National Sepsis Summit Dublin Castle 2016 Emergency Department

National Sepsis Summit Dublin Castle 2016 Emergency Department University Hospital Kerry Grainne Rohan (Sepsis Coordinator) Deirdre Hartnett (Staff Nurse/DN Student)

Where It Began • Masters studies in Nursing UCC 2014. • The impact of a sepsis training program on the knowledge and self-efficacy of ED staff in their detection and management of sepsis.

Education • • Pre survey Educational Intervention Post survey Generating discussion and awareness around sepsis detection and management.

Initial Survey

The One Year Review

The Revisit

The Implementation 2014 -2016 •

Team Approach Works Best • ED (Medical and Nursing) • Infection Control • Nurse Practice Development • Quality and Patient Safety • CNME

Team Approach Works Best • Sepsis Coordinator • Antimicrobial Pharmacist • NCHD’s from ED, Medicine and Surgery • HIPE Personnel

Initial Steps • Development of ED combined medical/nursing document and Flow Chart • Agreement of TIME ZERO • Dissemination of information via posters, flashcards and screen savers • Sepsis Tab established on UHK Notice board and training programme on the collection of blood cultures uploaded on same

Initial Steps • Business case prepared for post of Sepsis Coordinator & sent to the NMPDU • Glass blood culture bottles changed to plastic to facilitate transport via chute • Further education/awareness sessions arranged with Dr. Vida Hamilton, National Clinical Lead

Next Steps • Roll out of the ED documentation and accompanying SOP on Sepsis Management in ED • Development of Audit Tool • ‘Consider Sepsis’ tab on IPMS at triage • Blood gas analyser/lactate machine installed in CCU • Dr. Vida Hamilton attended Grand Rounds and ED education session • Sepsis awareness blitz in staff restaurant

More Steps • NMPDU agreement to fund Sepsis Coordinator post and individual appointed in September 2015 • Early Warning Score Compliance also part of the role

More Steps • Antimicrobial guidelines updated • Specific ‘Sepsis’ hours allocated to medical and Surgical Registrar and individuals appointed • Further Sepsis awareness/education provided to Medical, Surgical and Orthopaedic personnel

Audits • Monthly audits in ED • Ward audits which incorporate NEWS escalation protocols with Sepsis Screening. • Interdisciplinary, Sepsis Coordinator and NCHD’s

Leaning Forward, Looking Back 100% 90% 80% 70% 60% 50% 40% SEPTEMBER 2015. AUGUST 2016. 30% 20% 10% N YG E TE A CT X O O RY A N RI U LA U TP U T S U LT CU D O O N A RE S U ID FL BI SI O TI CS ED GN Y A W TH PA TI BL CO N SI D ER SE SI PS IS RS 0%

Further Steps • Maternal Sepsis Pilot • ‘Micro App’ launched with Antimicrobial Guidelines to include Sepsis, also available on all PC’s

Team Approach Works Best

The Kerry Area Quality and Patient Safety Awards 2015