Transcript Acute Kidney Injury - National Confidential Enquiry into

NCEPOD SEPSIS STUDY
Improving the quality of medical and surgical care
NCEPOD
To review medical and surgical practice and to
make recommendations to improve the quality
of the delivery of care.
By undertaking confidential surveys covering many different
aspects of medical care and making recommendations for
clinicians and management to implement.
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Improving the quality of medical and surgical care
SEPSIS study: Aim
“To identify and explore avoidable and
remediable factors in the process of care for
patients with known and suspected sepsis”
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Improving the quality of medical and surgical care
SEPSIS study: Objectives
• To examine organisational structures, processes,
protocols and care pathways for sepsis recognition and
management in hospitals from admission through to
discharge or death
• To identify avoidable and remediable factors in the
management of the care for a sample of adult patients
with sepsis, throughout the patient pathway from
presentation to primary care (if applicable) throughout
secondary care to discharge or death
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Improving the quality of medical and surgical care
Key areas
• Recognition of sepsis
• Evaluation of systems in place to facilitate
recognition/ escalation/ treatment
• Management of infection
• MDT approach
• Communication
• End of life care
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Improving the quality of medical and surgical care
Case Identification-prospective
• Prospective identification
• Study contacts set up in critical care (ICU/HDU)
and on critical care outreach team (CCOT)
• Study contacts identify cases in ICU/HDU and
seen by CCOT during study period: 6th-20th May
2014
• Study contacts complete case ID spreadsheet
and return to NCEPOD
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Improving the quality of medical and surgical care
Study population
• Adult patients (≥16 years old) that are seen by
the critical care outreach team (or equivalent) or
that are admitted directly to critical care with
sepsis during the study period:
6th - 20th May 2014
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Improving the quality of medical and surgical care
Exclusions
• Immunosuppressed neutropaenic patients on
chemotherapy, immunosuppressant drugs or
transplant programmes.
• Pregnant women up to 6 weeks post-partum (covered
by MBRRACE-UK sepsis study)
• Patients on end of life care pathway at time of
diagnosis or consultant-led decision made not to
escalate (prior to entry into the study)
• Patients that develop sepsis after 48 hours on
ICU/HDU
• Children <16 years
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Improving the quality of medical and surgical care
Data collection- retrospective
• Retrospective data collected on patients identified
– including consultant details, discharge/30 day outcome information
and ICD10 coding
• Clinician questionnaire – completed by named
consultant at time of diagnosis
- collect data on acute care up to 30 days after entry into the study
• Case note extracts
– admission to discharge/30 days after entry into the study.
• Organisational questionnaire
– collect data on organisation of care
– To be sent to all hospitals that deal with adult patients with sepsis
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Improving the quality of medical and surgical care
Advisor case review
• Multidisciplinary group of Advisors will be
recruited to review case notes and
questionnaires and rate the quality of care
• Advisors will be recruited from a number of
specialties including: emergency medicine,
acute medicine, critical care outreach, general
medicine, general surgery, intensive care.
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Improving the quality of medical and surgical care
Queries
• Findings will be published in Autumn 2015
• Please visit the NCEPOD website
http://www.ncepod.org.uk/sepsis.htm or
call 020 7251 9060 for more information
Thank you for your support!
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Improving the quality of medical and surgical care