@chris23han Boxing Clever in the fight against Sepsis 6 th July 2016 Cwm Taf University Health Board / Rocialle / 1000 Lives Andrew Hermon / Anne Evans

Sepsis High Mortality 40% Severe Sepsis 50% Septic Shock Biggest Cause of Maternal Death High Costs Associated Big Use of ITU Resources Timely Intervention is Paramount Across Wales it is a major problem 212 patients Identified in one 24 hour period

Response Saving 1000 Lives + Rapid Response To Acute Illness Learning Set (RRAILS) National Institute for Clinical Excellence (NICE 50) Sepsis 6 UK Sepsis Trust

Critical Care Outreach Two Sites, Two Teams, One Aim: To ensure that the delivery of critical care extends beyond the boundaries of the Intensive Care Unit.

Our Role Enhance the care of patients in Cwm Taf Referrals ITU/HDU Discharge Follow Up Education CVC / Tracheostomy monitoring Sepsis AKI

Patient Story Simple Interventions Right person, Right patient, Right time Critical Care Admissions: Avoided where able Facilitated when not

Our Achievements patient interventions per site per year Sepsis Pads, Sepsis Boxes World Sepsis Day Nurse / Junior medical education and training First 24/7 Team in Wales Presentation at 2 International Conferences Participation in international studies Bevan Innovation Award

Cwm Taf Sepsis Response Bag 2011

24 hour outcomes: NEWS NEWS scores significantly reduced after 24 hours. Only 5 patients had increased NEWS after 24 hours once the Sepsis Six intervention was initiated. P<0.001, Wilcoxon test

Preliminary 24hr Outcomes On ward improved 51 On ward triggering 21 On ICU within 4hr 11 On ICU > 4hr 6 DNAR 2 Deceased 1 No Data 8 Statistically significant drop in NEWS score. Biggest drop -8

Progress Sepsis bags are favourably associated with the delivery of the Sepsis Six and together have shown a significant drop in NEWS at 24hrs and an inferred better patient outcome.

Problems Use the bag who tops it up ? Outreach the main user The aim was for medical and nursing staff on the ward to utilise the bags more

Potential Solution A one stop shop for sepsis 6 delivery HOW ?

Working in Partnership

Disposable Sepsis Box

Bevan Commission Award Exemplar Award Money awarded will be spent on data capture Over the next twelve months the focus will be on: 1. Box usage and who is using it 2. Prevention of admissions to Critical Care

Thank you Any questions/discussion