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Somerset hospital nurse praised for sepsis improvement project

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A nurse has received national recognition for helping to dramatically improve sepsis care across Weston Area Health NHS Trust.

James Merrell, the trust’s lead nurse for deteriorating patient and sepsis, took action last year after noticing “unwarranted variation” in the trust’s rates of early detection and prompt treatment of the life-threatening condition.

“Clearly, addressing unwarranted variation in this way has led to better outcomes”

Susan Aitkenhead and Sarah Dodds

In September 2017, the trust, which has its main hospital site in Weston-super-Mare, recorded just a 17% compliance rate in use of the sepsis screening tool.

Mr Merrell, working in partnership with the director of quality and safety Natasha Goswell, introduced awareness raising campaigns, staff training and new sepsis alert practices. 

james merrell lead nurse deteriorating patient sepsis

james merrell lead nurse deteriorating patient sepsis

Source: Weston Area Health NHS Trust

James Merrell, lead nurse for deteriorating patient and sepsis at Weston Area Health NHS Trust

The work has today been highlighted in a blog by Susan Aitkenhead, NHS England’s director of nursing, professional development, and Sarah Dodds, director of nursing at Weston Area Health NHS Trust, to mark World Sepsis Day.

It said: “Weston General Hospital was making good progress in providing sepsis care but identified an opportunity to strengthen the sepsis care pathway, to not only save lives but to sustain improvements by using quality improvement methodology and integrating clinical governance.”

As part of the project, staff across all disciplines, including porters and receptionists, were offered new sepsis training.

A nursing leadership programme was created to empower nurses across the trust to take the lead in identifying and escalating patients who may have sepsis.

A sepsis multidisciplinary team was formed in a bid to provide a more united approach to sepsis care at Weston Area Health.

The validated NEWS (National Early Warning Scoring) assessment tool was introduced, which supports staff to identify any patient who may have sepsis at the earliest opportunity.

When someone is suspected of having the condition, staff are required to deliver the “Sepsis Six” within one hour, which consists of three diagnostic and three therapeutic steps.

Work to raise awareness of sepsis in both staff and patients was redoubled, including the installation of full-length posters in lifts.

As a result of these concentrated efforts, the use of the sepsis screening tool rose from 17% in September 2017 to 96% in January this year.

In the emergency department, screening for sepsis is over 90% and administration of intravenous antibiotics within one hour is at 89%. Sepsis screening and treatment for inpatients has reached 100%.

For sepsis, the average length of stay at Weston General Hospital has reduced from eight days in October 2017 to four days in May 2018, well below the national average length of stay of 12 days.

The blog by Ms Aitkenhead and Ms Dodds concluded: “Clearly, addressing unwarranted variation in this way has led to better outcomes and experiences for patients.”

Staff experience was positive with 100% saying they would recommend the sepsis training to colleagues and they feel confident to use the training in practice, and the intervention used were low cost.

Sepsis support groups have also been set up for patients after they are discharged.

Mr Merrell told Nursing Times: “It’s down to the team here. I facilitate a lot of the work we do around sepsis but having said that the team are the ones that move the quality improvement project forward and embed that into practice resulting in better patient experience, care and outcomes. We are really pleased.”




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