South Tees Hospitals NHS Trust

Sepsis Action Group

Wednesday 24th January2018 Room 10, LRI JCUH.

Subject / Discussion & Action Points
  1. Attendees and apologies for absence
/ Present:Tony Roberts (TR), Hanni Daduya (HD), Clare Bradbury (CB), Debbie Lockwood (DL), Tracy Farley (TF), Lindsey Garcia (LG), Helen Overton (HO), Isabel Gonzalez (IG)
Apologies:Doug Aitken, Judith Conner, Victoria Davidson, Jacqui Simpson (JS), Jo Mohan (JM), Johnathan Grimbley (JG).
  1. Minutes from last meeting, matters arising and summary of actions
/ Summary of Actions from previous meeting
  • IG to escalate the need for prioritising automatic sepsis screening to be built into evolve, via CSSG. To carry over
  • HO to check sepsis Champions data base and inform LG which wards are yet to nominate 
  • LG to escalate areas needing sepsis champions - To carry over
  • JJ to inform centre of achievements of chemotherapy day unit- to be carried over
  • JJ to arrange meeting between NEAS, STH and CDD
  • VD to write to TR in support of a CAP post
  • IG to send out survey to all areas re sepsis team performanceto be carried over

  1. CQUIN 2017/19
/ HO gave an update of the current CQUIN results, January data ED antibiotics currently at 49%. LG to report toCQUIN lead. LG will contact Gill Hunt to establish CQUIN lead following departure of Ruth James, in order to continue alignment within the sepsis work. TR understands that Emma Carter is the contact for CQUIN.IG asked if there was to be a CCG meeting for Q4. TR informed the group that a number of the contracting team have been made redundant with only 2 people left. LG said that deadlines will to challenging in relation to January pressures. IG stated that also no training has taken place and this should beescalated to CCG.
TR said that a meeting is arranged at North Tees Hospital to look at past 3 years of CAP data and 2 years of sepsis data. TR understands from Celia Ingham that in next year’s CQUIN there will be pressure for trusts to use NEWS. The NEWS survey was completed across the region and TR will circulate the results. CQUIN 2018/2019 to be published soon.
  1. Paediatric Sepsis at STH update
/ TF said that currently, electronic evolve is not working effectively and are back to paper. A meeting is planned in Februaryto review paediatric sepsis. Paediatrics has produced an information leaflet which is available on the intranet.
TR audit for shows PEWS too sensitive as a trigger for sepsis. Need to review PEWS (regional). No national update.IG will forward a network link for paediatrics to TF.
LG said that VitalPac have adapted for paediatrics will email Jacqueline.
  1. Maternity Sepsis at STH update
/ IG stated that Sepsis tool needs to be ratified however needs a member to attend group.
  1. Adult Sepsis at STH
/ HO explained that using clarity data on average 60 patients per month are audited.
IG asked what will happen to clarity post April. TR said clarity will likely continue on back of mortality review data. IG stressed the importance of bench marking for future changes and improvements. IG will circulate link for south tees sepsis intranet link.
TR asked when NEWS2 will be implemented. LG said that are working with VitalPac , IG suggested that will need to work across the trust and alongside NEAS to change over.
  1. Neutropenic sepsis
/ HD said need to target urine output, the data is showing poor compliance. HD has found delay’s in antibiotics is often due to poor access or poor documentation. HD has met with Sepsis nurses and Clarity to work towards being able to produce a more detailed report from clarity for neutropenic patients. HO also presented at the AOS oncology meeting in December. Teaching sessions are planned on ward 33 in the next month. IG asked if HD could present data at next meeting.
  1. Infection control
/ LG said we need to improve alignment with the IPC team and require representation from IPC at the meetings. IG would also like an IPC consultant to attend.TR understands that there may be a project to link to gram negatives with coding.
  1. National update /Regional Update
/ HO informed the group the next regional sepsis nurse meeting is 6th February 2018 at Q E Hospital Gateshead
IG The next Outreach meeting 6thmeeting and work look towards a co-ordinated role out of NEWS2. TR said that Lesley Durham has suggestedlooking at a national NEWS point prevalence. Some work in Wales by Tamos Skazkmanylinking NEWS + AKI alert.
  1. Prehospital and community
/ IG informed the group of work with NEAS and Dan Howarth in relation to pre alert to front of house and emergency department. This will look into more detail to check the correct patients are being pre alerted and the response from the acute setting is appropriate to the pre alert in the receiving department. This will then be analysed against hospital outcomes.
Data to be collected over 3 months or 100 patients then to repeat in Darlington and regionally.
  1. Adult CAP
/ Jo Mohan not present.
  1. Antibiotic pharmacist update.
/ DL explained that duringQ3 antibiotic usage of Piperacillin /tazobactamand meropenem has been reduced. However Jan 2018 has seen an increase.
A National table has been published (8/1/2018)South Tees has been registered incorrectly as a non-teaching hospital and this affects targets. DL is in the process of getting this corrected.
DL also mentioned the change in the unity form. HO said they have used the new one.
IG said that antibiotic guidance poster for review, this will be submitted to the next AWG.
  1. AOB
/ Nil to note
  1. Date of next meeting
/ Wednesday 14th March 08:00 – 09:00 Room 10. LRI. JCUH
Summary of Action
  • IG to circulate terms of reference.
  • IG will forward a network link for paediatrics to TF.
  • TR will circulate the results of NEWS survey
  • IG to circulate link for sepsis intranet page.
  • LG to liaise with IPC for representation at SAG.
  • IG and Sepsis team to review antibiotic guidance.
  • IG to escalate the need for prioritising automatic sepsis screening to be built into evolve, via CSSG.
  • LG to escalate areas needing sepsis champions
  • JJ to inform centre of achievements of chemotherapy day unit
  • IG to send out survey to all areas re sepsis team performance
  • LG to report to CQUIN lead, dip in compliance January 2018.
  • LG will contact Gill Hunt to establish CQUIN lead
  • HD could present data at next meeting

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