DETOUR OFF THE SEPIS ROAD: EARLY RECOGNITION IS KEY 

by Angela Buckles, RN, CNS-S
Murray State University

Introduction

Sepsis is the systemic inflammatory response to infection (Howell & Tisherman, 2006). The pathophysiology of sepsis is complex and typically involves the following components: inflammatory, procoagulant, antifibrinolytic, and microvascular (Wheeler, 2007). The occurrence of sepsis has increased dramatically. In the 1970’s, the US estimated 164,000 cases (Neviere, 2009). At present, the US reports approximately 750,000 cases a year and estimates 1 million cases by 2020 (O’Brien, Ali, Aberegg, & Abraham, 2007). With a mortality rate of 30%, an estimated 250,000 annual deaths, and hospital costs exceeding $16 billion, sepsis has become a burden (O’Brien et al, 2007, Kaplow & Hardin, 2007). It is imperative to increase the awareness and early recognition of sepsis. This article will review the definition, pathophysiology, and the current treatment plan for sepsis. Utilization of the Synergy Model and a case study will illustrate how early identification of sepsis can lead to improved patient outcomes.

Definition

The definition of sepsis ranges from the start of the systemic inflammatory response to multiple organ failure. Knowledge of the different stages of sepsis gives healthcare personnel the ability to intervene and choose appropriate treatment interventions. The following definitions are from Neviere, 2009. Systemic inflammatory response syndrome (SIRS) is clinically identified by the presence of two or more of the following: Cont'd

The Power of Preceptorship

by Dr. Susan M. Eley
Assistant Professor
Indiana State University

The clinical experience is an essential component to nursing education.  The identification of formal preceptors grows increasingly difficult as competition for clinical sites and nursing faculty shortages continue to place a strain on the system. 

Nurses serve as preceptors for new staff, novice student graduates, and nursing students at multiple levels of degree seeking from technical to master’s level.  New staff and or students demand additional time and preparation from the identified preceptor.  Preceptors may have formal training within the organization or from educational institutions affiliated with the facility.  However, the variation in formal preparation may be as brief as a few minutes to programs lasting weeks.

As important as the formal preceptor is to nursing education, all nurses must be prepared to be viewed as a preceptor to a new student or nurse. Cont'd
 

The Signs and Symptoms’ of Cardiomyopathy: The Awareness and Actions of the Registered Nurse

by Gary D. Goldberg, PhD
Clinical Professor of Medical Education
Angeles College of Nursing, Los Angeles, Ca.

ABSTRACT

    Cardiomyopathies come from many mechanisms, but the conditions may be divided into three major types:  First, dilated or congestive.  Second, hypertrophic, and third, restrictive.  A careful history-taking by the registered nurse or practitioner along with a complete physical examination can reveal cardiomyopathies, but it is appropriate to confirm the diagnosis with a transthoracic echocardiography and selected laboratory studies. 

Key Points –