Episode four of BBC Two’s Hospital showed Esme, a brave little girl who was being treated for Sepsis on the Paediatric Intensive Care Unit. We caught up with Sally Wood, Sepsis Lead Nurse and Abby Ford, Sepsis Improvement Nurse to learn a little bit more about sepsis and their roles.
How long have you both worked at NUH?
Sally: I’ve worked here for three and a half years. When I joined I was working in the Early Warning Score Team (EWS), which works to identify acutely unwell patients and I have been working in the Sepsis Team for the past two years. My background is in critical care.
Abby: I’ve worked at NUH since 2012. I’ve been in post since July last year so am still fairly new to the role. I previously worked as an Outreach Nurse and in Intensive Care.
How would you explain your role?
Sally: We work to help staff and patients identify sepsis. This is where the body’s response to an infection becomes out of control or dysregulated. Everyone will get infections at various points in their lives and normally their bodies can respond in an appropriate way to fight the infection. Some may need to seek assistance from their GP or pharmacy. But occasionally the body is unable to remain in control of its response to the infection and this is when sepsis can occur. Sepsis can affect anyone.
Abby: It is a really mixed role, with a big focus on improvement. We also do a lot of audit work which helps us to identify themes which we can then take back into our teaching.
Sally: A lot of our role is about knowing exactly how well we are doing for our patients who might have sepsis. Unless we know how good we are at identifying the patients and treating them within a particular time frame then we aren’t able to identify aspects of care which need supporting and improving. We work to national drivers and we also set our own NUH drivers because we want to know the bigger picture. We then feed that information back, both to senior management teams within the hospital and to staff on the wards who are involved in identifying sepsis cases.
What does the Sepsis Team set up look like?
Sally: Abby and I work closely but we are very privileged to have a wide net of experts that are part of the Sepsis Action Group that meets monthly. This includes medical consultant leads in adults and paediatrics, consultant microbiologists, the anti-microbial stewardship team, pharmacy, education team, emergency medicine, paediatrics and midwifery. You couldn’t achieve improvement and deliver it in a safe way for patients without all of those key people.
Abby: We have sepsis champions and link staff on the majority of adult wards. They do this role on top of their normal clinical roles. They will deliver new messages and smaller scale teaching to staff on the wards. We now have link staff in maternity and soon within paediatrics as well. We have some really good champions out there that are very keen and motivated to make changes.
Sally: And by using real time data, we can spot trends or outliers in particular areas and investigate why this is happening, we can then target a particular aspect of teaching with the staff in those areas.
What first made you interested in working in a sepsis role?
Sally: I’ve always been very interested in acutely unwell patients. My work in the EWS team made me realise the different sides to clinical nursing, including patient improvement and safety. There isn’t much time for front line staff to analyse their processes. I feel quite privileged that in my role I can look at how well we are doing, bring in external evidence and then tie it all together to come up with different ways of supporting improvement. There are some amazing staff at NUH who really want to know how well we are doing and how we can improve.
Abby: Being a Critical Care Nurse it has always been something that I’ve been interested in and wanted to know more about, being out on the wards we review a lot of patients with sepsis. When this role came up I thought it was a really nice link with the work I had done previously. It’s great being able to develop my knowledge around an area that is so relevant. I have also had personal experience of sepsis through a family member and I think this motivates me within the role.
What are the biggest challenges?
Sally: Everybody is so busy on the wards so we have had to really think outside the box as to how we can try to support and engage staff. We aren’t able to take staff off the wards for training days so we wanted an approach that engages staff in the first three seconds, so that they are keen to give up five minutes of their time to talk to us. So we came up with something called tea trolley teaching.
Abby: This teaching’s been received really well. We’ve come up with 8-10 different activities and we then take this on a trolley and deliver little sessions to the ward staff. We have provided this focussed delivery on three wards so far and have also taken it across every ward at City Hospital for World Sepsis Day last year (September 13th), it has really helped to have the support of the ward managers. They were really keen and it drew a lot of people in. We had a great time delivering this teaching and the ward staff were very engaging. The great thing about tea trolley teaching is that even staff who are restricted to staying in bays can get involved as we take the trolley to them and help make sure the patients are safe. We have had a few patients and relatives get involved as well which was great.
Sally: There is also a growing appreciation of the impact that suffering with sepsis can have on both the person themselves and also their close family or friends, and finding support for patients who have survived sepsis or to families of those who have suffered with sepsis can be a challenge. The UK Sepsis Trust have a very in depth website and contact line and the next Sepsis Support group in Nottinghamshire, supported by the UK Sepsis Trust and NUH Sepsis team will take place on May 24, 7-9pm, The Sportsman, Long Eaton.
Learn more about Sepsis from the UK Sepsis Trust.