Improvements to recognition and treatment of sepsis

Employees celebrating world sepsis day

To mark World Sepsis Day (Friday 13 September 2019), Hywel Dda University Health Board (UHB) has launched the National Early Warning Score (NEWS) tool for use in the community and GP practices to improve early recognition and treatment of sepsis. 

Sepsis is a life threatening condition that arises when the body’s response to an infection injures its own tissues and organs. It can be caused by something as simple as a cut or an insect bite, or an infection like pneumonia. It is also a risk following surgery, or for women who have just given birth.

NHS Wales became the first healthcare system in the world to implement the NEWS tool as the standard in all hospitals in 2012 but it has not been used by community nurses and GP practices until now.

NEWS enables clinicians and nurses to calculate a patient’s physical condition is at risk of deteriorating in a standardised and universally understood way.

Starting with Tenby Surgery and the Pembrokeshire District Nursing Team, the use of NEWS will be rolled out by Hywel Dda UHB across all district nursing teams and GP practices in Carmarthenshire, Ceredigion and Pembrokeshire over the next 18 months.

Mandy Rayani, Director of Nursing, Quality and Patient Experience at Hywel Dda UHB said: “In 2015 a Just Say Sepsis report identified that more than 70% of sepsis starts in the community.

“Now our district nursing teams and staff in GP practices across Hywel Dda will be able to use the universally recognised NEWS tool to identify sepsis early, treat it sooner and improve patient outcomes.”

Eve Lightfoot, former district nurse and now Trainee Advanced Nurse Practitioner in Primary Care at Ashgrove Surgery in Llanelli, was named Royal College of Nursing in Wales Nurse of the Year 2018 for her tireless work at a local and national level, supported by colleagues and the 1000 Lives RRAILS team, to develop the training and the tools to identify sepsis that are now being used in the community.

Eve said: “This journey started almost seven years ago when I began working as a community nurse. I had previously been employed as a junior sister in A&E, so was used to assessing unwell patients using the NEWS tool.

“It was apparent to me straight away that NEWS observations were not performed in the community and staff did not receive sepsis education training or have the equipment to carry out a full set of observations.

“The role of the district nurse is evolving, with much more complex care now being provided. We must empower nurses with the right tools, equipment and knowledge.

“Sepsis recognition and NEWS have now been added to the community nurse’s annual education update and is delivered by the resus department across the health board which is fantastic.”

This project is a part of the Health Board’s Quality and Improvement Collaborative. For more information about sepsis please visit www.nhsdirect.wales.nhs.uk/encyclopaedia/b/article/sepsis

What is sepsis? Source: Sepsis Trust UK

Sepsis is a condition caused by your body’s immune system responding abnormally to an infection, which can lead to tissue damage, organ failure, and death. The infection can start anywhere in your body; it may be only in one part, or it may be widespread.

Your immune system usually works to fight any germs (bacteria, viruses, fungi), or to prevent infection. However, for reasons we don’t fully understand, sometimes the immune system goes into overdrive and starts to attack our organs and other tissues. It can happen as a response to any injury or infection, anywhere in the body.

It can result from:

  • a chest infection causing pneumonia
  • a urine infection in the bladder
  • a problem in the abdomen, such as a burst ulcer or a hole in the bowel
  • an infected cut or bite
  • a wound from trauma or surgery
  • a leg ulcer or cellulitis

Sepsis can be caused by a huge variety of different germs, like streptococcus, e-coli, MRSA or C diff. Most cases are caused by common bacteria, which normally don’t make us ill.