SEPSIS

The United Kingdom National Institute for Health and Excellence( NICE) has released a draft quality standard for the management of sepsis.

According to the standard, patients should be assessed carefully for sepsis.

And when they are classified as high risk, they should be reviewed and treated within the hour.

Nursing Times says

Every patient with suspected sepsis should be examined for mottled or ashen appearance, cyanosis of the skin or mouth, non-blanching rash of the skin, any breach of skin integrity and any rash indicating potential infection.

They should also have their temperature, heart rate, respiratory rate, level of consciousness and oxygen saturation assessed.

In addition, NICE noted that children under 12 years with suspected sepsis should have capillary refill assessed.

Meanwhile, blood pressure should be measured in adults and young people over 12 years, in children aged five to 11 years if facilities – including a cuff of correct size – are available, in children under five years if heart rate or capillary refill time are abnormal and if facilities are available.

Any patient subsequently identified as high-risk should be reviewed immediately by senior hospital staff, and should get antibiotics and intravenous fluid treatment within one hour.

If it will take more than an hour to get to hospital, antibiotics can be given in GP practices or by ambulance staff, noted NICE.

Nursing Times reported Professor Gillian Leng as saying

We know from recent case reviews that there are inconsistencies in how people’s symptoms are assessed in different settings,”…“More can be done to provide rapid treatment.”

In nearly a third of cases in the UK, there were avoidable delays in administrating antibiotics and inconsistencies infusing IV fluid to treat.

Here is the NICE quality statement for sepsis.

NICE quality statements for sepsis

    •    Statement 1 – People with suspected sepsis are assessed to stratify risk of severe illness or death using a structured set of observations.

    •    Statement 2 – People with suspected sepsis in acute hospital settings and at least one criteria indicating high risk of severe illness or death are reviewed by a senior clinical decision-maker within one hour of risk being identified.

    •    Statement 3 – People with suspected sepsis in acute hospital settings and at least one criteria indicating high risk of severe illness or death have antibiotic treatment within one hour of risk being identified.

    •    Statement 4 – People with suspected sepsis in acute hospital settings, at least one criteria indicating high risk of severe illness or death, and with lactate over 2mmol/litre, have an intravenous fluid bolus within one hour of risk being identified.

    •    Statement 5 – People who have been seen by a healthcare professional and assessed as at low risk of sepsis are given information about symptoms to monitor and how to access medical care.

To learn more about sepsis:

Nursing Times Sepsis article.

https://www.nursingtimes.net/news/policies-and-guidance/sepsis-must-be-treated-within-the-hour-says-nice/7016415.article?blocktitle=Top-story&contentID=20558

NICE quality standard (27 pages)

https://www.nice.org.uk/guidance/GID-QS10032/documents/draft-quality-standard