The Australian Commission on Safety and Quality in Health Care, together with The George Institute for Global Health, has released the new national Sepsis Clinical Care Standard in a bid to better detect and treat the potentially deadly disease.
The standard outlines optimal care for patients in hospital with suspected sepsis – from the onset of signs and symptoms, through to discharge from hospital and follow-up care.
More than 8,700 Australians die from sepsis, a condition triggered by an infection that can turn into a deadly disease if undetected, each year. Sepsis is the body’s extreme response to an infection, causing damage to its own tissues and organs. People who survive sepsis often experience prolonged after-effects and can develop a lifelong disability.
The Commission’s National Sepsis Program is being implemented to improve early recognition, treatment, outcomes and post-discharge support for people at risk or diagnosed with sepsis in Australia.
Dr Carolyn Hullick, Clinical Director at the Commission and Emergency Physician in Hunter New England Health NSW, said sepsis is a medical emergency that can elude even the most astute doctors.
“Sepsis is complex, and it can be difficult to diagnose because the signs and symptoms can be subtle. Older patients may have delirium. They may be on medicines that impact on their body’s response to sepsis. Sepsis can also mimic other health conditions like gastro or heart disease,” said Dr Hullick.
“Yet the consequences of missing sepsis are dire, leading to multiple organ failure, disability or death.
“As an ED doctor, I know that diagnosing sepsis can be challenging, particularly when you’re treating a high volume of critical patients in a busy emergency department. It can be especially difficult with older people or very young children.”
Dr Hullick said the new Sepsis Clinical Care Standard would help ensure timely recognition of sepsis and provide a framework for healthcare services to create local systems for treatment.
“The new standard requires healthcare services to implement systems that flags people who may have sepsis, assess them urgently, and if necessary, escalate to a higher level of care. Rapid treatment is vital. If we delay sepsis treatment even by a few hours, it can have deadly consequences.
“To deliver antimicrobials to someone who has sepsis within 60 minutes, we need systems in place so that everyone in the ED team knows what they need to do,” she explained.
According to the Commission, evidence is growing that some sepsis survivors experience long-term health problems, which are poorly recognised and treated. To address this, another key focus of the standard is the planning for care after the patient leaves hospital, in recognition of the ongoing effects of sepsis and ‘post-sepsis syndrome’.
Professor Simon Finfer, intensivist and Professorial Fellow in the Critical Care Division at The George Institute for Global Health, described sepsis as the most common preventable cause of death and disability.
“The Sepsis Clinical Care Standard is a game-changer that will ensure healthcare workers recognise sepsis as a medical emergency and provide coordinated high-quality care to all Australians.
“If a patient is acutely ill or deteriorating rapidly – and there is no other obvious cause – we must consider sepsis as a possible diagnosis,” said Professor Finfer.
“If you suspect sepsis, either as a clinician or a patient, escalate your concerns to a healthcare professional who is skilled in managing sepsis. You must ask, ‘Could this be sepsis?’.”
Professor Finfer is also an advocate for having dedicated sepsis coordinators to oversee care for people with sepsis, in a similar way to trauma and cancer patients.
“Patients with sepsis are cared for by a range of specialist doctors and nurses with frequent transfers between teams. By recommending that hospitals need a dedicated sepsis care coordinator, the Sepsis Clinical Care Standard will help to ensure a comprehensive and holistic approach to this complex and devastating condition.
“Up to 50% of people who suffer sepsis and survive have ongoing medical problems which affect their physical, psychological and cognitive wellbeing. Unlike other conditions such as heart attack and stroke, there is no coordinated care or rehabilitation for sepsis survivors. The standard is a huge step forward.”
Access the Sepsis Clinical Care Standard here