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Content ArticleAdherence to best practices for sepsis management at a small community hospital was below system, state and national benchmarks and affected vital indicators, including mortality. This study carried out by Megan Kiser aimed to improve sepsis best practice compliance by implementing human factors–influenced interventions.
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Content Article
Sepsis: National Education Scotland resources
Patient_Safety_Learning posted an article in Deterioration and sepsis
This document brings together some of NHS Education for Scotland (NES) sepsis educational resources. Note: given the changes to the definition of sepsis, some of these resources may refer to previous, alternative terms, which are now not formally recognised. The management and need for urgent treatment remain unchanged, and resources will be updated, as appropriate. -
Content ArticleECRI’s Top 10 Patient Safety Concerns 2023 list identifies potential sources of danger for patients and staff. ECRI believe these risks require the greatest focus for the coming year and offer actionable recommendations for reducing these risks. ECRI conducts independent medical device evaluations, annually compiles scientific literature and patient safety events, concerns reported to or investigated by the organization, and other data sources to create its top 10 list.
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News Article
Young mother reveals sepsis warning signs after losing both feet and 10 fingers
Patient Safety Learning posted a news article in News
A young mother lost both her feet and all 10 fingers to sepsis after a significant delay in treatment, an investigation has found. Sadie Kemp has been left permanently disabled from the “dangerous condition”, whilst an NHS hospital probe found a 3.5 hour delay in starting her care. Sadie is now calling for lessons to be learned after the internal report found numerous concerns in her treatment that ultimately led to her needing multiple amputations. The 35-year-old mother-of-two first attended A&E with agonising back pain caused by a kidney stone on Christmas night 2021. She was given pain relief at Hinchingbrooke Hospital, Cambridgeshire, and sent home to return the following morning for a kidney scan. She returned the same night at 4am as her pain endured. An assessment at 5.40am found she may have also been suffering from sepsis, but the step-by-step guide to chart and treat the illness was not found in her notes as being done at the time. The investigation found not only should the sepsis have been discovered and treated sooner, but the “lack of effective treatment” of the sepsis prior to the surgery meant she needed prolonged critical care. Read full story Source: The Independent, 22 November 2022- Posted
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News Article
Coronavirus: Thousands of COVID-19 survivors could be diagnosed with sepsis, charity warns
Clive Flashman posted a news article in News
People are being warned to familiarise themselves with the symptoms of sepsis after a study found that as many as 20,000 COVID-19 survivors could be diagnosed with the condition within a year. One in five people who receive hospital treatment for the coronavirus are at risk, according to the UK Sepsis Trust. Sepsis is triggered when the body overreacts to an infection, causing the immune system to turn on itself - leading to tissue damage, organ failure and potentially death. If spotted quickly, it can be treated with antibiotics before it turns into septic shock and damages vital organs. Read the full article here.- Posted
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News Article
Baby boy died from sepsis after doctors’ delay giving antibiotics
Patient Safety Learning posted a news article in News
A three-month-old boy died from sepsis after ‘gross failures’ by medics to give him antibiotics until it was too late, an inquest ruled. Lewys Crawford died a day after he was admitted to the University Hospital of Wales in Cardiff with a high temperature last March. Jurors at Pontypridd Coroner’s Court said the failure of doctors to treat his illness with antibiotics until seven hours after his arrival had ‘significantly contributed’ to his death. They found the little boy died from natural causes contributed to by neglect in his care. Read full story Source: The Metro, 15 February 2020 -
News Article
'My baby died of sepsis - we can stop more deaths'
Patient Safety Learning posted a news article in News
New monitors that can detect the deadly blood condition sepsis are being fitted at a Scottish children's hospital. The equipment will be installed at the Royal Hospital for Children in Glasgow. Charlotte Cooper, who lost her nine-month-old daughter Heidi to sepsis last year, said she had "no doubt" the monitors would help save babies' lives. She told BBC Scotland: "You don't have time to come to terms with the fact that someone you love is dying from sepsis because it happens so quickly." Ms Cooper now wants to see the monitors installed in every paediatric ward in Scotland. "We need to do whatever we can to stop preventable deaths from sepsis in Scotland," she said. The monitors record and track changes in heart rate, temperature and blood pressure, and can pick up early sepsis symptoms. The machines, which have been installed in a critical care area, use the Paediatric Early Warning Scores to monitor the children for any signs of deterioration in their condition. Sepsis Research said early warning of the changes would mean sepsis being diagnosed and treated faster. The monitors were accepted on behalf of the hospital by senior staff nurse Sharon Pate, who said: "In a very busy paediatric word it is vital all our patients are monitored regularly and closely for signs of deterioration. The addition of these new monitors will greatly improve our ability to monitor patients and provide vital care." Read full story Source: BBC News, 4 February 2020- Posted
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News Article
'Alarming' one in five deaths due to sepsis
Patient Safety Learning posted a news article in News
