A Case of Survival: Living Through Necrotizing Fasciitis

Sunday, November 1, 2009

Lorinda Farris, WHNP, MSN
Women's Health Clinic, U.S. Air Force, Malcolm Grow Medical Center, Andrews Air Force Base, MD
Quincealea Brunk, RN, PhD
Independent Consultant, Cedar Rapids, IA
Sandra O'Sullivan, RN, MS, CCRN
Hershey Medical Center, The Pennsylvania State University, Hershey, PA

Learning Objective 1: discuss the the development of necrotizing fasciitis, identify clinical treatments, expected outcomes, and complications.

Learning Objective 2: analyze the evidence-based research literature on necrotizing fasciitis and case study to optimize the outcome of a patient dealing with this infectious process.

Practicing nurses are responsible for the nursing care of many patients with infections, but none or few are more in need of holistic nursing care than those with necrotizing fasciitis. Necrotizing fasciitis is a bacterial infection that is characterized by the destruction of skin and the soft tissues beneath it, including fat and the fascia covering the muscles. The tissues often die rapidly and the patient is sometimes said to be infected with “flesh-eating” bacteria.  When this rare but often fatal infection is encountered, knowledge of the disease process, treatment options, multiple complications, and expected clinical outcomes are essential knowledge for the nurse to plan for and provide quality care.
This session discusses necrotizing fasciitis using an evidence-based approach from the current research literature and a patient case study. In this case, necrosis of the tissues developed and expanded quickly from an everyday occurrence in a 47 year old, professional woman.  The disease process required hospitalization for almost two months and multiple surgical interventions.  Nursing management in the acute care and community based settings was essential to recovery.  Particularly as it pertains to various women’s healthcare issues, the devastating nature of the disease and treatments required extended therapies for psychosocial adjustment and return to activities of daily living.  Holistic and multidisciplinary interventions were integrated providing a sense of empowerment and feminine well-being. This presentation will include evidence- based comprehensive management for patient care, as well as psychosocial, extended therapy, and follow-up care required for successful outcomes.