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Changes in body temperature are a characteristic feature of sepsis. Often this means a rise in temperature or fever as the body attempts to fight the infection. But in some cases, especially in the later stages of sepsis, patients may develop low body temperature. While this is less common, it is associated with poorer outcomes, so it is important to be on the lookout for low as well as high temperatures when considering potential sepsis cases. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of the signs and symptoms of acute kidney injury • To familiarise yourself with the pathophysiology of acute kidney injury and associated complications • To understand the management of the patient with acute kidney injury in the critical care setting, including haemodynamic support and continuous renal replacement therapy Acute kidney injury is a sudden reduction in renal function which impairs the kidneys' ability to maintain fluid, electrolyte and acid-base balance. The syndrome often develops secondary to severe illness and is associated with a significant increase in morbidity and mortality rate in critically ill patients. This article gives an overview of the pathophysiology and aetiology of acute kidney injury, as well as the associated complications and clinical diagnostic signs. The authors also describe some common causes of the syndrome in critically ill patients, specifically sepsis, liver failure and cardiac failure, and discuss patient management in the critical care setting, with a focus on haemodynamic support and continuous renal replacement therapy. [ABSTRACT FROM AUTHOR]

The question arises as to whether there may be poorer and delayed care for complex diseases in the clinics at the weekend. Above all, it is discussed whether sepsis patients who are admitted at the weekend have a worse overall prognosis as a result. [ABSTRACT FROM AUTHOR]

A mid unprecedented NHS pressures and staff shortages, identifying when a patient is deteriorating – as with many aspects of care – can be at risk. [ABSTRACT FROM AUTHOR]

National guidance on sepsis treatment has been updated to ensure antibiotics are being used in a more targeted way for people at higher risk of severe illness or death. [ABSTRACT FROM AUTHOR]

Improving the blood culture pathway – in which blood cultures are collected, transported and analysed – is essential in ensuring the best outcomes for patients with sepsis and providing the most effective antimicrobial stewardship programmes, says NHS England. Through adherence to microbiology standards, the detection of significant bloodstream infection in the population can be substantially improved, it says in recent guidance. Each significant positive blood culture provides an opportunity to improve patient care. [ABSTRACT FROM AUTHOR]

Sepsis and severe infection are common reasons for admission to hospital, and perhaps the most common causes of inpatient deterioration, according to the UK Sepsis Trust (UKST). [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of the physiological development of sepsis • To learn how to recognise sepsis and commence management • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Sepsis is a complex condition defined as one or more life-threatening organ dysfunctions caused by a dysregulated host response to infection. Nurses have a vital role in the early identification of those with or at risk of developing sepsis. Prompt early treatment delivered using care bundles such as the 'sepsis six' can optimise patients' chances of survival and reduce the debilitating effects of this condition. [ABSTRACT FROM AUTHOR]

Cellulitis is an acute bacterial infection of the dermis and subcutaneous tissue. It occurs when a break in the skin allows microorganisms to enter, and is characterised by pain, warmth, swelling and redness. Normally, cellulitis affects the lower limbs, but other areas such as the arms, face, ears and trunk may also be affected. Generally, it is thought to affect one in 40 people each year. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTIs) are common and, although often uncomfortable and distressing, usually easy to treat. [ABSTRACT FROM AUTHOR]

I recently took up a new role as a deteriorating adult response team (DART) nurse at University Hospitals of Leicester NHS Trust. [ABSTRACT FROM AUTHOR]

Sepsis causes up to 48,000 deaths in the UK each year – more than breast, bowel and prostate cancer combined, says the UK Sepsis Trust. [ABSTRACT FROM AUTHOR]

Sepsis is a potentially life-threatening condition that is triggered by an infection. Sepsis is an urgent public health issue globally, and is one of the leading causes of death in emergency departments and hospitals. However, consensus definitions of sepsis are imprecise and the incidence costs of the condition are thought to be underestimated. This article discusses the incidence of sepsis globally and nationally, and the effects of the condition. It emphasises the early identification and effective management of sepsis which remain crucial to improving patient outcomes such as morbidity and mortality. It also outlines the nurse's role in providing sepsis care. [ABSTRACT FROM AUTHOR]

Prompt recognition of the shocked patient and administration of therapy is essential. Haemodynamic stabilization and correction of the underlying cause should be based on the pathophysiological processes that are occurring. Monitoring the patient's response to treatment depends on careful observation in a high-dependency area along with serial lactate measurements. By optimizing treatment of circulatory shock, its significant morbidity and mortality can be improved. Here, we give an overview of circulatory shock, recognition of the shocked patient and principles of treatment, and explore some of the underlying causes of shock and their management. [ABSTRACT FROM AUTHOR]

