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Effective management of sepsis

  • Ireland
  • General

23-12-2013

Sepsis or septicemia is a life-threatening infection which can result in widespread inflammation and blood clotting.

Thousands of deaths annually within the UK and Ireland have been recorded as being as a result of this infection, accounting for 30-50% of episodes of inpatient deterioration. The condition is also widely known because of its recent profile in the news, in relation to the death of Savita Halapanavar in October 2012.

Following an Inquest into her death, the jury delivered a verdict of medical misadventure and also strongly endorsed the Coroner – Dr Ciaran McLoughlin’s – nine recommendations which included:

  1. That the Medical Council should lay out when exactly a doctor can intervene to save the life of the mother in similar circumstances, which will help to remove fear and doubt on the part of the doctor and also to reassure the public.
  2. That blood samples are properly followed up on and proper procedures are put in place to ensure errors do not occur.
  3. Protocols are followed in the management of sepsis and there is proper training and guidelines for all medical and nursing personnel.
  4. Proper and effective communication should occur between staff on-call and a team coming on duty, with a dedicated handover time set aside for such communication.
  5. A protocol should be in place for sepsis, written by the department of microbiology for each hospital and each hospital directorate, and that this should be applied nationally.
  6. That a modified early warning score chart should be adopted by all hospitals in the state as soon as practicable.
  7. Early and effective communications with patients and/or their relatives to ensure that a treatment plan is readily explained and understood. This should be applied nationally.
  8. That medical notes and nursing notes should be separate documents and kept separate, and this should be applied nationally.
  9. No additions are made to the medical records of a deceased whose death is the subject of a Coroner’s inquiry. Additions may inhibit the inquiry and prohibit the making of recommendations which may prevent further fatalities. This should also be applied nationally.

The above recommendations demonstrate that there is a need nationally for effective response and management of sepsis within hospitals.

Suggestions for risk management practices include ensuring that an organisation is consistently promoting and reaffirming the vital responsibility each staff member must accept in performing their personal and professional duties to the best of their abilities, whether this is promoted through meetings or within staff handbooks, contracts or induction.

Staff should receive regular updates in relation to best practice guidelines published and all internal protocols and guidelines. This will encourage an environment of communication and support.

In the event that incidents occur, organisations should encourage staff to record the incident in as detailed and legible a manner as possible. Learning and sharing should always be communicated. Any concerns should also be voiced.

Disclaimer

This information is for guidance purposes only and should not be regarded as a substitute for taking legal advice. Please refer to the full terms and conditions on our website.

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