James Merrell, the lead nurse of trust for worsening patients and sepsis, took action last year after discovering "unjustified divergences" in the early detection and treatment of life-threatening conditions.

"Obviously, treating unjustified variations in this way has led to better results"

Susan Aitkenhead and Sarah Dodds

In September 2017, the Trust, headquartered in Weston-super-Mare, only achieved a 17% compliance rate using the sepsis screening tool.

Mr. Merrell, in collaboration with Director of Quality and Safety, Natasha Goswell, conducted awareness-raising campaigns, staff training and new alerting procedures for sepsis.

James Merrell lead nurse worsening patient sepsis

James Merrell lead nurse worsening patient sepsis

Source: Weston Area Health NHS Trust

James Merrell, senior nurse for patient worsening and sepsis at Weston Area Health NHS Trust

The work was highlighted today in a blog by Susan Aitkenhead, NHS England's director of nursing, professional development, and Sarah Dodds, director of nursing at the Weston Area Health NHS Trust, on World Sepsis Day.

She said, "The Weston General Hospital made good progress in providing sepsis, but identified a way to strengthen the sepsis care pathway, not only to save lives, but also to support improvements through quality improvement methods and the integration of clinical governance. "

The project offered staff in all disciplines, including wearers and receptionists, a new sepsis training.

A care program was created to empower nurses and carers throughout the Trust to take the lead in identifying and escalating patients with sepsis.

A multidisciplinary sepsis team was formed to provide a more consistent approach to sepsis care at Weston Area Health.

The validated National Early Warning Scoring (NSA) rating instrument has been introduced to help employees identify any patient who may have sepsis at the earliest possible stage.

In the event of suspected illness, employees must hand in the "Sepsis Six" within one hour, which consists of three diagnostic and three therapeutic steps.

Work to sensitize staff and patients for sepsis has been doubled, including the installation of full-length posters in elevators.

As a result of this concentrated effort, the use of the sepsis screening tool increased from 17% in September 2017 to 96% in January this year.

In the emergency department, sepsis screening is over 90% and intravenous administration of antibiotics within one hour is 89%. Sepsis screening and treatment for inpatients has reached 100%.

In sepsis, average length of stay at the Weston General Hospital has decreased from eight days in October 2017 to four days in May 2018, well below the national average length of stay of 12 days.

Ms. Aitkenhead's and Ms. Dodds' blog concludes, "Obviously, treating unjustified variations in this way has led to better outcomes and experiences for patients."

The staff experience was positive and 100% said they would recommend sepsis training to their colleagues and that they feel safe using the training in practice, and the intervention used was low cost.

Sepsis support groups were also set up for patients after they were released.


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