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A recent survey of more than 300 clinicians has revealed that more than two thirds (68%) are missing cases of sepsis, namely due to staff shortages and high patient caseloads.
Sepsis experts say the results indicate that the current staffing crisis within the NHS is therefore causing harm to patients, and urgent action must be taken to ensure there is consistent access to timely diagnostics.
Only half of healthcare professionals carry out all steps included in the Hour-1 Sepsis Bundle
Sepsis if a life-threatening medical emergency, and rapid diagnosis and immediate intervention is crucial to improving patient outcomes. Every year in the UK, a quarter of a million people are affected by sepsis, and five people die every hour because of it.
In light of these statistics, the UK Sepsis Trust and bioMérieux undertook a survey to assess clinicians’ knowledge and practice in the management of sepsis.
In total, 368 doctors across six European countries, including the UK, took part in the study. The results revealed that while 99% of respondents agreed sepsis is a serious condition, two thirds (67%) said there is sometimes delays to diagnosis, while a similar number (68%) said they do miss some cases in the hospitals in which they work.
A set of interventions, known as the Hour-1 Sepsis Bundle, has been designed to encourage clinicians to act as quickly as possible to obtain blood cultures, administer broad spectrum antibiotics, start appropriate fluid resuscitation, measure lactate, and begin vasopressors if clinically indicated.
While almost all of those surveyed said the Hour-1 Sepsis Bundle is followed in their hospital to at least some extent, only half (52%) of the healthcare professionals carry out all steps included in the Bundle. This means that nearly half (48%) of patients are not receiving the correct standard of care, increasing their risk of mortality.
Why is sepsis intervention not happening as quickly as it should?
The survey identified a number of reasons why there is a lack of adherence to the protocol. While the main barriers vary between countries, in the UK, the main ones identified are staff shortages (76%), high patient caseload (74%), test results not being communicated quickly enough (38%) and inability to rapidly reassess patients (36%).
While nearly all (99%) respondents agree early detection of sepsis can lead to significantly better outcomes, one in three (33%) said that a lack of rapid diagnostic tests is one of the main barriers to adhering to the stages outlined in the Sepsis Bundles
Mark Miller, Executive Vice President and Chief Medical Officer at bioMerieux said: “Diagnostic tests are vital for anyone suspected of sepsis, providing critical information on its presence and severity, the type and extent of infection at the source, how best to manage the patient and also to monitor their progress.
“Tests like blood cultures, other appropriate cultures, lactate and procalcitonin can give essential information for guiding optimal patient care in suspected and proven sepsis.”
How can adherence to Sepsis Bundles be improved?
More than half (56%) of the respondents said that health professionals need greater training on what Sepsis Bundles are and how to implement them in hospitals.
Three quarters (76%) also said that addressing the staffing crisis is key to improving adherence to sepsis protocols. As Dr Daniels explains: “As healthcare systems continue to grapple with issues such as staff shortages and evolving patient needs, urgent action must be taken to ensure that there is consistent access to timely diagnostics to improve patient care and outcomes.”
Dr Ron Daniels, world leading Sepsis expert and Chief Executive of the UK Sepsis Trust, added: “The current crisis in staffing within the NHS and a lack of access to timely diagnostics are causing harm for patients. With the increasing tendency to centralise laboratories within cities, organisations need to examine with a degree of urgency how they ensure the rapid processing and communication of time-sensitive tests to frontline clinicians.”