Implementing Paediatric Sepsis Six: Our Experience

Background: Sepsis campaigns in adults in the UK have been effective in improving early identification and management. There is limited data to assess the value of such campaigns in paediatrics. This project aims to assess compliance with the national standard and evaluate the effectiveness of a ‘Raising Sepsis Awareness’ (RSA) campaign in a district general hospital in the UK.

Objective: A baseline audit was undertaken to assess compliance to national targets for sepsis screening and antibiotic administration over a 3 month period. National targets were set at 90% for screening compliance, and 68% for antibiotic administration within 60 minutes. A re-audit was undertaken to evaluate the effectiveness of the RSA campaign.

Method: Patients were identified using the hospital’s electronic database and patient notes. Cases were reviewed to confirm the presence of sepsis triggers, appropriateness for screening and timing of antibiotics. Following the initial audit, we began a campaign which included teaching sessions for staff, posters displayed across the department and encouraging the use of sepsis toolkits informed by NICE guidelines.

Results: 30 cases of sepsis were reviewed between July-September 2016, of which 100% (30/30) met diagnostic criteria. Screening compliance was 100% (30/30). In 43% (13/30) of cases, antibiotics were administered within 60 minutes. At 72 hours into admission, 25 cases still required antibiotics, with 100% (25/25) of patients being reviewed. In the re-audit between October-December 2016, 68 cases of sepsis were identified where 95.8% (65/68) met diagnostic criteria. 100% (65/65) of cases were appropriately screened. Antibiotics were delivered within 60 minutes in 72.3% (47/65) of cases. All 59 patients requiring antibiotics at 72 hours were reviewed.

Conclusion: Our study showed a 29% improvement in compliance to national targets following the introduction of a RSA campaign. This study has demonstrated the value in educating staff and raising awareness of the paediatric sepsis six tool kit.