Sepsis toolkit
| Site: | Royal College of General Practitioners - Online Learning Environment |
| Course: | Clinical toolkits |
| Book: | Sepsis toolkit |
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| Date: | Saturday, 20 April 2024, 8:57 AM |
Description
Provides a collection of tools, knowledge, and current guidance to support the identifying and appropriate management of patients with sepsis.
About the toolkit
Sepsis is a rare life threatening condition that can develop rapidly from what might be otherwise innocuous infections. Recognising it at an early stage among the huge number of ordinary infections can be a challenge even to experienced clinicians.
Sepsis affected 123,000 people in England in 2014, resulting in approximately 37,000 deaths. 70% of cases derived from an infection developed in the community. It is estimated that there is potential to reduce deaths by up to 10,000 per annum by the optimisation of care.
Clinical resources and guidance for practices
The Sepsis Trust has created a range of resources to support clinicians in delivering the NICE guidelines. Similarly, GP clinical systems are being equipped to support clinicians by including the physiological values considered abnormal in the NICE Sepsis Guidelines.
NICE Guidance
- Sepsis: recognition, diagnosis, and early management (NICE CG51) National institute for Health and Care Excellence (2016)
- NICE Quality Standard QS161
- NHS England Sepsis Guidance Implementation Advice
- Fever under 5 Guidance
- Nice Guidance Meningococcal Septicaemia in under 16’s
CKS
Further Guidance
Sepsis Trust decision support tools
The following resources are based upon the NICE Sepsis Guidance CG51
- GP Paediatric Sepsis Decision Support Tool (Under 5)
- GP Paediatric Sepsis Decision Support Tool (Aged 5-11)
- GP toolkit for Adults and young people aged 12 and over
- Other resources including advice on pregnancy and OOH triage can also be found on the Sepsis Trust website
Top Tips for GPs and primary healthcare professionals
The top tips list was produced by participants at the RCGP Sepsis London workshop in November 2016.
Background information
National Early Warning Scoring system. Suggested by NCEPOD Report and others for potential use in General Practice, this has the value of providing a baseline recording of physiological variables and communicating risk and concern to secondary care colleague regarding sick adults. Its use as a screening tool in Primary Care is not established.
A Free NEWS 2 calculator can be downloaded on apple and android, which can consider hypercapnia both on and off supplemental oxygen
GP Clinical Systems
It is noted that all GP clinical systems have aide memoire and templates for the recording of physiology useful in the documentation patients who are unwell with infection. Although there has been no formal college input to the construction of these it is advised that clinicians consider use them. Their use is important not only in documenting the severely unwell with sepsis but also when recording when the signs of sepsis were absent, and that appropriate safety netting has been given.
Ultimately it is hoped that these systems will also support the production of early warning scores, admission leaflets and patient / parent advice leaflets.
Quality Improvement
To access shared learning networks to assist you in applying practical QI methodologies to better treat this clinical area, join our QI Ready platform.
National reports and legislation
Below are some of the most significant national reports and documents relating to sepsis.
Significant national reports
- Sepsis: Just Say Sepsis National Confidential Enquiry into Patient Outcomes and Death (NCEPOD), (2015)
- An avoidable death of a three-year-old child from sepsis A report by the Health Service Ombudsman for England
- Time to Act: Severe Sepsis rapid diagnosis and treatment saves lives Parliamentary and Health Service Ombudsman (2014)
- Root Cause Analysis Investigation Report 2014/41975. A Report on a multi-organisational investigation into the unexpected death from sepsis. NHS England and Kernow CCG (2016)
- Sepsis and the NHS – Annual Review by the All-Party Parliamentary Group on Sepsis APPG Sepsis 2015
- RCGP Sepsis Summit Consensus Report 2017
- Meningococcal Working Group Report
International Definitions and NICE Guidance
- The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Singer M, Deutschman CS, Seymour CW, et al.
Strategic Guidance
Patients and carers resources
Recognising Sepsis
This is a challenge for trained clinicians as the signs and symptoms can be varied and subtle at the onset of sepsis. Patients, parents and carers often ask what they should look out for.
Patients
Treating your infection without antibiotics Leaflets (with Safety netting advice) - Full range of leaflets in multiple languages can be found at the Target Antibiotic toolkit under leaflets to share with your patients.
Parents
- Spotting Sepsis in Children (SAM Leaflet)
- Spotting Sepsis under 5's Video for Parents
- Caring for Children with Fever at home
- Meningitis Baby Watch
Mobile Apps
Charitable Organisations
Meningitis Charities
Training and appraisal resources
Sepsis care and identification has been a focus of much attention with new definitions and guidelines. It is important that clinicians keep up to date.
Guidance for GPs:
At the national summit for the sepsis clinical priority in November 2018, we launched the booklet: Sepsis: Guidance for GPs (470 KB PDF), written by the RCGP Sepsis Clinical Priority team with support from Health Education England. It gives information on sepsis epidemiology, top tips for sepsis aware consultations and Sepsis leads, and clinical scenarios. The booklet is aimed to be used alongside e-learning and presentations to share sepsis learning across practices. The guidance booklet will be developed into a Train the Trainer PowerPoint presentation pack, allowing GPs to carry out workshops locally based on the findings and formats of the regional workshops undertaken by the sepsis clinical priority project over the last four years.
Education
There are scheduled events hosted by regional faculties, which feature sepsis treatment.
E- learning
- Health Education England and E-learning for Health Modules
- Immunisation E learning
- RCGP Essential Knowledge update 2017 - Covers sepsis and management of common infections
Practice Resources
Reception Staff Training. This package from Hartlepool & Stockton Health GP Federation has been developed to assist practices in reception staff training in identifying areas of concern when taking calls from patients. It covers Chest Pain, Stroke symptoms (FAST), Breathlessness and Sepsis. It is ideally delivered by a trained practice lead for sepsis.
- Deteriorating Patients: an introduction for GP reception staff, including chest pain, stroke, breathlessness and sepsis - Workbook (613 KB PDF)
- Deteriorating Patients: an introduction for GP reception staff, including chest pain, stroke, breathlessness and sepsis - Slides (337 KB PDF)
Podcasts
Building Sepsis Aware Communities
Just Say Sepsis! Sepsis, Physiology and Communication
Suspect Sepsis? Communicating with Ambulance Services
Sepsis: Spreading the news
Sepsis: Listen to us part 1
Sepsis: Listen to us part 2
Webinar
Information for commissioners
The RCGP is currently working with Health Education England, NHS England and others to try and identify the areas of sepsis care which need to be in place to operationalise the recent guidance and strategic planning to create a uniform pathway for the recognition, diagnosis and definitive treatment of sepsis.