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Sepsis in the Emergency Department

Identifying barriers to delivery of the Sepsis 6 bundle

Published quality improvement report by BMJ

Despite falling short of the target, this project shows a promising initial step in sepsis management.

The Sepsis 6 is an internationally accepted management bundle that, when initiated within one hour of identifying sepsis, can reduce morbidity and mortality.

This management bundle was advocated by the Scottish Patient Safety Programme as part of its Acute Adult campaign launched in 2008 and adopted by NHS Tayside in 2012.

Despite this, the Emergency Department (ED) of Ninewells Hospital, a tertiary referral centre and major teaching hospital in Scotland, was displaying poor success in the Sepsis 6.

James BentleySusan HendersonShobhan ThakoreMichael Donald, and Weijie Wang set out to improve compliance by evaluating the application of all aspects of the NHS Tayside Sepsis 6 bundle within one hour of ED triage time, to identify what human factors may influence achieving the one hour The Sepsis 6 bundle.

The following aim was created in order to address the problem: Ninewells ED will have 75% compliance with the Sepsis 6 management bundle, for patients displaying two or more SIRS criteria and a presumed infection, by the end of December 2014.

Tailored interventions were put into place including educational sessions, regular audit and personal feedback and checklist Sepsis 6 sticker. These interventions promoted a steady increase in compliance from an initial rate of 51.0% to 74.3%.

Despite falling short of the target, this project shows a promising initial step in sepsis management. There was, however, a significant improvement in compliance with the Sepsis 6 bundle.

quoteBMJ Quality Improvement Reports publishes quality improvement work, original research and reviews. The online-only, open access journal covers all aspects of quality and patient safety in healthcare.