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

2. 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

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

4. 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.

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

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

8. Our Achievements 1000+ 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

9. Cwm Taf Sepsis Response Bag 2011

10. 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

11. 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

12. 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.

13. 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

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

15. Working in Partnership

16. Disposable Sepsis Box

17. 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

18. Thank you Any questions/discussion