Boxing Clever in the fight against Sepsis 6 th July 2016 Cwm Taf University Health Board / Rocialle / 1000 Lives Andrew Hermon / Anne Evans @chris 23 han
Sepsis • • High Mortality 40% Severe Sepsis 50% Septic Shock Biggest Cause of Maternal Death • • • High Costs Associated Big Use of ITU Resources Timely Intervention is Paramount Across Wales it is a major problem 212 patients Identified in one 24 hour period
Response • Saving 1000 Lives + • Rapid Response To Acute Illness Learning Set (RRAILS) • National Institute for Clinical Excellence (NICE 50) • Sepsis 6 • UK Sepsis Trust
Critical Care Outreach Two Sites, Two Teams, One Aim: To ensure that the delivery of critical care extends beyond the boundaries of the Intensive Care Unit.
Our Role Enhance the care of patients in Cwm Taf Referrals ITU/HDU Discharge Follow Up Education CVC / Tracheostomy monitoring Sepsis AKI
Patient Story Simple Interventions Right person, Right patient, Right time Critical Care Admissions: Avoided where able Facilitated when not
Our Achievements 1000+ patient interventions per site per year Sepsis Pads, Sepsis Boxes World Sepsis Day Nurse / Junior medical education and training First 24/7 Team in Wales Presentation at 2 International Conferences Participation in international studies Bevan Innovation Award
Cwm Taf Sepsis Response Bag 2011
24 hour outcomes: NEWS scores significantly reduced after 24 hours. Only 5 patients had increased NEWS after 24 hours once the Sepsis Six intervention was initiated. P<0. 001, Wilcoxon test
Preliminary 24 hr Outcomes On ward improved 51 On ward triggering 21 On ICU within 4 hr 11 On ICU > 4 hr 6 DNAR Deceased No Data 2 1 8 Statistically significant drop in NEWS score. Biggest drop -8
Progress Sepsis bags are favourably associated with the delivery of the Sepsis Six and together have shown a significant drop in NEWS at 24 hrs and an inferred better patient outcome.
Problems Use the bag who tops it up ? Outreach the main user The aim was for medical and nursing staff on the ward to utilise the bags more
Potential Solution A one stop shop for sepsis 6 delivery HOW ?
Working in Partnership
Disposable Sepsis Box
Bevan Commission Award Exemplar Award Money awarded will be spent on data capture Over the next twelve months the focus will be on: 1. Box usage and who is using it 2. Prevention of admissions to Critical Care
Thank you Any questions/discussion
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