This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice. The article evaluates the rationale for the use of an early-warning score system in the identification of patients at risk of deterioration, in particular the identification of sepsis and septic shock in the emergency setting. In this article, one research article will be selected and critiqued; however, in practice several appropriate articles should be reviewed to draw firm conclusions. Some of the barriers to the implementation of evidence-based practice and the dissemination of research will be discussed. [ABSTRACT FROM AUTHOR]

Seven years ago, following what should have been a routine hospital procedure, Katie Dutton contracted sepsis. Now, she is using her experience to teach others how to spot and manage patients who are deteriorating. [ABSTRACT FROM AUTHOR]

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Pathological changes in the circulation reduce the blood supply to major organs, causing them to fail. This may lead to death, therefore rapid recognition and treatment of sepsis is vital. Sepsis research has focused on patients in acute hospital settings. However, most cases of sepsis originate in the community, suggesting that the identification of sepsis and delivery of timely care is necessary before hospital admission. Therefore, it is essential that nurses practising in the community are provided with appropriate sepsis guidelines that can be implemented immediately. The UK Sepsis Trust has developed the General Practice Sepsis Decision Support Tool, which has been designed specifically for use in the community. This article provides an overview of how the tool is used in the community and how it works in conjunction with the 'Sepsis Six' care bundle and care bundles for hospital settings. Changes to the terminology used in relation to sepsis and recent guidelines are also explained. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced neutropenia may result in significant physical, social and emotional consequences for patients receiving anticancer therapy. Chemotherapy-induced neutropenia also leads to delays in treatment and reductions in dose intensity. In some cases neutropenia may be prevented by the use of granulocyte-colony stimulating factor, but it remains one of the most common side effects of chemotherapy. Patients who are neutropenic have a reduced ability to fight infection and are at increased risk of developing neutropenic sepsis. Nurses need to be able to recognise the signs and symptoms of neutropenic sepsis to ensure early diagnosis and treatment. There are evidence-based pathways for the treatment of patients with neutropenic sepsis and nurses have the potential to develop services and initiatives to support best practice for this group of patients. [ABSTRACT FROM AUTHOR]

Abdominal sepsis and trauma are the main indications for open abdomen. However, there is no robust evidence that open abdomen is better than closed in these cases. When using open abdomen, treatment goals are to control the source of infection, protect the bowel from damage, minimise adhesions between the bowel and abdominal wall, facilitate nursing care and allow permanent closure of the wound by bringing the fascial edges closer. Several temporary abdominal closure techniques exist, but are associated with high mortality and morbidity rates. There is no evidence that any specific temporary abdominal closure technique is better than others; however, negative pressure wound therapy appears to be a popular method of management of open abdomen. [ABSTRACT FROM AUTHOR]

The article focuses on the approach taken by U.S. hospitals to reduce sepsis infection and mortality. Topics covered include the development of triage criteria to screen emergency department patients for sepsis at North Shore-Long Island Jewish Health System, the implementation of protocols for the aggressive detection and treatment of sepsis at Intermountain Healthcare and the keys to the success of the sepsis initiative at Wake Forest Baptist Health. INSET: Sepsis Primer.

The article discusses the emergency department (ED) nurse-led team's improvement of care for patients with sepsis at University Hospitals of Leicester National Health Service (NHS) Trust as of 2018. Topics covered include team's lookout for and screening of ED patients with signs of sepsis, and its members' possession of a sepsis phone which colleagues can call if a patient is suspected to be at risk. Also noted is the resulting decline of hospital mortality rates due to the team's work.

The article focuses on a trial conducted on more than 4,500 in rural India aimed to demonstrate the potentials of probiotic to protect humans against diseases. It mentions that the trial was led by Pinaki Panigrahi of the University of Nebraska Medical Center and that the result of the trial called synbiotic has the possibility to provid a cost-effective way to address early-infant mortality. It adds that the multiyear trial reveals a decrease on the cases of infant death and sepsis by 40%.

The article announces that Royal Aberdeen Children's Hospital (RACH) emergency department (ED) senior staff nurse, Drew McDonald, has received the 2017 RCNi Nurse Awards in the child health category.

