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Sepsis Freedom of Information Request QuestionnaireCompleted By:Sara Quinton / Dr R. DanielsDate: 21st April 2014On Behalf of: Heart of England NHS Foundation TrustEmail: sarah.quinton@heartofengland.ns.uk Darren.daniels @heartofengland.nhs.ukDoes your Trust have a mechanism for recording incidents of severe sepsis and septic shock?YesIf Yes, please go to Question 2.If No, please go to Question 5.Is sepsis on the Trust’s risk register?YesNote: Sepsis is on the site risk register for Solihull site, but not for whole TrustIs there a nominated Consultant with responsibility for sepsis at the Trust?NoDoes the Trust resource sepsis nurses and/or dedicated Consultant time?NoHow does the Trust record cases of sepsis? (e.g. ICD-10) How is the data reported to the Executive?______________________________________________________________________________________Yes the Trust uses ICD-10 codes.Unsure how information is reported to the ExecutiveHow many patients were diagnosed with severe sepsis in: No. Of patients admitted with diagnosis of Sepsis Shock (ICD-10 code R57.2)?YearTotal2012/13582013/1479Grand Total137How many patients were diagnosed with septic shock in (if included in severe sepsis, tick here ):No. Of patients admitted with diagnosis of Severe Sepsis as a result of disease classified elsewhere (ICD-10 code R65.1)?YearTotal2012/13192013/1433Grand Total52Prior to 2012/13, ICD-10 codes for Sepsis Shock and Severe Sepsis did not exist. As a result I can only produce data for 2012/13 and 2013/14. Does the Trust have an established pathway for basic care once a patient is diagnosed with sepsis? YesIf Yes, please go to Question 9If No, please go to Question 11Does the Trust follow the Sepsis Six guidelines?YesIf not using the Sepsis Six, please identify the pathway below________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Does the Trust use an Early Goal-Directed Therapy (EGDT) pathway for patients arriving in the Emergency Department with septic shock?YesIf yes, please go to question 13If no, please go to question 14How is EGDT initiated in patients arriving in the Emergency Department with septic shock? By ITU medical team By ITU nursing teamDoes the Trust audit the time taken for a patient to receive antibiotics within the first hour as recommended by the ‘Start Smart then Focus’ guidance provided by the Department of Health?YesNote: Have antibiotic dashboard, which records all stat doses prescribed electronically and audits time to administration, currently in pilot form on one site, to be rolled out across the Trust.If Yes, please go to Question 14.If No, please go to Question 15.What percentage of patients with early signs of severe sepsis received antibiotics within an hour as recommended?__Full data not available at this time__________________________________________Do you have an escalation and communication pathway in place for patients with severe sepsis to facilitate senior involvement and inter-departmental transfers? YesDo you provide a blood gas machine or near patient testing allowing measurement of lactate in the Emergency Department and Intensive Care Unit to allow early recognition of sepsis?_Blood Gas Machine with Lactate available in ED & ICU _______________________________Are you aware of the recently released report of the Parliamentary and Health Service Ombudsman on Sepsis; and if so have you made any changes to the way you record and deal with Sepsis at the Trust? Yes – sepsis is a workstream for the Trust Deteriorating Patient Group and the Trust is also part of NHS Quest collaborative which has sepsis as a workstream .Not aware of any changes to the way in which we record sepsis___________The Parliamentary and Health Service Ombudsman recommended that senior staff were available 24 hours a day 7 days a week and should be consulted when severe sepsis is present. Does your Trust have senior Consultant cover 24 hours a day 7 days a week for all acute specialities admitting patients?YesAny Further Comments:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ................
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