates that between 1999 and 2015, the rate of deaths from prescription opioid overdoses increased 471 percent among women, compared with an increase of 218 percent among men; and heroin deaths among women increased at more than twice the rate than among men. Also, the differences in how prescription opioid and heroin use impacts women and men are often not well understood. There are potentially many factors that affect a woman’s path to opioid misuse and dependancy, including biological and social influences, past experiences, geography, and demographic characteristics. However, many knowledge gaps remain on how these relate to the opioid misuse.

According to the The Centers for Disease Control and Prevention (CDC), women are more likely than men to experience chronic pain, and use prescription opioid pain medications for longer periods and in higher doses. Women tend to use substances differently than men, sometimes using a smaller amount of drugs for a shorter period of time before they become dependent. In March of 2016, the CDC issued the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016, which summarized the research literature on the benefits and risks associated with prescribing opioids and provides an evidence-based guide for prescribers and patients to share decision-making responsibility about opioid use, and alternative treatment options for chronic pain management.   

As a women’s health nurse practitioner, this has significant impact to my practice, and my licensing. Some states now require opioid education in order to renew prescriptive authority. Combatting this problem requires a multi-factorial approach. We all need to be more aware and vigilant with prescribing, confirming orders, patient education, and post-surgical follow up.
Dowell, D., Haegerich, T., & Chou, R. (2016, March 18). CDC Guideline for Prescribing Opioids for Chronic Pain — United States,  2016. Retrieved from Centers for Disease Control and Prevention : https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

Office on Women's Health. (2016, December). White Paper: Opioid Use, Misuse, and Overdose in Women. Retrieved from Women'sHealth.gov: https://www.womenshealth.gov/files/documents/white-paper-opioid-508.pdf

Pacira Pharmaceuticals, Inc. . (2017, September 26). Plan Against Pain . Retrieved from The United States for Non-Dependence: An Analysis of the Impact of Opioid Overprescribing in America: http://www.planagainstpain.com/resources/usnd/
Lynne Centrella Rudderow, MSN, RN, CRNP, WHNP-BC, CCE



Posted: 11/6/2017 8:30:56 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Patient Safety

Inspired Nurses Calendar 2017: Beautiful Colors

Lippincott NursingCenter.com is partnering with Lippincott Solutions to bring you an inspired nurse’s story every month. Here is October’s nurse story, “Beautiful Colors.” 

Beautiful Colors
Leeann Vidt, R.N. supervisor
Oakmont Center for Nursing
beautiful-colors_october-2017.jpgAs all life must come to an end, some families find it difficult to face emotionally. I observe them looking scared to talk with or touch a dying loved one, so I will often enter the room, sit on the bed, and take the patient’s hand in mine, then I will ask them if they think the fall leaves are beautiful with all those wonderful colors. They always answer, yes, and look at me puzzled. I then tell them that those leaves are actually dying and that something so beautiful should not be feared. I tell them the greatest gift to give their loved one is loving memories. I ask starter questions, such as what their favorite vacation or holiday spent together was. As they answer with smiles across their lips, I quietly exit the room and close the door. Nothing warms my heart like hearing the laughter behind that door. And then after the patient passes, I am thanked for making the passage from this life a better memory for them. I tell them that their loved one left within a circle of love, just as they had lived.

This is why I love nursing. To be able to help someone change such a scary situation into a sweet memory, makes those difficult, stressed shifts well worth my nursing cap.

To see all 2016-2017 stories or to share an inspiring story of your own about being a nurse, or how you were inspired by another, and enter to win prizes, visit http://lippincottsolutions.com/inspirednurses.  Be sure to check our blog every month for a new inspired nurse’s story.


Posted: 10/29/2017 7:53:23 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

National Conference for Nurse Practitioners (NCNP): Fall 2017

anne-woods-lisa-bonsall-at-ncnp-(1).JPGEarlier this month, we had a great showing of advanced practice nurses for our fall National Conference for Nurse Practitioners (NCNP). It was one week after Nursing Management Congress2017 and one week after the deadly mass shooting in Las Vegas. Being in town for both conferences was an experience – as we shifted gears for a different group of nursing professionals and also remained a presence in a city that was dealing with tragedy and starting to heal.