Sepsis is a systemic inflammation caused by severe infection. It is a condition that is life-threatening, progresses rapidly, and affects multiple system functions. An evidence-based medical sepsis bundles model has been used for sepsis care in clinic practice. Therefore, a holistic nursing care protocol for patients with sepsis is needed to improve medical outcomes. This case study describes a nursing experience using Levine's Conservation Model to care for a patient with sepsis. Data were collected using physical assessment, medical chart reviews, written communications with the patient, interviews patient family members, and observing the patient during intensive care hospitalization from June 10th, 2011 through July 5th, 2011. Levin's Conservation Model, used as the nursing guideline, successfully identified patient issues including failure to conserve energy, structural, personal and social integrity. Interventions included: (1) sepsis bundles and early goal directed therapy to reduce patient energy expenditure; (2) prevention of infection to maintain structural function; and (3) enhancement of selfesteem, privacy, family cohesion, and social activities to maintaining personal and social integrity functions. The interventions helped the case adapt successfully to the sepsis-related imbalance. This case report provides a valuable nursing care experience as a reference for similar sepsis cases in the future. [ABSTRACT FROM AUTHOR]

The development of infection in a burn can lead to poor healing outcomes and possibly sepsis. Although most patients with burns treated in the primary care setting are unlikely to develop life-threatening infections, clinicians would still benefit from an understanding of the factors that may increase the risk of infection, signs and symptoms of infection, and when to seek specialist advice. [ABSTRACT FROM AUTHOR]

Serogroup B meningococcal disease is the last main cause of bacterial meningitis and septicaemia in the UK. There is currently no vaccine against this serogroup. This article outlines the nature of meningococcal disease and highlights recent guidance from the National Institute for Health and Clinical Excellence on recognising and managing the disease in primary and secondary care. An update on progress towards a preventive vaccine is also discussed. [ABSTRACT FROM AUTHOR]

Infection is a significant challenge in burn care, particularly for those patients who have major burn injuries. This article aims to review the literature and establish best practice in prevention and treatment of infection in patients with major burns. The article considers the causes and clinical features of wound infection, and examines systemic and local methods of prevention and treatment. [ABSTRACT FROM AUTHOR]

The article discusses important facts highlighting recognition and management of sepsis in various clinical settings. Topics covered include the definition of sepsis and septic shock according to the guidance published by the National Institute for Health and Care Excellence (NICE), the use of structured approach in assessing a patient, and sepsis treatment. It also discusses the highlights of the first world sepsis online congress hosted by the Global Sepsis Aliance on September 8-9, 2016.

Sepsis is associated with a high incidence of mortality and morbidity, however with appropriate strategies for monitoring and early targeted intervention mortality rates decline. This article examines the basic pathophysiology of the inflammatory response to tissue injury and the effects this has on circulation. A partnership of the Society of Critical Care Medicine, the European Society of Intensive Care Medicine and the International Sepsis Forum has developed the surviving sepsis strategy, which includes the sepsis six treatment pathway and early goal-directed therapy incorporating the six-hour care bundle. [ABSTRACT FROM AUTHOR]

A former nurse who lost three limbs to sepsis and used her experience to raise awareness of the illness took her own life, an inquest has heard. [ABSTRACT FROM AUTHOR]

This article outlines a nurse-led system to identify patients with severe sepsis outside critical care settings. It also discusses how the Surviving Sepsis Campaign's severe sepsis resuscitation care bundle can be initiated. Patient outcome and audit results are examined. [ABSTRACT FROM AUTHOR]

The article presents different kinds of skin infections caused due to drug reactions. There are reports of skin reactions for almost every drug and about 14% of adverse drug reactions in hospital patients are cutaneous or allergic in nature. Exanthematous is the most common type of drug rash and can mimic viral exanthema such as measles or scarlet fever. Urticaria is the second most common type of drug reaction. There are raised, itchy, red weals of varying sizes across the body. Toxic epidermal necrolysis is uncommon but life-threatening due to skin and water loss or septicemia.

This article outlines the causes, signs and symptoms of systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis and septic shock, the implications and available treatments. The article also highlights a campaign to reduce the incidence of sepsis and reflects on efforts to reduce healthcare-associated infections. [ABSTRACT FROM AUTHOR]

The article reports on a difference in mortality among patients with severe sepsis in Europe compared with patients in the U.S., according to data from the Surviving Sepsis Campaign.

The article discusses the use of acid suppression therapy to prevent stress ulcers. Various factors cause stress ulcers, they include trauma, organ failure, sepsis and thermal injury. This kind of therapy makes use of acid-suppressive agents that lessen gastric acid or protect the stomach mucosa from acid. Drugs for acid suppression include ranitidine and cimetidine.

