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Waikato DHB recognised for Sepsis Ready programme

Fuseworks Media
Fuseworks Media

Waikato DHB’s Sepsis Ready programme has received a Continuous Improvement rating- from independent auditors and Ministry of Health recognising the work done at the DHB’s hospitals to dramatically improve early recognition and response of patients with sepsis.

Sepsis moves fast, so it is vital that hospital staff know what to look for and what to do when it happens, wherever the patient is located. That is the first step in saving lives and reducing long term effects of this life-threatening condition.

Sepsis is currently the biggest cause of in-hospital death in the Waikato. More than 70 percent of cases will present to an emergency department, with the remainder developing sepsis as an inpatient on a general ward.

Research and clinical studies by Waikato DHB clinicians have led the way in New Zealand for a more urgent clinical focus on sepsis, education of health professionals, and wider public awareness.

Work started at Waikato DHB in 2016, when data collection indicated sepsis was an issue and appeared to be increasing. A baseline audit was done, and in early 2017 a large, multi-disciplinary action group was set up to plan and deliver a Sepsis Ready programme.

From mid-2017 the group led the development of clinical protocols and clinical staff education, supported by an audit of all patients admitted to Critical Care with sepsis plus an ongoing audit of 20 patients per month admitted via ED with sepsis or who developed sepsis in hospital. Following a "soft launch" at Thames and Waikato emergency departments, the Sepsis Ready programme was extended organisation-wide on World Sepsis Day 13 September 2018.

"People have often heard of blood poisoning (toto pirau) and septicaemia but sepsis is the accepted term for an overwhelming immune response to infection that damages the body’s tissues and vital organs."

Since then, there has been a dramatic improvement in the care received by patients showing signs and symptoms of sepsis. An audit of 68 patients over the age of 15 admitted to Critical Care (ICU/HDU) with sepsis between September and October 2018 identified the following improvements:

Average time to first medical review improves from 44 minutes to 22 minutes

Antibiotics received within the first hour improves from 63% to 77%

Protocol-driven antimicrobials improves from 55%to 91%

Adequate fluid bolus administered within first hour improves from 77% to 94%

Work to date would not have been possible without the drive and passion of the Sepsis Action Group which includes nursing and medical representation, as well as education programme leaders, data analysts and consumers and, since April 2018, a dedicated sepsis nurse coordinator.

The Sepsis Action Group members and the nurse coordinator continue to raise the profile of sepsis across the DHB. This year there will be a focus on spreading into the community and primary care setting as well as raising awareness among the public.

Three of the action group’s clinical leaders, Paul Huggan, Robert Martynoga and Dan Dobbins, set up the Sepsis Trust NZ and associated website, a first for New Zealand, where sepsis information and clinical tools are available and free for use. ACC has given the trust additional support to further improve the recognition and management of in-hospital sepsis throughout New Zealand as it is currently a major cause of treatment injury claims.

- The Health and Disability Services Standards define Continuous Improvement as: Having fully attained the criterion the service can in addition clearly demonstrate a review process including analysis and reporting of findings, evidence of action taken based on those findings, and improvements to service provision and consumers’ safety or satisfaction as a result of the review process.

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