The dedicated sepsis team at Lancashire Teaching Hospitals was established earlier this year, with a focus on teaching and educating staff on wards about identifying and treating sepsis.
Since the team was set up, they have focused on developing a sepsis screening and action tool, which has now been deployed throughout the organisation, and the team are ensuring that all teams are fully trained to use this and use it consistently with all relevant patients. This includes use of a flow chart to help assess a patient correctly.
This then leads to implementation of the sepsis six pathway when sepsis is suspected (administer oxygen, take blood cultures, give IV antibiotics, give IV fluids, check serial lactates and routine bloods, and measure urine output). Since the team started work, sepsis screening has doubled.
Earlier this month, the North West Ambulance Service (NWAS) alerted staff at Royal Preston Hospital that a patient with suspected neutropenic sepsis was on the way into hospital. Neutropenic sepsis is a potentially life threatening complication of anticancer treatment. Chemotherapy can reduce the number of white blood cells (neutrophils) produced by the bone marrow. These white cells are essential for fighting infection. If the number of white cells in the blood is low, this is called neutropenia. Therefore, patients with neutropenia are much more liable to infection.
The NWAS team commenced delivery of the sepsis six in the ambulance; and then took the patient into the emergency department at 09:42. The sepsis team and staff in the emergency department had then finished delivery of the sepsis six and administered antibiotics at 09:50; within 15 minutes of the patient’s arrival.
The patient, a 79 year old gentleman from Preston, said: “I received super-efficient treatment from the team at Lancashire Teaching Hospitals, and I was surprised how quick I was treated. The attention that I received from the sepsis team and the emergency department was second to none. I am also very thankful to the ambulance team for getting me there so quick, and to all involved within my care.”
Georgina Singleton, Sepsis Nurse at Lancashire Teaching Hospitals said: “On this occasion, the sepsis six elements were completed in less than 15 minutes which was due to the fantastic teamwork from the North West Ambulance Service, our emergency department and our sepsis team. This just shows how important it is to have a dedicated sepsis team. We’re on standby in case incidents such as these take place and we can act quickly to treat our patients; and the patient may not have been treated as quickly if we didn’t have this team in place. We’re also focusing on improving awareness and education around sepsis to prompt staff to always think of sepsis.”
This month alone, the team have reviewed 86 patients for sepsis due to their increased visibility and focus on early recognition and treatment. The sepsis six has to be completed within an hour, due to the mortality from sepsis increasing by 7.6% every hour that it is left untreated.
Emma Duane, Lead Sepsis Nurse at Lancashire Teaching Hospitals said: “As a team, we are very passionate about the management of sepsis, which can often be very difficult to diagnose. What makes our team so unique is that we have a clear, common goal to “reduce morbidity and mortality from sepsis”, and we recognise that no one person can achieve this goal alone. This is an example of fantastic teamwork from all parties involved, and it is an accolade to the teams that we were able to help this patient so quickly.”