SLIDE 1
Overview
- Patients who trigger for Sepsis in the Surgical
team are reviewed at the monthly audit meetings.
- Exceptions and learning points are agreed and
actioned.
- Completed surgical case reviews are
NHS Shetland Progress with Sepsis Six Dr Brodyn Poulton Consultant - - PowerPoint PPT Presentation
NHS Shetland Progress with Sepsis Six Dr Brodyn Poulton Consultant - - PowerPoint PPT Presentation
NHS Shetland Progress with Sepsis Six Dr Brodyn Poulton Consultant Anaesthetist April 2013 Overview Patients who trigger for Sepsis in the Surgical team are reviewed at the monthly audit meetings. Exceptions and learning points are
SLIDE 2
SLIDE 3
Case 1
- 83 year old male, developed chest infection
after surgical repair of #NOF.
- All measures taken, other than specifically
documenting SIRS.
- Abx: Guideline compliant, given within the
hour.
SLIDE 4
Case 2
- 72 year old male with acute cholecystitis.
- No blood cultures, U&E taken, SIRS/Sepsis not
documented.
- Amoxicillin given within the hour.
- Gentamicin given at five hours, 600 mg. Given
in spite of no U&E and steadily worsening
- liguria. Developed ARF, requiring
haemofiltration.
SLIDE 5
Case 3
- 46 year old male, presumed submandibular
abscess.
- All measures taken, except specifically
documenting SIRS/Sepsis in the notes.
- Correct Abx, given within the hour.
SLIDE 6
Case 4
- 25 year old male, ulcerative colitis, colectomy.
- 27/2/2013 – Readmitted. Technically met
criteria for Sepsis / MEWS 4.
- Temp 38 C. However, CRP minimally elevated,
and WCC in normal range.
- Impression: overactive stoma and
dehydration.
- Managed appropriately, no antibiotics.
SLIDE 7
Case 5
- 88 year old female, spiked temp 38 C post
surgical repair of #NOF.
- Technically had SIRS and MEWS 4.
- However, 2 MEWS points for SaO2 consistent
with age!
- Clinical impression: chest infection.
- Started on appropriate Abx.
SLIDE 8
Case 6
- 66 year old male. Syringomyelia, wheelchair
bound since 1991.
- Presented with Severe Sepsis, MEWS 6.
- All measures taken, including documenting
“Sepsis Six”.
- Tazocin, changed to Cotrimoxazole.
SLIDE 9
Summary Data table
Date Patient sequence number Compliance % Compliance with Sepsis six bundle 06/01/13 1 6/6 100 03/02/13 2 5/6 83 09/02/13 3 4/6 67 27/02/13 4 4/5 80 14/03/13 5 4/6 67 16/03/13 6 6/6 100 25/03/13 7 6/6 100 25/03/13 8 6/6 100
SLIDE 10
Summary data chart
10 20 30 40 50 60 70 80 90 100 1 2 3 4 5 6 7 8
% Compliance with Sepsis six bundle
% Compliance
SLIDE 11
Next actions
- Get next progress update from the medical
team
- Implement lactate measurement – software
upgrade needed to do this underway.
- Continue to promote principles of Sepsis Six
- Continue to monitor compliance.