We have medical cover Monday to Friday 9am-5pm so the majority of our care is Nurse and Therapist led.
Through reviewing urgent transfers to acute hospitals we noted that staff were not consistently identifying Sepsis or implementing our Sepsis Pathway.
Working with the Advanced Nurse Practitioner (ANP) we devised a teaching session covering identification of Sepsis including National Early Warning Score (NEWS), Sepsis Pathway implementation, and SBAR (Situation, Background, Assessment, and Response) which we use as a guide to handing over between services including to Paramedic Crews.
Night site practitioners supported this work at night and the ANP rolled out the session to all Registered Nurses (RNs). The session was made as interactive as possible using resources from Sepsis UK (http://sepsistrust.org/).
The session uses video clips, presentation of pathways and scenarios based on case studies from within our own services. The session is run as clinical supervision supporting professional development. By bringing staff together from across the site we improve networking, promote shared learning, and help nurses to view each other as a resource for clinical decision making.
The RN’s then have an opportunity to work alongside the ANP when implementing the Sepsis Pathway during the day shift. This allows for one to one tuition, real time question and answer opportunities and feedback for the staff member. During this period staff identified that it would be helpful to have equipment and guidance in one easily accessible place.
Our ANP has reviewed our emergency trolleys and implemented a “Sepsis Drawer” or “Sepsis Kit” for each area. Within weeks of commencing the training we were able to identify an improvement in the early detection of Sepsis and its management.
For the last 3 months of data analysed through a review of the patients’ notes following reporting as an incident, all episodes of Sepsis were correctly identified, the Sepsis Pathway implemented, and treatment initiated or the patient transferred in line with the pathway.
The session has been shared with other ANP’s within the Trust and a roll out programme is underway in the 12 other inpatient sites within the Trust. The training is running monthly at Crawley to ensure all new RN’s receive this training and will be adapted to train our adult and community nursing teams
Alongside an improvement in clinical practice in the identification and management of Sepsis we noted additional benefits including:
• Positive feedback from staff regarding the clinical supervision formatsupporting revalidation
• Feedback from staff that they feel more empowered regarding clinical decision making in general
• Feedback from staff that they value feedback about their performance either confirming that they have done the right things or where they need to make changes
• Feedback from staff that they have a greater understanding of the ANP role