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Shropshire nurse-led sepsis project improves screening

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A project led by nurses to tackle sepsis at NHS hospitals in Shropshire has led to patients being screened faster and other improvements in the service, according to the trust running the hospitals.

The work at Shrewsbury and Telford Hospital Trust, which has included raising awareness of the condition among staff and ensuring screening tools are utilised more effectively, has meant nurses are completing screening observations and documentation in a quarter of the time they used to.

Currently at least four patients at the trust die from sepsis each month but the aim is to reduce that by at least half.

The changes to practice are the result of a “rapid process improvement week” inspired by the trust’s five-year partnership with the Virginia Mason Institute in the US, a Seattle-based healthcare training organisation which has pioneered the use of such techniques to boost the quality of care.

“We found some staff didn’t have a clear understanding of what sepsis is”

Viola Jones

“When challenged to improve screening and recognition of sepsis we found some staff didn’t have a clear understanding of what sepsis is,” said Viola Jones, a staff nurse at the trust who is leading the project, which launched around three months ago.

“To combat this we produced a simple leaflet that explains what sepsis is that comes with a quiz to ensure the information learned in the leaflet is retained,” she added.

The project has so far focussed on acute medical care but the leaflet will be rolled out to all trust staff including nurses, doctors and healthcare assistants.

Other developments include changes to the ways screening tools are used. Previously the trust’s sepsis screening tool was a separate document, which staff found complicated, said Ms Jones. This meant some patients were not being screened when they should be, she added.

“Sepsis is definitely being screened for and recognised more quickly because of the education we have done”

Viola Jones

Now a new tool is being used and is part of standard nursing documentation and this had led to screening being carried out much faster.

“Before it wasn’t part of nursing documentation – it was a separate piece of paper and we were finding staff weren’t going to find that piece of paper even though it was easily accessible,” said Ms Jones.

Previously it took staff around 45 minutes for screening to take place after nurses had completed the relevant paperwork, but that reduced to 10 minutes in the first two months of the scheme being introduced.

The trust also identified shortcomings in preserving patients’ dignity and privacy with 80% having observations and swab tests taken in a public area.

This led to a reorganisation of a doctor’s consultation room to allow testing to be done in private.

Results from the first two months of the project show this has also helped save time, indicated by the fact nurses previously had to take 62 steps to reach the observation machine but now it is nearby.

The first three months of the scheme are still due to be analysed but Ms Jones said anecdotal evidence suggested those at risk of sepsis were being tested and getting treatment faster.

“It is definitely being screened for and recognised more quickly because of the education we have done around sepsis,” she said.

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