Recent healthcare initiatives affecting sepsis training

You’ll likely already be aware that several healthcare initiatives and changes have been launched in recent weeks, including Martha’s Rule, the national PEWS and MEWS rollouts and the revision to NICE sepsis guidelines. As The UK Sepsis Trust’s e-Learning partner, Premier IT works closely with the charity to ensure that their digital training upskills learners on these changes, enabling them to provide the best possible care for their patients.

One of the main changes affecting the diagnosis and treatment of sepsis is the partial update to NICE’s recognition, diagnosis, and early management of suspected sepsis guideline. Published on 31st January 2024, these updates recommend better targeting of antibiotics for suspected sepsis to ensure the right people receive treatment as soon as possible, but the medicines are not overused, which can lead to antibiotic resistance. The guidance recommends using NEWS2 to help assess people with suspected sepsis who are aged 16 or over, are not and have not recently been pregnant, and are in an acute hospital setting, acute mental health setting or ambulance. It also provides further advice on assessing patients most at risk, when to give antibiotics and identifying the source of infection.

In the press release accompanying the launch of the NICE updates, UK Sepsis Trust Founder and Joint CEO Dr Ron Daniels said: “We welcome that NICE have provided this important update to their national guidance… These revisions help end a period of instability, with healthcare professionals previously facing varying guidance from the Academy of Medical Royal Colleges. We’re now presented with an opportunity to deliver a coordinated and cohesive approach to the recognition and management of sepsis across the NHS. We’re delighted to be supporting the updated NICE guideline with a suite of clinical tools, which we hope will be used by healthcare practitioners to save lives”. As part of this support, Premier IT is now finalising changes to their existing suite of sepsis modules in collaboration with The UK Sepsis Trust to reflect these important revisions, including updating the Red and Amber flag criteria and slides containing screening information.

However, it is not just the updated NICE guidelines which are affecting the diagnosis and treatment of sepsis. In November 2023, NHS England launched the national Paediatric Early Warning System (PEWS). This nationally validated system is designed to effectively recognise and respond to the deterioration of children or young people in a healthcare environment. The UK Sepsis Trust paediatric module, Sepsis in Children will be available with a choice of two pathways. The updated NICE guidelines will be available on the first pathway, but a National PEWS pathway can be selected by anyone working at any organisation already using the new national PEWS score.  Further information about the rollout can be found on the Royal College of Paediatrics and Child Health website here.

Similarly, for the first time, a common early warning score is being introduced to help identify deterioration across all maternity units in England. The Maternity Early Warning Score (MEWS) tool will ensure that all staff and those cared for by maternity services benefit from a clear evidence-based system – and a common language to help escalate concerns. It will soon be rolled out across the country following a successful pilot and to complement this, The UK Sepsis Trust is currently working with Premier IT to develop a Sepsis in Maternity module which we hope to launch in early Spring.

Finally, you may have read in the press in the last fortnight, about Martha’s Rule. This new initiative gives families of patients the ability to trigger an independent review from a critical care team if they are worried that the condition of a loved one is deteriorating. The driver behind this change was the death of 13-year-old Martha Mills. Following a pancreatic injury sustained falling off her bike, Martha developed sepsis whilst being treated in the hospital. A 2022 coroner’s report concluded that, if the concerns of Martha’s family had been responded to more promptly, and Martha was transferred to intensive care earlier, she probably would have survived. Martha’s Rule will roll out to at least 100 acute sites from April, and will then be extended to all acute hospitals, subject to Government funding. NHS teams will also be looking at an adapted model for community and mental health hospitals in the future. Hopefully, this initiative will save lives. Very often, it is the family and carers of loved ones who may notice the changes in deterioration that aren’t measurable by equipment. All our e-Learning emphasises the importance of listening to family and carers. For more information about why Martha’s Rule is so important, read UKST Ambassador, Melissa Mead MBE's personal account here.

Martha’s Rule will also have significant implications for Critical Care rostering and notifications. On 13 March, Emma Gaulter, our e-Rostering Project Manager, will be discussing this in greater detail and sharing how our e-Rostering tool, Zebra, can be used to help meet these challenges.

In the meantime, if you would like to know more about how to keep your staff updated with the latest changes to sepsis education, please contact me at nhumber@premierit.com to arrange a demo.