One in five deaths around the world is caused by sepsis, also known as blood poisoning, shows the most comprehensive analysis of the condition. The report estimates 11 million people a year are dying from sepsis - more than are killed by cancer. The researchers at the University of Washington said the "alarming" figures were double previous estimates. Most cases were in poor and middle income countries, but even wealthier nations are dealing with sepsis. There has been a big push within the health service to identify the signs of sepsis more quickly and to begin treatment. The challenge is to get better at identifying patients with sepsis in order to treat them before it is too late. Early treatment with antibiotics or anti-virals to clear an infection can make a massive difference. Prof Mohsen Naghavi said: "We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable. We need renewed focus on sepsis prevention among newborns and on tackling antimicrobial resistance, an important driver of the condition." Read full story Source: BBC News, 17 January 2020 -
News ArticleMore than 80% of patients who have signs of a deadly sepsis infection before high-risk surgery are not getting antibiotics fast enough, a major NHS report has warned. Sepsis kills an estimated 44,000 people in England every year and rapid access to antibiotics within the first hour after diagnosis is vital to halt the infection. However, a review of performance across 179 NHS hospitals has found a majority of patients undergoing emergency bowel surgery are not getting medication early enough. A leak of the bowel can cause sepsis and while antibiotics will help treat the infection, surgery is essential to repair any sepsis-causing leak. The Royal College of Anaesthetists, which carried out the study for the NHS, said although the number of patients getting surgery in time had improved over the last five years, the numbers receiving antibiotics within an hour had not. Read full story Source: The Independent, 4 January 2020
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News Article
Sepsis: getting the balance right
Patient Safety Learning posted a news article in News
Public and professional understanding of sepsis has increased greatly in recent years. This has led to campaigns to diagnose sepsis early in the clinical course of the illness and to start treatment with antibiotics and fluid replacement promptly. But could this pressure to improve sepsis management be counterproductive and lead to overdiagnosis of sepsis? This was the argument made by the authors of a recent letter to the Lancet. One problem arising from overdiagnosis of sepsis is the overuse of broad spectrum antibiotics, says Paul Morgan in an Editorial to the BMJ. Another concern is that the emphasis on the early treatment of sepsis detracts from the recognition, diagnosis, and treatment of other acute illnesses. Read full story (paywalled) Source: BMJ, 28 November 2019 -
Content ArticleThis article details the case and findings of an investigation by the Parliamentary and Health Service Ombudsman (PHSO) into the death of Stephen Durkin. Stephen died after suffering organ failure from sepsis, while under the care of Wye Valley NHS Trust. His wife, Michelle Durkin, subsequently made a complaint that delays in the diagnosis and treatment of sepsis led to her husband’s death.
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Content ArticleThis Annual Quality Statement provides a summary of the work of Cardiff and Vale University Health Board in 2019-2020, with a particular focus on community mental health.
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Content ArticleThis article in Patient Safety looks at a new approach to identifying and monitoring patients with sepsis developed by a team of nurses at WellSpan Health in the USA. The Central Alert Team (CAT) works remotely, looking for indicators of sepsis in patient charts and vital signs. They relay information and treatment advice to nurses working at the bedside and take an adaptive approach to find the best ways of working. This focused approach means the CAT nurses are able to quickly identify patients who are deteriorating and ensure treatment is administered at the right time.
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Content ArticlePost-operative sepsis is the term used to describe a rare complication of surgery; when sepsis has occurred shortly after an operation which affects one or more organs of the body. In severe cases it can cause life-threatening multi-organ failure, which requires admission to an Intensive Care Unit. This patient/relative guide, from the UK Sepsis Trust, looks at causes, symptoms and treatments for post-operative sepsis.
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Content ArticleIn this article for the Patient Safety Network, the authors highlight ways in which the Covid-19 pandemic initiated drastic modifications to the way in which health services are delivered across care settings, in particular in hospital emergency departments and inpatient units. They examine particular challenges highlighted by patient safety organisations (PSOs), including increases in safety incidents relating to pressure sores, sepsis, infections and communication issues. The article also highlights innovations to support safety that have been developed during the pandemic.
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- Patient safety incident
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Content ArticleRhian Rose underwent feticide on 22 November 2019 and was admitted to a maternity ward on 24 November 2019 for medical termination of pregnancy. By the evening of her admission, Rhian had clear symptoms of infection, however the sepsis pathway and antibiotics were not commenced until the following morning. In the late afternoon on 25 November 2019, Rhian became acutely unwell resulting in unconsciousness, emergency caesarean section, subsequent cardiac arrest and eventually her death. In this report the Coroner raises concerns about a lack of informed consent and discussion of maternal wishes and the mode of delivery highlighted by this case. He highlights a lack of guidance relating to the infection risk when a mother is attending for delivery following feticide.
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Content ArticleJane Bruce was discharged from hospital on 24 March 2020 and was receiving wound care from the community nursing team twice a week, after surgery on a fracture following a fall in November 2019. She initially appeared to be recovering until 29 April when her pain increased significantly, rendering her bed-bound, with the exudate from the wound significantly increased. She continued to deteriorate and presented to Leicester Royal Infirmary on 1 May with features consistent with sepsis, and subsequently died the following day. In her report, the Coroner highlights concerns about an absence of continuity in Ms Bruce’s wound care. She notes that she had been seen by several different nurses but due to lack of photographic evidence/accessible electronic records they did not have the relevant information to recognise the change in her condition.
