HOSPITALS & HEALTHCARE FACILITIES complaints etc.


In April 2018, NHS watchdogs warned that patients were dying of sepsis because ill-trained staff were failing to spot the signs. But, while sepsis can be extremely difficult to recognise and diagnose, it can sometimes be prevented - and in many cases it is treatable. There is therefore an urgent need for diagnostic improvements so that the possibility of sepsis remains front-of-mind whenever medical staff assess their patients.


Great strides are already being made to ensure that this is the case. For example, a new alert system developed by Cambridge University is currently being trialed by doctors at the university’s hospitals.


The system works by constantly analysing the temperature, pulse rate, blood pressure and level of consciousness of at-risk patients. Medical staff are then alerted via a text message if any of these observations suggest the presence of sepsis in a patient. So far the trial has been a success and is said to have led to a seven-fold increase in the number of patients receiving life-saving drugs at the hospitals concerned.


“The term ‘sepsis’ was only coined in 1991 when an international panel of health experts used it to define any condition in which the body has an abnormal response to an infection.”


Meanwhile, new NHS England guidelines issued in April this year require staff to alert senior doctors within a one-hour window if any patient suspected of suffering from sepsis fails to respond to treatment. In fact, where staff neglect to report such cases in the proscribed time period, the hospital could face financial penalties.


Other steps are being taken to raise awareness of sepsis and focus the attention of medical staff on the condition. For example, the Intensive Care Society has launched a campaign to encourage a greater understanding of sepsis in order to reduce the number of preventable deaths. Working with the UK Sepsis Trust, the society is calling for the better recording of cases in hospitals.


In September 2018 the NHS launched its Suspicion of Sepsis Dashboard tool which provides staff with an overall picture of hospital admissions, enabling them to assess the scale of the problem at a local, regional, and national level.


The Dashboard provides intelligence as to whether interventions in sepsis care are improving outcomes for patients and is also helping with vital planning procedures.


All these advances spell good news for our future safety. However, some simple measures can help to prevent sepsis from occurring in the first place.


Wound care plays a decisive role in preventing the occurrence of sepsis. Any break in the skin could allow


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bacteria to enter and cause an infection – and this is particularly the case where a high-risk patient with a weakened immune system is suffering from a chronic wound. It is therefore vital that all wounds are constantly monitored by hospital staff and are cleaned thoroughly between dressing changes.


Since sepsis occurs as a result of the body’s response to an infection, hand hygiene plays an important role in preventing the spread of infections in the first place.


According to the World Health Organisation (WHO), hand hygiene is thought to reduce up to 40% of healthcare- related infections. This is why the WHO made sepsis the theme of its 2018 SAVE LIVES: Clean Your Hands, urging healthcare professionals to apply the organisation’s ‘Five Moments of Hand Hygiene’ at all times.


Introduced in 2009 to reduce the burden of healthcare- associated infections, WHO’s Five Moments of Hand Hygiene state that staff should wash their hands before touching a patient, before carrying out any aseptic procedure, after any exposure to body fluid, after touching a patient and after touching the patient’s surroundings.


Sepsis is a frightening threat to our health - particularly that of vulnerable hospital patients. But it is encouraging to note that we are constantly making new breakthroughs.


For example, researchers in Leicester recently discovered that people being treated for sepsis in intensive care wards carry higher than usual levels of a molecule called nociceptin, which is produced by the immune cells. In March this year, researchers were awarded £190,000 for a three-year project to further investigate the role of nociceptin in sepsis.


“There an urgent need for diagnostic


improvements so that the possibility of sepsis remains front-of-mind whenever medical staff assess their patients.”


We now understand that early detection of sepsis is vital, with every hour of delay linked to a seven per cent reduction in the chances of survival. In April 2019 it was reported that a computer-aided model developed in the UK could be used to predict the development of the condition. The National Early Warning Score (cNEWS) collects data that can help to identify early symptoms of sepsis, with the generated score used to support clinical judgment.


There is a positive side to our fear of sepsis. It has helped to engender a greater understanding of the condition and engender more medical research. Through a combination of improved awareness, increased research, better training, enhanced wound care and a greater attention to hand hygiene, we can all help to diminish the risk it poses.


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