Sepsis Educational Resources - Quality Improvement Hub

Sepsis Educational Resources NHS Education for Scotland September 2016

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Sepsis Educational Resources 1: NHS Scotland National Early Warning Score (NEWS) and Sepsis Screening Tool This iPhone and Android app – a collaboration between NHS Education for Scotland and the Scottish Patient Safety Programme – provides:  A national early warning scoring system to alert clinicians to the deteriorating patient and acute illness.  A sepsis screening tool for the prompt recognition and timely initiation of treatment.  The app is currently being updated to include a section on maternal health and a new set of recommendations for the identification and management of adults with sepsis. Further information  Available online: http://ow.ly/5SCq303FNzg  Contact: [email protected]

Sepsis Educational Resources (V1.4, September 2016)

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Sepsis Educational Resources 2: NES Sepsis Interest Group The (virtual) NES Sepsis Interest Group aims to support a coordinated approach to sepsis education, training and management. Further information  Contact: [email protected]

3: Quality Improvement Hub – Sepsis Page This NES contributed page provides introductory information on sepsis, with links to other resources. Further information  Available online: http://ow.ly/VKvH303FNMG (last revised 2014)  Contact: [email protected]


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Sepsis Educational Resources 4: Publication – Sepsis chapter in ‘Scottish Core Obstetric Teaching and Training in Emergencies’ (SCOTTIE) Course This course supports maternity staff dealing with obstetric emergencies. All course participants receive a manual, which contains a chapter on sepsis. This is currently being updated to include new information on sepsis. Further information  Available online:  http://www.scottishmaternity.org/scottie.htm  http://www.knowledge.scot.nhs.uk/smmdp.aspx  Contact: [email protected]


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Sepsis Educational Resources 5: Publication – Sepsis chapter in ‘Scottish Maternity Recognition, Evaluation, Assessment, Critical Treatment and Stabilisation (REACTS) High Dependency Unit (HDU)’ Course This course enhances staff skills and knowledge in the recognition and management of critically ill obstetric women requiring high dependency care. All course participants receive a manual, which contains a chapter on sepsis (currently being updated to include new information). Further information  Available online:  http://ow.ly/fBxd303FUD9  http://www.knowledge.scot.nhs.uk/smmdp.aspx  Contact: [email protected]


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Sepsis Educational Resources 6: Maternal Sepsis e-Learning Package This online package aims to support maternity care practitioners to spot the early warning signs of sepsis and take appropriate action. Simulated real-life scenarios are included to aid learning and teaching. The package is available publicly, but is also available to NHS Scotland health boards on the ‘learnPro NHS’ site. The resource has been developed by the Scottish MultiProfessional Maternity Development Programme (SMMDP) in collaboration with Healthcare Improvement Scotland and NHS Scotland. It is currently being updated to include new information on sepsis. Further information  Available online:  http://ow.ly/MZ43303FW2j  http://www.scottishmaternity.org/maternal-sepsis-e-learning.htm  Contact: [email protected]


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Sepsis Educational Resources 7: Webinar – Principles of infection and sepsis management This webinar was recorded in 2012 and presents the principles of infection and sepsis management. It is used as part of Vocational Training (password is required for access). Further information  Contact: [email protected]

8: Webcast – Diagnosis and treatment of sepsis This presentation was recorded in May 2013 at a specialist training event for Scottish Antimicrobial Pharmacists, and is used as part of Vocational Training. Further information  Available online:  http://ow.ly/n2Ra303z5ZS  https://vimeo.com/67558487  Contact: [email protected] Note: Since the recording of these resources, international definitions of sepsis have changed. The term “severe sepsis” is no longer recognised, and within the continuum of infection, “sepsis” includes the features previously described as “severe sepsis”. The management of sepsis and the need for urgent treatment remain unchanged.


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Sepsis Educational Resources 9: Aseptic Technique e-Learning Programme This e-Learning programme unravels existing rituals and provides clarity and structure to the application of Aseptic Technique in the health and care setting. The programme is available within the ‘learnPro NHS’ site and consists of the following eight modules: 1. 2. 3. 4. 5. 6. 7. 8.

Principles of Aseptic Technique Insertion of a Peripheral Vascular Catheter Taking a Blood Culture Sample Inserting an Indwelling Urethral Catheter Applying Aseptic Technique when carrying out Wound Care Taking a Specimen for Microbial Examination Long Term Central Vascular Access Devices Management of Arteriovenous Fistula (AVF)

Further information  Available online: http://ow.ly/UujX303G0Ok  Contact: [email protected]


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Sepsis Educational Resources Additional Resources 10: Urinary Catheterisation

Launched in 2011, this e-Learning module provides knowledge in practical skills for those involved in the delivery of care for patients/clients with urinary catheters in the NHS and non-NHS setting.

