Objective: In the UK alone, 245,000 people are affected by sepsis with at least 48,000 people losing their lives in sepsis-related illnesses every year. This is more than breast, bowel and prostate cancer combined. Globally, sepsis claims 11 million lives a year. Yet, for many patients, with early diagnosis it is easily treatable. The UK sepsis trust developed a sepsis screening and action tool which helps clinicians screen for and identify possible sepsis at all levels and across specialities. In the NHS staffing levels vary from junior doctors and trainee advanced care practitioners to registrars and senior consultants which can lead to sepsis being missed at initial presentation. The screening and action tool enables nursing staff at triage to start the tool, if the patient flags up for possible sepsis a Doctor is asked to review the patient and treat with the sepsis 6 action tool. The Emergency department at Royal Derby hospital guidance is to use the sepsis screening and action tool to ensure patients are being picked up early and treated timely and effectively. We conducted a Quality improvement project as an audit showed compliance with the sepsis screening and action tool was 20%. Our problem statement was many patients presenting to RDH ED with suspected sepsis will not be screened for sepsis via the sepsis screening and action tool. This may lead to delays or noncompliance to the sepsis 6 pathway which effectively will lead to morbidities in this patient population. Our rationale for was improving the recognition of sepsis via the standardised sepsis screening and action tool will help raise the awareness and assure early recognition of septic patients amongst healthcare professionals working in the emergency department. Design: We assembled a QI team ranging from nursing staff, doctors, ACP’s and Helth care workers. We used four separate PDSA cycles over the course of 9 months. These help form a structured method which is commonly used to test changes as part of an improvement initiative or project. It enabled the team to thoroughly and efficiently test and evaluate your ideas for change and involves four steps. We also used a Driver Diagram to help address and map out the process. Results: At the start of the project the compliance to the sepsis screening and action tool was 20 %, we managed through 4 PDSA cycles to improve the compliance to 60%. We further broke the action tool down to further asses which components to focus on. The components we investigated were One hour antibiotics given, blood cultures taken, target oxygen saturation, blood gas/lactate taken, fluid given, monior input/output chart. Antibiotics given in one hour improved from 82% to 100 %, blood cultures taken from 65% to 95%, target sats and blood gas/lactate level was constant 100% and remained 100%. Although documentation of input/output charting was 10% at the start of the project and 30% at the end. Conclusion: We manged to improve the compliance to the sepsis screening and action tool from 20% to 60%, which in turn improved one hour antibiotics, blood cultures taken, fluids prescribed which effectively improved the identification and treatment of patients with suspected sepsis in our emergency department.
Keywords: Epsis Quality Improvement Project Sepsis 6.