SEPSIS MANAGEMENT
Score (NEWS) works better than the SOFA system, so United Kingdom hospitals use NEWS. One of the biggest advantages of the NEWS score is its very good prediction of mortality: l NEWS score 4+ mortality 20% l NEWS score 6+ mortality 23% l NEWS score 8+ mortality 29%.
Following the original document and implementation of NEWS, many clinical staff have undertaken training to raise their knowledge base and the UK Sepsis Trust Campaign leaflets are widely displayed in GP surgeries, Ambulances and A&E departments.
Education and training
The NEWS provides the basis for standardising the training of all staff engaged in the care of patients in hospitals and pre- hospital assessment of patients. The education of staff should also be extended to incorporate all undergraduate training for medical, nursing and allied healthcare professionals. NEWS is supported by an online training module and certification9 and this has been added to by Health Education England. A scoping exercise10
was undertaken to
gain an understanding of the current state of sepsis education and training for healthcare staff across England. The exercise concluded that there was wide variation in training across all groups, and there were still significant gaps in three key areas. These key areas are primary care, community settings, including residential and care homes, and management and executive teams within healthcare providers. Many healthcare institutions provide sepsis training at induction and during training but that these are not accessible to permanent staff. The Royal College of Physicians et al recommend that Sepsis awareness and NEWS becomes part of NHS mandatory education for NHS clinical staff. Since this document was written there is a wide range of on-line tools and resources which have become available and are ready for access by clinical staff.
Conclusion
Provision of simple effective tools which are standardised across the NHS is an excellent way to reduce harm and save lives. Since sepsis is so variable and leads to potentially such devastating outcomes with very little notice, it is to be welcomed that the NHS has woken up to raising awareness of this problem. The unified and systematic approach to the first assessment and triage of acutely ill patients undoubtedly saves many lives. It is up to the Trusts to ensure that all staff receive their training and ‘Think Sepsis’.
References
1. Royal College of Physicians 2017. National early warning score (NEWS) 2: Standardising the
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assessment of acute illness severity in the NHS. An updated report of a working party. Accessed at
https://www.rcplondon.ac.uk/projects/outputs/ national-early-warning-score-news-2
2. Patient Safety Alert. NHS Improvement April 2018. Resources to support the safe adoption of the revised National Early Warning Score ( NEWS2) Accessed at
https://improvement.nhs.uk/ documents/2508/Patient_Safety_Alert_- _adoption_of_NEWS2.pdf
3. NEWS Frequently Asked Questions. Accessed at
https://www.england.nhs.uk/ourwork/clinical- policy/sepsis/nationalearlywarningscore/news- frequently-asked-questions
4. Smith GB, Prytherch DR, Schmidt PE, Featherstone PI.
2008.Review and performance evaluation of aggregate weighted ‘track and trigger’ systems. Resuscitation: 77:170–179. Accessed at
https://www.resuscitationjournal.com/ article/S0300...
5. Royal College of Physicians. 2012. National Early Warning Score. NEWS: standardising the assessment of acute-illness severity in the NHS:
Royal College of Physicians, London
6. Suspicion of Sepsis Dashboard accessed at
https://www.ahsnnetwork.com/case- study/suspicion-of-sepsis
7. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. Accessed at
https://www.nice.org.uk/guidance/ng51
8. World Health Organisation 2018. Sepsis Technical Expert Meeting. Accessed at
https://www.who.int/ servicedeliverysafety/areas/sepsis_meeting-report- 2018.pdf
9. Standardising the Assessment of Acute-Illness Severity in the NHS. Accessed at
http://tfinews.ocbmedia.com
10. Health Education England 2016 Getting it right. Executive Summary Accessed at
https://www.hee.nhs.uk/sites/default/files/ documents/Executive%20summary%20- %20Getting%20it%20right%20The%20current% 20state%20of%20sepsis%20education%20and% 20training%20for%20healthcare%20staff% 20across%20England.pdf
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