Nurses at one of the largest hospital trusts in England have highlighted how the experience of one of their patients sparked a new initiative to prevent sepsis, which will be featured in a television programme on the condition.
Emergency department patients are to be given sepsis advice as part of efforts to prevent and treat sepsis at Nottingham University Hospitals NHS Trust.
“We knew providing more support and information to patients early on would be a good idea”
New leaflets will be given to appropriate patients with an infection but who are deemed safe to be discharged. It contains advice on recovery but also signs of possible sepsis to watch out for.
The trust’s sepsis team decided to prioritise the idea of a leaflet after hearing the story of sepsis patient Karl Goodere-Dale who had been suffering from a chest infection and was sent home.
Next morning, he collapsed and had to be rushed to the trust’s Queen’s Medical Centre. He was diagnosed with sepsis and treated but still faced eight weeks in hospital and a lengthy recovery.
Sally Wood, the trust’s lead sepsis nurse, said speaking to Mr Goodere-Dale about his experience had prompted the writing of the leaflet.
“After hearing about Karl’s experience, we knew providing more support and information to patients early on would be a good idea,” she said. “It will help patients think about sepsis appropriately and help clinicians begin treatment sooner.
“There has been a lot of positive feedback from patients and staff – it’s just one of a number of ways we are trying to build on our sepsis work of the last decade,” she added.
“We will be working with colleagues to encourage them to identify patients at risk of harm from sepsis”
The trust said it had made “steady progress” in detecting and treating sepsis over the last seven years and mortality data indicated that it was performing well compared to peer hospitals.
It highlighted the introduction of automatic screening for adult patients, using an automated e-observation system, which meant 91% of patients were screened for sepsis at its hospitals.
Since 2010, the time taken for a patient with sepsis to be seen by a critical care specialist has been halved – from seven hours down to under four.
Meanwhile, in August, the trust also introduced mandatory training in recognition and treating patients with sepsis for clinical staff.
Dr Marc Chikhani, the trust’s sepsis lead, said: “We have been really pleased by the progress made over the last decade and that is due to the hard work of so many people.
“But we know there is still work to do and we are looking at the next step for improvement,” he said.
He added: “As part of our work around World Sepsis Day, we will be working with colleagues to encourage them to identify patients at risk of harm from sepsis, and communicate the need for urgent treatment, especially how vital it is to administer antibiotics as soon as possible to give the best chance of treatment success”.
The BBC programme revealed that, based on the figures it had collected, one in four NHS hospital trusts was failing to give antibiotics to half their patients with sepsis within the recommended time.
Figures from 104 trusts covering the 12 months to March 2017 showed 78% of patients were being screened and 63% were getting antibiotics within one hour, said the BBC in a news report on the programme’s findings.
Based on the data, the following trusts in England scored below 50% for numbers of patients screened for sepsis or given antibiotics to treat it.
- Administering immediate antibiotics reduces deaths from sepsis
- Ensuring early recognition and treatment of sepsis and septic shock
Lowest scoring NHS England trusts on screening for sepsis
- Liverpool Heart and Chest Foundation NHS Trust – 8%
- East Sussex Healthcare NHS Trust – 27%
- Peterborough & Stamford Hospitals NHS Foundation Trust – 30%
- Mid Cheshire Hospitals Foundation Trust – 31%
- University Hospitals Coventry & Warwickshire – 35%
- Kettering General Hospital – 36%
- Stockport NHS Foundation Trust – 45%
- Worcestershire Acute Hospitals NHS Trust – 46.6%
- Dorset County Hospital NHS Foundation Trust – 47%
- University Hospitals Bristol NHS Foundation Trust – 48%
- Gateshead Health NHS Foundation Trust – 48%
- City Hospitals Sunderland NHS Foundation Trust – 49%
Lowest scoring NHS England trusts on treating sepsis with antibiotics
- Bradford Teaching Hospital – 25%
- University Hospitals Coventry & Warwickshire – 26%
- Shrewsbury & Telford Hospital – 28%
- Dartford & Gravesham NHS Trust – 30%
- Countess of Chester Hospital NHS Foundation Trust – 33%
- Dorset County Hospital NHS Foundation Trust – 33%
- Wye Valley NHS Trust – 34%
- Rotherham NHS Foundation Trust – 36%
- Brighton & Sussex University Hospitals NHS Trust – 38%
- Milton Keynes Hospital – 39%
- Aintree University Hospital Foundation Trust – 39%
- City Hospitals Sunderland – 39%
- Airedale NHS Foundation Trust – 42%
- Royal Cornwall Hospitals NHS Trust – 43%
- Stockport NHS Foundation Trust – 43%
- Mid Cheshire Hospitals NHS Foundation Trust – 46%
- East & North Herefordshire NHS Trust – 46%
- Ipswich Hospital NHS Trust – 46%
- County Durham & Darlington NHS Foundation Trust – 48%
- Portsmouth Hospitals NHS Trust – 49%
- The Royal Bournemouth and Christchurch Hospitals NHS Trust – 49%
- North Cumbria University Hospitals NHS Trust – 49%
- Gloucestershire Hospitals NHS Trust – 49%