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New obligations on hospital nurses to tackle sepsis

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Hospital nurses will be required to alert consultants if patients with suspected sepsis do not respond to treatment within an hour, under new rules being brought in to reduce deaths.

The guidance is being mandated by NHS England from April, as part of ambitions to speed up diagnosis of sepsis and take action at the earliest opportunity to improve chances of survival.

“It will ensure rapid and effective treatment for the patients who need it most”

Tim Nutbeam

Using the national early warning score (NEWS) system, health professionals will be obliged to look for sepsis at the earliest opportunity in patients arriving in accident and emergency or those already on hospital wards.

Healthcare staff will also be expected to take “sufficient note” of non-specific symptoms and concerns expressed by relatives and carers about changes in the patient’s behaviour.

When patients are put on treatment for suspected sepsis, concerns must be escalated to senior doctors if they do not show signs on improvement within an hour.

The guidance has been drawn up by NHS England in collaboration with the Royal College of Physicians, the Royal College of GPs, NICE and the UK Sepsis Trust (UKST).

Dr Tim Nutbeam, clinical advisor for the UKST, said this development followed three years of work between the charity and NHS England to improve sepsis care in hospitals.

“The UKST welcomes this initiative; if delivered correctly it will ensure rapid and effective treatment for the patients who need it most, whilst ensuring that senior clinical decision-makers are supported in making informed, balanced decisions in relation to the prescribing of antibiotics,” he said.

“We have been working with NHS England for the past three years to improve the recognition and management of sepsis in hospitals,” Dr Nutbeam added. “This next step will ensure that every patient receives the attention they require within existing resource.”

“NEWS2 is a simple but incredibly useful tool”

Bryan Williams

The guidance ties in with a government-ordered review of clinical measures in the NHS, including the four-hour accident and emergency waiting time standard, to determine whether they are still fit for purpose and reflect significant advances in practice.

The review, being conducted by top doctors, nurses and hospital bosses, will shortly present its full recommendations for new targets to be trialled over the next few months.

This will include a new measure for patients with the most serious illnesses and injuries, like sepsis, to ensure that they receive the right care in the right time.

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Professor Bryan Williams

It also comes as the NHS works to roll out NEWS2 – the latest version of the early warning score tool that helps identify acutely unwell patients – to acute and ambulance trusts.

Professor Bryan Williams, chair of the NEWS development group and clinical lead for NEWS at the Royal College of Physicians, said: “NEWS2 is a simple but incredibly useful tool to help identify patients at risk of clinical deterioration due to sepsis and is helping transform the speed and effectiveness of treatment for these patients across the NHS. 

“We welcome plans to roll NEWS2 out to acute and ambulance trusts to help identify sepsis at the earliest possible stage and save lives,” he added.

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