As a frequent attendee at NCNP, I often attend a wide variety of topics and speakers. With my background in critical care and women’s health, I am interested in both the acute care and primary care sessions. I had the opportunity this time to meet and learn from new experts and I found myself picking up on a certain theme, which I didn’t realize when I originally registered and picked my sessions! I think you’ll pick up on this as you read through some of these clinical and professional pearls that I picked up at the conference…

“Isn’t it time that nursing is referred to as one of the STEM [science, technology, engineering, and mathematics] professions?”
Keynote Address: Finding Your NP Voice
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP
“A high HDL cholesterol is only as good as a low LDL.”
Dyslipidemia: Going Beyond the Current Treatment Options
“One in four heroin users started with prescription opioids.”
New Trends in Street Drugs and Legal Highs Part 1
Andrea Efre, DNP, ARNP, ANP-BC
“The opioid OD triad: unresponsive/coma, respiratory depression/failure, and CNS depression (mioisis).”
New Trends in Street Drugs and Legal Highs Part 2
Andrea Efre, DNP, ARNP, ANP-BC
“When calculating the anion gap, for every one gram decrease in albumin from normal, add 2.5 to anion gap.”
Understanding Sepsis
Sophia Chu Rodgers, FNP, ACNP, FAANP, FCCM, FAANP
“Repeated doses of ibuprofen and acetaminophen can prolong the duration of a viral illness.”
Antimicrobial Update: A Focus on Respiratory Infections
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP
“Adverse drug reactions are responsible for an increase of two days for hospital length of stay.”
Pharmacogenomics and Chronic Pain: Putting Science Back Into the Treatment of Pain
Brett Badgley Snodgrass, MSN, FNP-BC
“Herbal and dietary supplements are at least the fourth most common cause of drug-induced hepatic disease necessitation liver transplant.”
5 Things I Wish I Knew Last Year
Louis Kuritzky, MD
“Prescribing cascade refers to when a new problem arises that is associated with the side effect of a medication and additional medications are added to treat it.”
Polypharmacy: What the Nurse Practitioner Should Know
Audrey M. Stevenson, PhD, MPH, MSN, FNP-BC
The theme I’m referring to above is drug information. These pearls are just a handful from the sessions I attended. There were also sessions on pharmacologic management of dementia, biologics, hormone replacement, direct oral anticoagulants, sleep medications, medical marijuana, opioid prescribing, non-opioid analgesics, and pharmacologic management of obesity. Wow!
I also attended back-to-back sessions on street drugs and spent some time with the Drug Enforcement Agency in the Exhibit Hall. The current opioid epidemic in the United States is not just a big city problem; it’s happening no matter where you are, among all ages, and it’s a big concern. Think about the prescribing you do on a daily basis. Drug approvals, indications, and warnings are constantly changing, and we must keep our knowledge up-to-date. Now, think about the number of drug overdoses you see, or patients and families that you know are dealing with addiction. These numbers are rising and, as nurse practitioners, we have a responsibility to appropriately assess and manage pain, and prescribe responsibly.



Posted: 10/27/2017 11:00:34 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Continuing Education

Lippincott NursingCenter.com Announces a Donation Campaign to the American Red Cross

In a time following numerous natural disasters and the deadliest mass shooting in modern U.S. history, healthcare professionals are reminded how vitally important emergency preparedness protocols are in times of crisis. However, the rippling side effects continue after the initial impact of traumatic incidents. Crises of this size and scale can trigger post-traumatic stress disorder (PTSD) among anyone who experiences or witnesses the traumatic event. In the wake of these recent events, Lippincott NursingCenter.com is offering a PTSD continuing education (CE) collection for $1.00 until 12/31/2017. All proceeds from this collection will be donated to the American Red Cross.

Recognizing PTSD Symptoms
Nurses are in the position to make an impact in times of crisis beyond providing acute patient care. In the aftermath, recognizing the signs of post-traumatic stress disorder (PTSD) is critically important. Managing PTSD in patients and, at times, amongst peers requires nurses to stay in-the-know on what classifies as PTSD and how they can deliver care. The National Institutes for Mental Health identifies four diagnostic criteria for PTSD (National Institute of Mental Health, 2016):

  1. At least one re-experiencing symptom (flashbacks, bad dreams, frightening thoughts)
  2. At least one avoidance symptom (staying away from places that are reminders of the trauma, avoiding related thoughts and feelings)
  3. At least two arousal and reactivity symptoms (startling easily, feeling tense, sleeping difficulty, angry outbursts)
  4. At least two cognition and mood symptoms (trouble remembering key features of the trauma, negative thoughts about self or the world, guilt or blame, loss of interest in enjoyable activities)

Continuing Education
It is imperative for nurses to perpetually learn and prepare for crises of this nature in an effort to provide optimal patient care and patient outcomes. Lippincott NursingCenter.com offers an array of free journal articles and resources that can be found here to help nurses be prepared to exercise their training in an unpremeditated situation and successfully recognize and manage PTSD in patients and peers.

                                                                More Reading & Resources
                                                              Focus On: Post-Traumatic Stress Disorder


Posted: 10/20/2017 10:31:07 AM by Lindsey Lynch | with 8 comments

Categories: Diseases & Conditions

Plunging Forward in the Aftermath of the Las Vegas Tragedy

Las Vegas is different this week. And that’s no surprise. This city has been shocked by the largest mass shooting in modern U.S. history. Some of us were here that day; some of us flew in on Monday. All of us are safe. All of us are deeply saddened. All of us want to do something to help.

