G14\u2005Quality improvement: improving management of paediatrics sepsis in busy district general hospital

Abstract

Background The Quality improvement programme was undertaken to improve management of sepsis in children 0–16 years, who attend Children’s Emergency Department at Basildon University Hospital NHS Foundation Trust. A new Paediatric Sepsis tool was developed and piloted and rolled out in May 2018. Intervention The 100 case notes were reviewed. The data was collected by Clinical Practice Facilitator. The findings were shared and reviewed by the multidisciplinary team. The team discussed new changes. This led to the development of teaching tool for staff and review of new sepsis tool. The new sepsis tool was piloted in May 2018. The significant parental concern was added as a trigger to a tool. The pathways of management were changed. We also raised awareness of staff. The Clinical Practice Facilitators developed study days for nursing staff. All new doctors are given teaching induction about sepsis. The Sepsis data is shared with all staff on ward board. Results The Weekly review of 30 patients per month since May 2018 and from August 5 cases per week are reviewed. In the first 2 weeks, 19 children triggered sepsis on the new tool. 8 patients were appropriately deescalated by a senior clinician. The old sepsis 6 tool used to trigger 40 patients per month. The screening within 1\u2009hour including Lactate was done in 100%. The Antibiotics within 1\u2009hour was given in 94%. This has increased from Previous 69%. The assessment of fluids and bolus was given 100%. Conclusion The improvement in the management of sepsis in our patients has been done by using PDSA methodology. A new tool was piloted. The parents and staff feedback were used to make changes for local use. The teaching tool for Nursing staff and Juniors doctors at induction was developed by the team. The sharing the data and learnings from them too by our paediatric staff is also helpful. The challenge moving forward is to keep consistency. We plan to continuously monitor.