Five people die as a result of sepsis every hour in the UK, and one quarter of survivors are left with life-changing after-effects, according to the UK Sepsis Trust. The condition can be difficult to spot as symptoms are similar to many other common conditions. However, if detected and treated early, outcomes are positive. [ABSTRACT FROM AUTHOR]

Cattle abortion is a significant health and welfare issue that causes economic loss in treatment costs, lost production and labour inputs. Infection can result in abortion, mummification, stillbirth, or the birth of live deformed calves. Salmonella can cause outbreaks of abortion - so-called abortion storms - within herds rather than isolated and sporadic cases, typical of some other causes of pregnancy failure. [Extracted from the article]

The article paper-based sensor could help identify sepsis in hospital patients by accurately monitoring their breathing rate.

The article features nursing student Katie Dutton, winner of the Andrew Parker Student Nurse Award. Topics discussed include how Dutton's personal bout with sepsis inspired her to embark on an advocacy to improve sepsis recognition among nursing students. Also mentioned is the success of Dutton's student-led Sepsis Champion campaign at De Montfort University which was adapted by the school in its nursing curriculum.

The article discusses the prevention, identification and treatment of neutropenic sepsis, a complication of chemotherapy.

An interview with community staff nurse Naomi Forsyth is presented. She talks about the nature of their continuing professional development (CPD) activity on the symptoms, treatment and prevention of neutropenic sepsis. She discusses the things she learned from the activity. She explains how she changed or improved her practice.

The Sepsis Six screening tool has been updated to help nurses and other staff boost survival rates by recognising sepsis more quickly. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To optimise your practice when undertaking temperature measurements at various sites • To understand the importance of measuring temperature to provide information about a patient's health and its role in diagnosis and patient monitoring • To recognise the link between elevated temperature and potential bacterial or viral infections • To enhance your knowledge of the factors that can influence the accuracy of temperature readings Rationale and key points: Temperature is a vital sign that is included in all early warning scoring tools and as part of patient observations. This article outlines the main non-invasive methods that can be used to measure a patient's temperature. • Temperature is important in establishing a baseline to evaluate treatment, monitoring signs of any allergic reaction or infection, and recognising significant changes in temperature, for example hypothermia and hyperthermia. • Nurses should understand the pathophysiology of temperature regulation and be familiar with the various methods used to measure temperature. They should also be aware of the environmental factors that may result in inaccurate temperature readings. • It is crucial to identify any signs of clinical deterioration in patients, including elevated or lowered temperature, and respond to these in a timely manner. Reflective activity: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice in measuring patients' temperature. 2. How this article could be used to provide information to patients about temperature measurements. [ABSTRACT FROM AUTHOR]

Vets are urging poultry flock-keepers to take precautions against blackhead after a warm, wet summer saw a rise in the number of cases. The bird ingests the caecal worm heterakis, or its larvae or eggs, which have been infected by the blackhead protozoa. Unfortunately, the blackhead protozoa can become encased in the caecal worm egg, where they are protected and may remain viable in the range for several years. [Extracted from the article]

This section offers news briefs on the nursing practice in Great Britain as of July 2019, including the call for training of nurses on how to give long-term support to people who have survived sepsis, the move by the Royal College of Nursing (RCN) to call for an overhaul of tattoo parlors' infection control rules, and a study on the effect of a phone call from a community nurse to older people after they leave hospital on their readmission.

If you suspect sepsis you must act. That was the message from sepsis survivor Tom Ray to nurses at RCN congress. [ABSTRACT FROM AUTHOR]

Essential information: Sepsis, which claims 52,000 lives a year in the UK, occurs when the body has an abnormal immune response to an infection, which causes organs to start failing. Sepsis can be triggered by any infection, but most commonly it occurs in response to bacterial infections of the lungs, urinary tract, abdominal organs or skin and soft tissues. It can be difficult to spot because symptoms can also indicate less serious conditions, but early treatment is vital. [ABSTRACT FROM AUTHOR]

This section offers news briefs related to nursing including a low-cost rapid detection test for sepsis that can give a result immediately, the inclusion of King's College London (KCL), the University of Manchester and the University of Southampton in the top ten universities in the world for nursing courses, and a tool from Charity Diabetes UK to help nurses talk to patients about the possibility of type 2 diabetes remission.

The article reports that the SOS Insights Dashboard information tool that measures suspicion of sepsis data could drive improvements in care, according to consultant nurse John Welch who helped to develop it.