Sepsis

What is sepsis?

Sepsis is a life-threatening condition that arises when the body's response to an infection causes it to attack its own tissues and organs. In sepsis, patient's immune system goes into overdrive setting off a series of reactions including widespread inflammation. This can cause a significant decrease in blood pressure reducing the blood supply to vital organs and starving them of oxygen. Sepsis can lead to multiple organ failure and death especially if not recognised early and treated quickly. 

The number of people developing sepsis is increasing, with around 123,000 cases each year in England. An estimated 37,000 deaths are associated with the condition (NHS England) - Sepsis Epidemiology UK 2000 to 2012 from a critical care perspective (PDF). 

For those who survive sepsis, many patients suffer long term physical and mental problems such as post-traumatic stress disorder, cognitive problems, chronic pain and organ dysfunction.

Nurses and health care support workers who see their patients on a regular basis, and are usually the first healthcare worker to see them, are well placed to recognise the signs of sepsis early and raise the alarm to enable prompt identification and treatment. In hospital settings early sepsis recognition by ward nurses has been shown to improve survival for patients in hospital with sepsis (Torsvik et al, 2016).

If a person you care for looks or feels unwell, doing an early warning score such as the National Early Warning Score (NEWS) can help you to recognise sepsis, raise the alarm quickly to a senior colleague or health care professional and prioritise care so they can be treated within the hour.

Guidance on assessing adults for sepsis

This RCN resource (PDF) contains guidance on how to assess adults for sepsis and what to do if you think a patient could have sepsis.

If a person presents with signs or symptoms that indicate possible infection, think 'could this be sepsis?' and act fast to raise the alarm to the most senior health care professional immediately, whatever setting you work in.

Your workplace will have local formal policies and protocols for the early identification and management of patients with sepsis, which you should familiarise yourself with regularly.

RCN activity

The RCN recognises the importance of the identification, management and prevention where possible of sepsis. As a professional nursing organisation we are  involved and supportive of sepsis-specific work strategically and collaboratively with other Colleges and networks. Much of this work is England-focused but as a UK-wide organisation, we retain oversight in managing the UK perspective for sepsis specific to nursing. We are signposting and promoting the sepsis agenda and work streams to our members through a number of mediums.

• The RCN liaises with other Royal Colleges and governmental work streams to ensure the nursing voice is present and ensures a consistent message. The RCN is represented on the following sepsis-specific working groups:
  
  • Health Education England Sepsis Working Group
  • NHS England Cross-systems Sepsis Board 
  • NICE sepsis quality standard Group
• The RCN comments on all sepsis-specific guidance developed by other Colleges, stakeholders and external bodies, educational material and information to ensure the information is relevant and applicable to nurses and nursing.
• The RCN has a sepsis-specific clinical topic sub-page on the website which provides a brief background section on sepsis, the role of the nurse/HCSW and signposts to other resources. A HCSW-specific page on ‘First Steps’ has also been created as an online learning resource to support HCSWs with their induction and early learning.
• Sepsis-specific subject guides have been created which introduce members to key sepsis resources, books and journals within the library
• As part of our suite of reference cards, 25,000 sepsis pocket-sized crib cards have been printed. The information on the cards provides guidance and support with care delivery and have been designed to be applicable for all health care settings whether the member is a HCSW, nursing student or RGN.