Launch of National Sepsis Report 2011- 2015
The first National Sepsis Report 2011-2015 was launched at the 1st National Patient Safety Office Conference last December in Dublin Castle.
National Clinical Guideline No. 6: Sepsis Management was published in November 2014 and outlines evidence-based recommendations for the diagnosis and treatment of patients with sepsis in Ireland, with the aim of reducing morbidity and mortality. These recommendations include measuring the burden of sepsis to inform planning and to audit the implementation process both to feedback to hospital sepsis committees and to monitor the effectiveness of the programme.
The Hospital In-Patient Enquiry (HIPE) system was used as the data source. Administrative data is widely used in quality improvement projects (QI) and has been validated in sepsis QI assessment.
- incidence and associated mortality increases with age
- mortality increases with co-morbidities
- mortality increases in winter
- the most common sites of infection are the respiratory tract, the abdomen and the urinary tract
- In 2015
- there were 10,000 cases documented
- average crude hospital mortality rate was 20.7%
- sepsis was associated with 2% of admissions and 18.8% of mortalities
- 30% of cases were admitted to critical care
- the mortality in cases admitted to critical care was 33.4%
- all critical care sites were equally efficacious
- Between 2011 and 2015
- the number of cases increased by 37%
- the average length of stay decreased by 13.6%
- the mortality decreased by 15%
At the launch of the report, Dr Vida Hamilton, HSE National Clinical Lead for Sepsis, stated that, “We have an ageing population, by 2041 it is estimated that 25% of the population will be over 65 years, and that sepsis is an age-related condition. The most effective therapy is early recognition and treatment and this occurs in the Emergency Departments and on the Hospital Wards. The Centre for Disease Control (CDC) has reported that 70-80% of all sepsis cases are admitted from the community. Credit must be given to the acute hospitals, all of whom have put together sepsis committees to provide education, training and support to the front line staff who care for these patients in an enviroment of limited resources and competing priorities.”
The National Sepsis Management Guideline was commissioned by the National Clinical Effectiveness Committee (NCEC) in partnership with HSE Clinical Strategy & Programmes Divison. The National Sepsis Programme, tasked with implementing the guideline, works with clinical progarammes, local hospital sepsis committees, expert clinicians, regulatory bodies, postgraduate training bodies and patients with the aim of giving patients the best opportunity to survive. It has developed clinical decision support tools, an e-learning programme (on HSEland) and provided education sessions throughout the country.
The National Sepsis Guideline is used in conjunction with clinical judgment and patient preference when making decisions about what is appropriate for each patient or population of patients. It was accredited by the National Institute for Health and Care Excellence (NICE) in 2015.
The National Sepsis Report was developed in collaboration with the Health Pricing Office and the Quality Improvement Division, HSE.