11: Recognising Surgical Site Infection

Launched in June 2015, this resource aims to improve practice in the diagnosis and reporting of Surgical Site Infection (SSI), and to aid understanding of the implications of a SSI on the patient. Available as an online module, a pocket guide, and a ‘train the trainer’ presentation.

12: Skin Tears – Prevention, Assessment and Management

Launched in June 2015, this resource is available in video and workbook formats, and aims to support the implementation and best practice on the prevention and management of skin tears in all healthcare settings.


Available online: http://ow.ly/smnh303G8BC Contact: [email protected] Available online: http://ow.ly/zYW7303G9ix Contact: [email protected]

Available online: http://ow.ly/cE1C303GhJD Contact: [email protected]

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Sepsis Educational Resources

Launched in June 2015, this e-Learning module provides staff working in health and 13: Promotion of social care with the necessary knowledge of Continence and the the causes of incontinence and the Assessment of Bladder treatment options available. Practitioners Dysfunction in Adults can assist patients/clients to maintain continence, and where possible, avoid the insertion of an indwelling urethral catheter.

14: Prevention and Management of Pressure Ulcers – Tissue Viability

Available online: http://ow.ly/ZRvg303G9V2 Contact: [email protected]

This e-Learning module aims to help health and social care staff to understand pressure ulcers: how they form; how they are treated; Available online: and crucially how they can be prevented. http://ow.ly/bRgu303GdXl This resource is also available as a hard copy reference and workbook. Contact: [email protected] Launched in 2009 and updated in March 2015.


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Sepsis Educational Resources Appendix Sepsis is a potentially life threatening condition that is triggered by an infection. The body’s immune system goes into overdrive, setting off a series of reactions, including inflammation and blood clotting. This can lead to a significant decrease in blood pressure, which can mean that blood supply to vital organs is reduced (1). In lay terms, the body’s response to infection injures its own tissues and organs (2). Symptoms of sepsis may include fever or chills, elevated heart rate, and rapid breathing (1,3,4). Other symptoms can include severe muscle pain, slurred speech, pale or mottled skin, and confusion or disorientation (4,5). Definitions around sepsis are evolving (6), however the following consensual ones are offered (2,7,8): “Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.” (2) “Septic shock is a subset of sepsis in which circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality.” (2) In the UK, it is currently estimated that there are 150,000 cases of sepsis every year, and over 40,000 of these are severe cases (9). This document brings together some of our NHS Education for Scotland (NES) sepsis educational resources. Note: given the changes to the definitions of sepsis, some of these resources may refer to previous/alternative terms, which are now not formally recognised. The management and the need for urgent treatment remain unchanged, and resources will be updated, as appropriate. Finally, a range of other resources that are aimed at preventing, reducing and managing infection are also presented. Dr Nancy El-Farargy, [email protected], NHS Education for Scotland, Edinburgh, September 2016.


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Sepsis Educational Resources References 1. 2.

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4. 5. 6. 7.

8. 9.

NHS Choices, (2016). Sepsis. Available from: http://www.nhs.uk/Conditions/Blood-poisoning/Pages/Introduction.aspx [Accessed 26 August 2016]. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al., (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8):801–10. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2016.0287 [Accessed 26 August 2016]. McClelland H, Moxon A., (2014). Early identification and treatment of sepsis. Nursing Times, 110(4):14–7. Available from: http://www.nursingtimes.net/nursing-practice/specialisms/infection-control/early-identification-and-treatment-ofsepsis/5067163.article National Institute for Health and Clinical Excellence, (2016). Sepsis: recognition, diagnosis and early management: NICE guideline. Available from: https://www.nice.org.uk/guidance/NG51 [Accessed 13 July 2016]. NHS Choices, (2015). Septic shock. Available from: http://www.nhs.uk/conditions/septic-shock/Pages/Introduction.aspx [Accessed 26 August 2016]. Abraham E. (2016). New definitions for sepsis and septic shock: Continuing evolution but with much still to be done. JAMA, 315(8):757–9. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al., (2016). Consensus Definitions for Sepsis and Septic Shock (video). Available from: http://jama.jamanetwork.com/multimediaPlayer.aspx?mediaid=12511362 [Accessed 26 August 2016]. JAMA Network, (2016). Consensus Definitions for Sepsis and Septic Shock. Available from: http://sites.jamanetwork.com/sepsis/ [Accessed 26 August 2016]. NICE, (2016). Sepsis is just as urgent as heart attack, says NICE . Available from: https://www.nice.org.uk/news/article/sepsis-is-just-as-urgent-as-heart-attack-says-nice [Accessed 26 August 2016].


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