Paediatric Sepsis

Quality Improvement Poster Download

Background & Problem

National and international drive to improve sepsis recognition and early management. Raised by CQC in recent inspection of the trust as an area to improve.

Aim

• To improve early identification of children who fulfil the criteria of suspected sepsis and their timely assessment and management including senior review and implementation of the ‘sepsis six’ within 6 months.
• Target: 30% children presenting with a fever to EKU or PAU to have a sepsis screening tool completed.

Method

Quality improvement tools including a driver diagram and fish-bone analysis were used to study the problem and create change ideas. The paediatric sepsis screening and action tool I had recently adapted was then piloted for one week. Following this and further consultation and adaption the recently written paediatric sepsis policy and tool were launched for use within the department. I audited compliance with the tool prior to and after the launch. CQUIN sepsis data was used to compare time to antibiotics pre and post the tool launch. Time to senior review, cannulation and lactate measurement was also recorded.

Results

Mean compliance has improved since the relaunch from 72% to 83%.

Mean time for giving IV antibiotics has markedly improved since relaunch from 3 hrs 8 mins to 1hr 12 mins.

Implications

Compliance of the use of the tool has improved following education and training around sepsis. In turn this is likely to have increased staff awareness and recognition of sepsis.

Implementation of the tool has markedly improved time in which antibiotics are given which in turn is likely to improve prognosis and survival for these patients.

Continued use of the tool should be encouraged especially with those at highest risk in our population, i.e. under ones, immuno-compromised, recent surgery. The tool should also be used in other clinical area who treat children i.e. ED. These are areas to look at in the future.

Sepsis in children can be difficult to diagnose and clinician variance is high. I would also like to focus on the routine measurement of lactate in those children with suspected sepsis and audit this data in the future to see if this improves recognition.

Paediatric sepsis is a huge ongoing project and I look forward to recruiting and working with other members of the team locally and nationally to improve recognition and management further.