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Sepsis at JPUH

Supported by JPUH Transformation Team. Sepsis at JPUH. THE STORY SO FAR. Supported by JPUH Transformation Team. Every year in the UK there are 150,000 cases of Sepsis, resulting in a staggering 44,000 deaths – more than bowel, breast and prostate cancer combined. Sepsis at JPUH

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Sepsis at JPUH

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  1. Supported by JPUH Transformation Team Sepsis at JPUH THE STORY SO FAR

  2. Supported by JPUH Transformation Team Every year in the UK there are 150,000 cases of Sepsis, resulting in a staggering 44,000 deaths – more than bowel, breast and prostate cancer combined.

  3. Sepsis at JPUH 116deaths due to Sepsis from July 2015 to July 2016. 44 with a primary diagnosis (41 sepsis and 3 septic shock), 72 more with some diagnosis of sepsis.

  4. Supported by JPUH Transformation Team Sepsis at JPUH July 16 Mortality increases by 8% for every hour of delay in Antibiotic Administration

  5. Supported by JPUH Transformation Team

  6. Supported by JPUH Transformation Team

  7. Supported by JPUH Transformation Team

  8. New Outpatients & Children's Sepsis Easy Guides coming very soon.

  9. New PGD

  10. Spreading the message around • Bespoke teaching on all wards • Corporate induction • ALERT • HCA induction • Overseas nurse induction • Mini ALERT • Critical care study days • CLAW • Grand Round 10th Nov 16 • All A&E Staff Trained in Nov 16 • Sepsis Teaching F1 & F2 completed. • Sepsis week in February and April. • Ward Study days when required. • National publications: NHS Improvement & Academy of Fab Stuff.

  11. Supported by JPUH Transformation Team Sepsis at JPUH Dec.16 68% July 16 58% July 16 Mortality increases by 8% for every hour of delay in Antibiotic Administration

  12. JPUH 22nd of 95 nationally JPUH 34th of 87 nationally CQUIN indicator 2a(ii) (Percentage of adult ED patient requiring review that were reviewed) CQUIN indicator 2a(ii) (Percentage of adult IPS requiring review that were reviewed)

  13. CQUIN Performance (Adult ED review), December 2016 CQUIN Performance (Adult IP review), December 2016

  14. Mean LoS for patients with sepsis, Sep-Dec 2016 Text Mean length of stay, by month of discharge, given primary diagnosis group of “Septicaemia (except in labour)”, for patients at JPUH; comparison to acute providers nationally and in the East of England. Source: Dr Foster Healthcare Intelligence Portal.

  15. Crude mortality rate of sepsis cases, July-Dec 2016 (by quarter) Given a primary diagnosis group of “Septicaemia (except in labour)”, the proportion of patients with an outcome of death, by quarter of discharge, for patients at JPUH; comparison to acute providers nationally and in the East of England. JPUH figures for periods: Q2 10 deaths on 69 spells, Q3 11 deaths on 91 spells. Source: Dr Foster Healthcare Intelligence Portal.

  16. PROUD OF THE PAGET THE RELATIVE RISK OF MORTALITY AND READMISSION FOR SEPSIS PATIENTS WAS ALSO WELL BELOW THE EXPECTED AT THE END OF DECEMBER. IF YOU ARE GOING TO DEVELOP SEPSIS, ONE OF THE BEST PLACES TO BE IS AT THE JAMES PAGET UNIVERSITY HOSPITAL .

  17. PROUD OF THE PAGET

  18. DOCUMENTATION, DOCUMENTATION, DOCUMENTATION!

  19. Management Sepsis 6: 1.- Oxygen 2.- IV fluids 3.- Blood cultures / Sputum cultures 4.- Antibiotics – prescribe according to hospital guidelines 5.- Lactate + blood tests 6.- Monitor Urine output

  20. Blood cultures • In all septic patients who are started on antibiotics irrespective of temperature. • Part of sepsis 6 bundle • Ideally, obtained prior to administration of antimicrobial therapy whilst adhering to strict ANTT procedures. • Adults – 2 bottles per set – Aerobic and Anaerobic • Very important to identify causative agent. Also enables antibiotic susceptibility testing

  21. When IV antibiotics are administered to a septic patient within one hour, the mortality is reduced by half.

  22. Supported by JPUH Transformation Team Thank you

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