What we need to do to reduce the number of sepsis cases in the UK
With 200,000 cases in the UK every year, compulsory training in sepsis is vital
Gillian Priday wants to see compulsory training in sepsis for all children’s nurses and other healthcare professionals wherever they work
Sepsis a global killer, and for the survivors, families and carers the recognition of having to face lifelong consequences is common.
Although work to combat sepsis takes place in acute care NHS trusts, there is no regional sepsis strategy or action plan in the UK. There is a desperate need for further work, providing considerable scope to improve survival and reduce long-term disability for patients, as well as an opportunity to reduce health and social care costs significantly.
Why it is so difficult to identify
Sepsis is identified as the body’s systemic inflammatory response to infection, which may cause multi-organ damage, shock and death (UK Sepsis Trust 2019). It can be extremely difficult to identify for professionals and the public alike. Symptoms often suggest other illnesses. For example it can initially look like flu, gastroenteritis or a chest infection.
There is no one sign, and symptoms present differently between adults and children. Awareness of sepsis signs and symptoms needs better public awareness to help people recognise the potential symptoms of sepsis and seek help quickly rather than waiting days before they present.
UK healthcare spending for sepsis treatment is £15 billion per year, according to the UK Sepsis Trust. It also estimates there are 200,000 cases across the UK per year, with up to 60,000 deaths (UK Sepsis Trust 2019).
Considerable effort has been focused on reducing the number of avoidable deaths from sepsis. There are, however, still significant gaps across services, with many healthcare professionals lacking a basic knowledge.
How to reduce risk of dying
The literature tells us administering immediate antibiotics – defined as within one hour when people present to emergency departments with suspected sepsis – reduces their risk of dying by one third compared with later administration. However, in practice, up to one third of people in the UK do not receive antibiotics within the hour (UK Sepsis Trust 2019).
There is a national call to achieve more consistent early identification and treatment of sepsis in children and young adults.
Variation in training across the UK
Although many nurses and healthcare assistants are aware of and trained in responding to sepsis, some are not, and there is significant variation across the UK in the training provided to different professional groups.
Highlighting the standardisation and implementation of a paediatric early warning scoring system (PEWS) and the recognition of further training needs for nurses supported discussion about sepsis at RCN congress this year.
Last year NHS England highlighted that, by using PEWS, there was an improved likelihood of identifying the risk of deterioration. A uniform, recognised UK-wide PEWS score would ensure improvements in identifying and treating deterioration due to sepsis. It would also mirror the National Early Warning Score for adults – where patient care has improved – to support the safe care of children in hospitals, primary care and community settings.
At RCN congress I raised sepsis for discussion because there are deaths and long-term harm that can be prevented. This led to a resolution calling for sepsis training to be mandatory in all healthcare settings. It also called for protected time and funding for continuing professional development for nurses. We need support to help us to identify and treat sepsis in all healthcare settings.
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