Nursing Management Congress 2017, our annual conference for nurse leaders, is taking place this week at The Mirage Casino & Resort. Conference staff and attendees came to Las Vegas to continue our tradition. And while it’s been a different mood here this week, we will not let the actions of one person stop us from learning, networking, and supporting one another. We’re nurses. We are here and we are here to help.

What we’ve been doing

Upon arrival here, our conference chairperson, Pamela Hunt, BS, MSN, RN, NE-BC, immediately contacted University Medical Center to see how our large group of nurse leaders could best serve their network. Because of the overwhelming response from local businesses and volunteers, our services have not been required on-site. Like many all over the world, we have been thinking and praying for the victims and their families, and all the first responders and health care providers.
 “We are truly saddened and heartbroken at the recent events and tragedy in Las Vegas. While we continue to hold the victims and families in our thoughts and prayers – we are a resilient and dedicated group of nursing professionals who have gathered for a week of learning, education and networking. Our goal is to remain committed to providing strategies for improving the quality and cost-effectiveness of care delivery as nursing best practices. And no one will take that from us.”
-Pamela Hunt, BS, MSN, RN, NE-BC, Nursing Management Congress2017 Chairperson

NMC-Dr-Cheatham.JPGIn a sad coincidence, the topic of the keynote address was Orlando Active Shooter: Lessons Learned.  We all listened closely to this sobering presentation from Michael L. Cheatham, MD, FACS, FCCM, Chief Surgical Quality Officer, Orlando Regional Medical Center. Dr. Cheatham emphasized the importance of preparation and drills, focusing on being ready when, not if, the next mass casualty occurs.

Here are some things other things I learned:
  • There have been 273 mass casualty events this year as a result of gun violence.
  • During a mass casualty event, the Health Insurance Portability and Accountability Act (HIPAA) allows sharing of names and conditions to identify victims.
  • While we know gun violence is a public health crisis, the Dickey Amendment prohibits the use of federal funds to study this issue.
  • Stop the Bleed is an initiative to train the public how to help in a bleeding emergency. 
 In coordination with the Mirage Casino & Resort, a blood drive was organized to be held here at the conference. We are proud of the nurse leaders who are lining up to contribute to this cause! As nurses, we know how important it is to have an adequate supply of blood products for a typical shift. I can only imagine the number of units of blood that have been transfused at UMC over the past several days.
NMC-Blood-Drive.JPG NMC-Heroes-Thank-you.JPG   

What you can do

Thousands of people attended the outdoor concert on Sunday, October 1, 2017. There were also many witnesses including hotel guests, entertainers, and employees in the tourism industry  During a cab ride from the airport to Nursing Management Congress, Karen Innocent, DNP, RN, CRNP, ANP-BC, CMSRN, Executive Director, Continuing Education, listened to her taxi driver share her experience driving many frightened concert-goers away from Mandalay Bay. The driver kept repeating “I was in shock.”.

Unlike many other mass casualty events that had a local impact, the survivors and witnesses who were tourists in Las Vegas will be heading home to their communities around the U.S. They may present to your health system, clinic, or office for health care in the coming months. They may experience post-traumatic stress disorder (PTSD). Will you be able to recognize it?
The National Institutes for Mental Health identifies four diagnostic criteria for PTSD (National Institute of Mental Health, 2016):
  1. At least one re-experiencing symptom (flashbacks, bad dreams, frightening thoughts)
  2. At least one avoidance symptom (staying away from places that are reminders of the trauma, avoiding related thoughts and feelings)
  3. At least two arousal and reactivity symptoms (startling easily, feeling tense, sleeping difficulty, angry outbursts)
  4. At least two cognition and mood symptoms (trouble remembering key features of the trauma, negative thoughts about self or the world, guilt or blame, loss of interest in enjoyable activities)
It is critical for all of us to be prepared both for the occurrence of mass casualty events and for the care of patients who are affected as a result. Recognize the importance of preparation and drills. Make sure your institution has a Hospital Incident Command Center. Ask questions. Get involved. Be prepared.
National Institute of Mental Health. (2016, February). Post-Traumatic Stress Disorder. Retrieved from National Institute of Mental Health: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
Lisa Bonsall, MSN, RN, CRNP
Senior Clinical Editor, Lippincott NursingCenter.com
Karen Innocent, DNP, RN, CRNP, ANP-BC, CMSRN
Executive Director, Continuing Education


Posted: 10/5/2017 8:20:27 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments