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to recognition of the acutely ill infant and child, recognising the difficulty in distinguishing between simple viral illnesses and life-threatening bacterial infections in very young patients. This Healthcare Safety Investigation Branch investigation reviewed the case of Mohammad, a baby who had become unwell and was taken to an emergency department by ambulance following a call to NHS 111. He arrived at 8.04pm and was considered to have a mild viral illness, subsequently being transferred to a paediatric observational ward, and discharged at 11.45pm with a diagnosis of likely bronchiolitis. At approximately 3.40am his mother contacted the ward as his condition worsened, which resulted in a 999 call. The ambulance crew did not consider that Mohammad was seriously ill so did not conduct a ‘blue light’ emergency transfer to hospital. Mohammad was admitted to the emergency department at approximately 4.40am and suffered a respiratory and then cardiac arrest at 5:28am, with attempts to resuscitate unsuccessful and stopped at 6:10am. Mohammad died of septicaemia caused by meningococcus (serogroup B) bacteria.
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- Investigation
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EventThis conference focuses on recognising and responding to the deteriorating patient and ensuring best practice in the use of NEWS2. The conference will include National Developments including the recommendations on NEWS2 and Covid-19, and implementing the recommendations from the Healthcare Safety Investigation Branch Report Investigation into recognising and responding to critically unwell patients. The day will include practical case study based sessions on identifying patients at risk of deterioration, improving practice in patient observations, the role of human factors in responding to the deteriorating patient, improving escalation and understanding success factors in escalation, sepsis and Covid-19, involving patients and families in recognising deterioration, using clinical judgement, and improving the communication and use of NEWS2 in the community, including care homes, and at the interface of care. The Recording of NEWS2 score, escalation time and response time for unplanned critical care admissions is now an NHS CQUIN goal. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/deteriorating-patient-summit or email kate@hc-uk.org.uk. hub members receive a 20% discount. Email: info@pslhub.org Follow on Twitter @HCUK_Clare #DeterioratingPatient
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EventThe Deteriorating Patient Summit focuses on recognising and responding to the deteriorating patient through improving the reliability of patient observations and ensuring quality of care. The conference will include national developments, including the recent recommendations on NEWS2 and Covid-19, and implementing the recommendations from the HSIB Investigation into recognising and responding to critically unwell patients. The conference will include practical case study based sessions on identifying patients at risk of deterioration, improving practice in patient observations, responding to the deteriorating patient, improving escalation and understanding success factors in escalation, sepsis and Covid-19, involving patients and families in recognising deterioration, and improving the communication and use of NEWS2 in the community, including care homes, and at the interface of care. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/deteriorating-patient-summit or email kate@hc-uk.org.uk hub members receive a 20% discount. Email info@pslhub.org for discount code Follow on Twitter @HCUK_Clare #DeterioratingPatient
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Community Post
On the Radar...
Claire Cox posted a topic in Deterioration and sepsis
Lets talks NEWS... Nurse and carer worry, I like to think that Critical Care outreach teams take this very seriously and that the 'worry' has a heavy influence in our management. Many of our patients may score 0, but warrant a trip to the ITU (AKI patients for instance). However, as part of our escalation policy it states that staff should alert the doctor and or the Outreach team when NEWS is 5 or 3 in one parameter. This causes the 'radar referral effect'. We often have a group of these patients on our list. Personally, I find them difficult to prioritise as they are often receiving frequent observations and have a plan. By concentrating on this group and make sure they have everything in place can take time, but... what about those not scoring in this threshold? Do they get pushed to the bottom of the list? Should nurses follow this protocol to safeguard themselves as well as the patient or are we not looking for sick patients in the right place? Don't get me wrong, the NEWS has been revolutionary in the way we deal with deterioration, but as a tool to prioritise this may not be the case. There are softer signs at play here....has anyone got any solutions to deal with the 'radar referals' Lots to discuss @Ron Daniels @Emma Richardson @LIz Staveacre @Danielle Haupt @Kirsty Wood -
Community PostSepsis Awareness Month is around the corner and World Sepsis Day is on 13 September. What are you doing to raise awareness of the killer condition, which affects more than 250,000 people in the UK?
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Content ArticleA series of videos on managing deterioration, including: Introduction to sepsis and serious illness Preventing the spread of infection Soft signs of deterioration NEWS What is it Measuring the respiratory rate Measuring oxygen saturation Measuring blood pressure Measuring the heart rate Measuring the level of alertness How to measure temperature Calculating and recording a NEWS score Structured communications and escalation Treatment escalation plans and resuscitation Recognising deterioration in people with a learning disabilities How to use your pulse oximeter and Covid-19 diary.
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Content ArticleFailure to be aware of and to follow clinical guidelines and protocols could constitute clinical negligence, but not in all cases, and much will depend on the facts of each case. John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses aspects of the law on clinical guidelines and other care management tools.
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- Legal issue
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