For this paper, I struggled to organize my thoughts and coherently put my thoughts on paper. This gave my paper an initial impression of being all over the place and jumbled up. My sentences were too long and confusing. For editing, I asked for help from a classmate who gave me some helpful tips on how to rewrite many of my sentences. For this paper, I successfully reread my paper several times and rearranged some of my paragraphs in an effort to establish flow. One thing I want to work on or attempt in future papers is to make an outline before hand which lists my individual topic sentences and the supporting points for individual paragraph

Sepsis: A Common Cause of Death in Hospitals
When hearing the word “sepsis” many people will not register its meaning. However, sepsis is said to annually affect 1.7 million adults in the US (Rhee et al., 2019), making sepsis a health issue that should be discussed more often. So, what is sepsis? According to the Centers for Disease Control and Prevention (CDC), sepsis is an extreme reaction the body has to the presence of any infection throughout your body. Sepsis damages body tissue, causes organ failure, and sometimes even leads to death. Dr Chanu Rhee and his team worked to determine how common sepsis is, its causes, and its association with mortality in hospitals. Out of the 1.7 million people who are affected by sepsis more than 250,000 people die. On a larger scale only 14.7% of people with sepsis die, but 250,000 people dying annually due to a bodily reaction which seems to be preventable and treatable is alarming! The lack of knowledge regarding sepsis is prohibiting people from recognizing its signs. To prevent mortality due to sepsis, it might be helpful if one is able to identify the symptoms early on so that it may be treated before things get out of hand.
In order to be able to accurately diagnose sepsis or pre-existing infection early on, one has to know what causes infection, which leads to sepsis, who is most likely to get the infection, and what are the signs and symptoms. Infections are caused by any germs or bacteria entering into the body. Once this infection has progressed and been left untreated, then sepsis may develop. Sepsis is most common in people who are over 65 years old or under 1 year old. However, people with weakened immune systems, people who have any chronic medical conditions — such as diabetes, lung disease, cancer, or kidney disease— and anyone who has been in a hospital, especially after undergoing surgery, is at risk (CDC, 2018). If one meets any of the high risk characteristics, then it is crucial that they can recognize any of the signs and symptoms- an extremely high, or rapidly increasing, heart rate, fever, shivering, feeling cold, constant confusion, shortness of breath, clammy skin, and/or extreme pain (CDC, 2018). The earlier these signs are identified, the better the chances are for a doctor to treat and hopefully cease the sepsis.
For their research, Dr. Chanu Rhee and his colleagues randomly choose 600 patients who had died or been referred to hospice. Hospice is end of life care for those who have very high probabilities of dying from their terminal illnesses. Additionally, they tracked the care given to these patients while they were alive. They recorded everything, from when they received medication to errors in administration of medication, in order to determine the probability of preventability of death based on treatment. Through their research, Dr. Chanu Rhee and his team were able to find out that more than half of the patients that died or went to hospice had some presence of sepsis. In two-thirds of the cases, sepsis was the immediate cause of death. When calculating the preventability of death due to sepsis, the results showed that only one in eight cases in which sepsis was the immediate cause of death could have been prevented through better hospital care. It is commonly thought that the quality and resources of the hospital is connected to the development of sepsis. However, it was not stated that being in a public hospital increased or decreased the development of sepsis in patients. It was not specified for private hospitals either. Therefore, it is evident that the problem of sepsis has to do with treating it after it is present, rather than with preventing it through better or more expensive care.
The extent to which death was preventable varied amongst the cases in which sepsis was an immediate cause of death. Only 1.3% of sepsis was thought to be definitely preventable, 2.3% moderately preventable, and 8.3% possibly preventable. By measuring preventability, this research measured the effectiveness of the care given to the patients once the infection was already recognized. However, throughout this research, there were additional factors which could have possibly affected the preventability. One of the factors is that the subjects chosen for this research were reported to have had other underlying medical conditions. These conditions include various cancers, pneumonia, chronic heart and lung diseases, or dementia. Furthermore, about 40% of the patients who died from sepsis met the qualifications for hospice before being admitted to the hospital. In other words, the conditions which the patients possessed before developing sepsis and before stepping foot into the hospital, could have been the reason why the sepsis was able to kill more than half of the patients. This is another aspect which could have affected the preventability of death. Since the underlying illnesses of the patients could have been too progressed, coupling it with sepsis would have been too much for the body. Additionally, it is unclear whether the sepsis was already present when the patients came to the hospital nor how long it took to diagnose it. In 77.3% of the cases, there were no accounts of inadequate care given, yet seven out of eight cases were thought to be unpreventable deaths from an infection that is highly treatable when found on time. The high percentage of adequate care administered, shows that the steps for treatment were met. However, the timestamp of when sepsis developed and when it was treated is not given. This would have left it undetected for a long time, to the point where even the most superb hospital care could not get rid of it. This leads to an idea which Dr. Chanu Rhee’s research was not aimed at- what can be done in order to prevent death due to sepsis?
Upon inspection of the research conducted by Dr. Chanu Rhee and his colleagues, the only thing that was not addressed was the effectiveness of detecting signs and symptoms for an earlier diagnosis of sepsis. The ability for early detection would require the help of family members bringing concerns to the doctors, who might miss some of the signs. After all, doctors are humans too. Imagine being in a hospital with a relative, and seeing them start to shiver, seeing the sheen of sweat glistening on them, and hearing them complain of pain. Now imagine being able to ask the doctor “does my relative have sepsis?” rather than “what is happening?” It would be refreshing to know that one question can save so much time in diagnosing a relative. However, one has to know the signs before they can expect to help in diagnosis. This can be viewed as simple in a low risk case. However, when dealing with high risk cases, it can be important to ask additional questions— more than just “is it sepsis?” There is prospect for further research on this topic. Exploring how knowledge of the symptoms can positively affect treatment time and how sepsis can be prevented and/or aggressively treated, when coupled with strong underlying illnesses, might be able to help in decreasing the high sepsis-associated mortality rates.

References
Rhee, C. et al. 2019. Prevalence, Underlying Causes, and Preventability of Sepsis-Associated Mortality in US Acute Care Hospitals. JAMA Network. [Internet]. [Accessed March 4 2019]. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724768

Sepsis: What are the Signs and Symptoms? Centers for Disease Control and Prevention. [Internet]. [Reviewed June 19, 2018; Accessed March 4, 2019]. Available from: https://www.cdc.gov/sepsis/signs-symptoms.html

Sepsis:What is Sepsis? Centers for Disease Control and Prevention. [Internet].[Reviewed June 22, 2018; Accessed March 4 2019]. Available from: https://www.cdc.gov/sepsis/what-is-sepsis.html