Reflective accounts

Managing encephalitis

A CPD article improved Abby Morrow-Barnes’s knowledge of the nursing care and treatment of patients with encephalitis
Woman with a headache

A CPD article improved Abby Morrow-Barness knowledge of the nursing care and treatment of patients with encephalitis

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article discussed the causes, symptoms, assessments and treatment of encephalitis, which is inflammation of the brain tissue (parenchyma).

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article stated the two main causes of encephalitis are direct infection of the brain parenchyma by various pathogens and inflammation triggered by an abnormal response of the patients immune system that often occurs after a mild, non-specific infection. The most commonly identified infectious cause of encephalitis is herpes simplex virus.

I learned the brain becomes inflamed and swollen

...

A CPD article improved Abby Morrow-Barnes’s knowledge of the nursing care and treatment of patients with encephalitis


Headache is part of the classic triad of encephalitis symptoms  Photo: iStock

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article discussed the causes, symptoms, assessments and treatment of encephalitis, which is inflammation of the brain tissue (parenchyma).

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article stated the two main causes of encephalitis are direct infection of the brain parenchyma by various pathogens and inflammation triggered by an abnormal response of the patient’s immune system that often occurs after a mild, non-specific infection. The most commonly identified infectious cause of encephalitis is herpes simplex virus.

I learned the brain becomes inflamed and swollen in patients with encephalitis, and that doctors are required to investigate its specific cause and begin treatment. Nurses should be aware that often no specific cause of encephalitis is found.

Patients with encephalitis usually present with an encephalopathy, which is an altered level of consciousness or a change in personality, behaviour or cognition. Encephalitis has a classic triad of symptoms: fever, altered consciousness and headache that may last several days. Patients might also present with limb weakness, seizures, hallucinations, irritability and unusual behaviour.

Early management should include specific treatments, such as aciclovir and broad spectrum antibiotics. Other treatments include corticosteroids, immunoglobulin, and plasma exchange.

How did you change or improve your practice?

In my experience, one difficult aspect of caring for patients with encephalitis is their challenging behaviour, and it can be difficult to explain this behaviour to their family members. This article gave me evidence-based information to enhance my practice and to educate family members about the symptoms of the condition.

I was interested to learn about the treatments available, in particular plasma exchange or immunoglobulin, which I have not used in my practice. I will consider services available to support patients and their families during their rehabilitation. For example, the article included useful information about charities that support patients with encephalitis and their families throughout their recovery, such as the Encephalitis Society, the Child Brain Injury Trust, and Headway.

Acute confusion is a common challenge for nurses caring for patients with encephalitis, and this confusion may fluctuate. I will ensure a thorough neurological examination is performed on the patient’s admission, which includes a Glasgow Coma Scale assessment and a Mini-Mental State Assessment. Patients may, however, develop subtle psychiatric features that are inadequately assessed by these tools; therefore, I will ensure I take relatives’ concerns seriously if they state the patient is not their usual self.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

This article is relevant to the theme of practising effectively, because it provides evidence-based information about assessing and managing encephalitis.

It is also relevant to the theme of prioritising people, which requires nurses to assess and respond to people’s physical, social and psychological needs. The article outlined the different assessments used to identify encephalitis, and the range of treatments available.

Abby Morrow-Barnes is a staff nurse at Warwick Hospital


This reflective account is based on NS819 Matata C, Easton A, Michael B et al (2015) Managing patients with encephalitis. Nursing Standard. 30, 11, 50-58. These questions are the same as those on the NMC templates that UK nurses and midwives must use for revalidation

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