Inspired Nurses Calendar 2017: I’m Just Like You

Lippincott NursingCenter.com is partnering with Lippincott Solutions to bring you an inspired nurse’s story every month. Here is September’s nurse story, “I’m Just Like You.”
September-2017.jpgI’m Just Like You
Angela Townsend, BSN, RN
Home Health
When I was 17, I was diagnosed with Type 1 Diabetes. It was at that moment when I decided to become a nurse. I've found that my own personal experience having a chronic illness has not only increased my understanding and passion for teaching others with diabetes, it has allowed me an empathy towards my patients that I never thought possible. I teach my patients about their illnesses and let them know, "hey, I have to do this too." It has made my experience as a nurse in an ever-changing world of medicine, so much more rewarding!
To see all 2016-2017 stories or to share an inspiring story of your own about being a nurse, or how you were inspired by another, and enter to win prizes, visit http://lippincottsolutions.com/inspirednurses.  Be sure to check our blog every month for a new inspired nurse’s story.



Posted: 9/27/2017 8:01:04 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

What is sepsis? What the public needs to know

sepsis-is-a-medical-emergency-(2).PNGSepsis is a medical emergency. It is a complication of the body’s response to an infection that can lead to life threatening tissue damage, organ failure and death (CDC, 2017). By increasing awareness of the early signs and symptoms of sepsis and risk factors for developing sepsis, we could improve survival and decrease complications. Like many life-threatening conditions, time is of the essence. Early detection and treatment of sepsis is the cornerstone of managing this medical emergency. According to the most recent data from 2013, sepsis was the most expensive condition treated in US hospitals accounting for $23.7 billion, or 6.2% of aggregate cost for all hospitalizations (Torio & Moore, 2016). To increase awareness and improve outcomes related to sepsis, we summarized key teaching points to communicate with patients and the public about this medical emergency. 

Here are the top 10 things to teach patients and the public about sepsis:

  1. Any type of infection can lead to sepsis. The four most common are lung, urinary tract, GI tract, and skin infections (CDC, 2017). 
  2. Sepsis begins outside the hospital in 80% of those affected (CDC, 2017).
  3. Sepsis affects approximately one million people in the US annually (NIH, 2017); patients hospitalized with sepsis are eight times more likely to die during hospitalization (Hall et al. 2011). 
  4. Sepsis is the result of an abnormal inflammatory response that the body has to an infection. The overwhelming inflammatory reaction is what leads to the symptoms of sepsis and the associated organ failures.
  5. Risk factors for developing sepsis are age (those older than 65 and those under one-year old [CDC, 2017] are highest at risk); weakened immune systems due to medication or disease; and chronic illness, such as diabetes or COPD.
  6. Early signs and symptoms of sepsis include fever, chills, fast heartbeat, confusion, shortness of breath, rapid breathing or severe pain (with no obvious cause).
  7. There are no specific diagnostic tests for sepsis. Diagnosis is based on clinical examination which is why it is critical to seek prompt medical attention if there is any concern for sepsis.  
  8. Taking measures to prevent infection, such as hand washing, vaccinations, and smoking cessation (since chronic lung disease is a risk factor), can help prevent infections that could lead to sepsis.
  9. There are likely genetic components and other biological factors that make some people more susceptible to developing sepsis in response to an infection. Ongoing research continues to help us understand sepsis and the optimal treatment supporting the goal to improve early diagnosis and improve outcomes. 
  10. Seek medical attention if you have an infection and any signs or symptoms of sepsis. Early identification and treatment are critical in improving survival and reducing complications.
Improving public awareness of sepsis can save lives. By educating patients and the public, you can make a difference by encouraging someone to seek treatment for this medical emergency that can potentially be overlooked and mistaken for other less threatening illness. Are there any other important items you routinely educate your patients and families about to improve awareness of sepsis? If so, please share your expertise with us.

Centers for Disease Control and Prevention (CDC). Sepsis Questions and Answers. Updated April 13, 2017. https://www.cdc.gov/sepsis/basic/qa.html. Accessed August 21, 2017.  
Hall, M.J., Williams, S.N, DeFrances, C.J, & Golosinkiy, A. (2011). Inpatient Care for Septicemia or Sepsis: A Challenge for Patients and Hospital. NCHS Data Brief No. 62, June 2011. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/nchs/data/databriefs/db62.htm. Accessed August 22, 2017.
Torio, C.M. & Moore, B.J. (2016). National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013. Statistical Brief #204. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. May 2016. https://www.ncbi.nlm.nih.gov/books/NBK368492/#sb204.s2. Accessed August 20, 2017
National Institutes of Health (NIH): National Institute of General Medical Sciences. Sepsis Fact Sheet. Updated January 2017. https://www.nigms.nih.gov/education/pages/factsheet_sepsis.aspx. Accessed August 22, 2017.

Posted: 9/19/2017 10:39:22 AM by Lisa Bonsall, MSN, RN, CRNP | with 2 comments

Categories: Diseases & Conditions

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