Responding to NICE – developing a regional sepsis pathway

Abstract

A complex landscape Sepsis is a major cause of avoidable death. Early recognition and treatment of sepsis might save up to 10,000 lives in the UK each year, but survival falls by up to 7-8% for every hour delay in treatment. 1 Differing international and UK (National Institute of Health and Care Excellence [NICE]) guidelines were published in 2016, 1-3 resulting in confusion among clinicians Clinical and scientifi c letters about the most appropriate strategy for sepsis identification and management. A recent national survey demonstrated substantial variation in local guidelines and practice. 4 For example, only one-quarter of acute trusts planned to implement the NICE guidelines as published. Most planned to adapt the guidelines for local implementation. Many respondents felt that the NICE guidance required simplification to ensure better adherence. Proposed modifications included using aggregate rather than single 'red flag' National Early Warning Scores for high-risk AHSN meeeng Agreed aim to review NICE and for regional approach to implementaaon AHSN meeeng Fleshed out aims-tool to be based on simplified NICE algorithm, using UK Sepsis Trust template, incorporaang both red and amber criteria Subgroup meeeng Details of tool refined AHSN meeeng Reviewed changes, agreed two models Algorithm 1 including amber criteria Trialled by one trust Algorithm 2 simplified Trialled by five trusts Algorithm 1 dropped Amber criteria too complex AHSN meeeng All six trusts adopt algorithm 2 NICE Coordinated by clinical lead Email refinement of tool Fig 1. Process for developing a regional sepsis pathway. CMJv18n3-Murray_Kishore.indd 263 CMJv18n3-Murray_Kishore.indd 263 5/16/18 8:42 AM 5/16/18 8:42 AM