Minister Harris welcomes Resolution on Sepsis at World Health Assembly
Ireland is a co-sponsor of the resolution on improving the prevention, diagnosis and management of sepsis
Today (Friday May 26th) in Geneva, the 70th WHO World Health Assembly agreed a resolution, co-sponsored by Ireland, on improving the prevention, diagnosis and management of sepsis.
Minister for Health Simon Harris TD said, “I welcome today’s resolution at the World Health Assembly on improving the prevention, diagnosis and management of sepsis, which my Department had developed with other Member States. The resolution is an important step in improving patient safety.
“In Ireland, over a short period of time, we have advanced considerable developments in sepsis management . My Department, in collaboration with the HSE, has led a significant programme for change in the recognition and management of sepsis since the National Clinical Effectiveness Committee (NCEC) published the National Clinical Guideline on Sepsis in 2014.
“Our goal is to reduce avoidable sepsis and there is much that can be done. Sepsis cases can be reduced with vaccination, good sanitation and hygiene. Recognising that sepsis is a time-dependent medical emergency with survival optimised by early recognition and treatment – time matters. New tools and training for doctors and nurses have been introduced across all our hospitals.”
Sepsis is a life-threatening illness triggered by infection that causes the immune system to malfunction and the organ systems to fail. It is colloquially known as ‘blood poisoning’.
Sepsis is a global problem, as recognised by the WHO resolution. All countries are challenged by sepsis and its contribution to both mortality and morbidity. In 2015, there were almost 9,000 cases of sepsis in adult inpatients in Ireland, mirroring the international experience.
The WHO resolution recommends training in sepsis recognition and management, promotion of hand hygiene, access to vaccination programmes, infection control, public awareness and evidence based guidelines.
The HSE has established a national sepsis programme including a national clinical lead, an education programme, treatment pathways, data monitoring and full implementation of the NCEC National Clinical Guideline on Sepsis.
Sepsis can affect a person of any age, from any social background and can strike irrespective of underlying good health or concurrent medical conditions.
Regarding the international sepsis resolution, Dr Vida Hamilton, National Clinical Lead for Sepsis in Ireland said, “This is a huge step forward for healthcare worldwide, as much can be achieved with relatively simple but timely interventions, which need to be supported by Member Governments’ healthcare policies, the curricula of medical and nursing schools and postgraduate bodies and the executive structures of healthcare provision. Mortality reduction in patients with septic shock, the most severe form, requires ongoing research funding to improve understanding of the disease process so that additional treatments can be identified and mortality reduced. Ireland has a robust sepsis quality improvement programme and I am proud of it’s role in supporting this global initiative.”
Ms Brigid Doherty, CEO of Patient Focus welcomed the announcement, commenting that, “Sepsis management is essential for patient safety. It’s not just about prevention of death, it’s also prevention of life-long medical problems for the patient. Sepsis must be identified and treated in a timely manner – all staff should be aware of our national NCEC sepsis guideline which must be embedded into practice. It is used in conjunction with a health professional’s clinical and observational skills. Escalation to senior clinicians as a matter of urgency is essential when symptoms develop.”
Note to Editors
The National Clinical Effectiveness Committee
The National Clinical Effectiveness Committee (NCEC) was established as part of the Patient Safety First Initiative in September 2010. It is one of the Workstreams of the newly established National Patient Safety Office in the Department of Health. The NCECs mission is to provide a framework for national endorsement of clinical guidelines and audit to optimise patient and service-user care.
The NCEC has a remit to establish and implement processes for the prioritisation and quality assurance of clinical guidelines and clinical audit so as to recommend them to the Minister for Health to become part of a suite of National Clinical Guidelines and National Clinical Audit.
The NCEC, chaired by Dr Karen Ryan, is made up of key stakeholders including clinicians, patient representatives, the Department of Health, health managers, regulatory bodies, training and education bodies, clinical indemnity agencies and private healthcare.
National Clinical Guideline – Sepsis Management
The terms sepsis, severe sepsis and septic shock are used to describe the systemic inflammatory response of patients to infection, as a continuum of progressive and life threatening severity. Sepsis is the clinical syndrome defined by the presence of both infection and a systemic inflammatory response.
Sepsis is the 10th leading cause of death worldwide, more than bowel cancer, breast cancer, road traffic accidents and HIV/AIDS combined and is a common time- dependent medical emergency. Internationally, approaches to sepsis management based on early recognition of sepsis and timely referral to critical care have reported reductions in mortality from severe sepsis/septic shock in the order of 20-30%.
International consensus shows that there are approximately 300 cases per 100,000 population per annum. This compares with 208 cases of myocardial infarction per 100,000 per year and 223 cases of stroke.
European studies estimate that a typical episode of severe sepsis will cost a healthcare institution around €25,000.
(Source: HSE National Sepsis report 2011-2015)
Between 2011 and 2015 in Ireland:
- The number of sepsis cases increased by 37% and the rate of in-hospital sepsis associated mortality decreased by 15%. These figures mirror the international experience in the industrialised world and are largely related to an ageing population with a longer life expectancy and increased co-morbidity load.
- Increased healthcare usage was partially offset by a 13.6% decrease in average length of stay, however, patients with infection and/or sepsis as whole or part of their clinical diagnosis occupied 48% of all hospital bed days in 2015.
- Mortality is associated with increasing age, the presence of co-morbidities and season.
Sepsis can be recognised when an infection gets worse or comes on very fast and some of the following symptoms occur:
- New onset confusion
- Sustained fast breathing rate
- Sustained fast pulse rate
- Severe leg pain or the inability to stand
- Very cold, pale hands and feet with dizziness on standing
- No urine and no urge to go for more than 12 hours
- A non-blanching rash, this is a rash that can be spotty or patchy but that does not disappear when pressed on by a glass.
Further information on the NPSO – http://health.gov.ie/national-patient-safety-office/
Further information on the NCEC – http://health.gov.ie/national-patient-safety-office/ncec/governance-ncec/
Further information on the National Clinical Guideline on Sepsis – http://health.gov.ie/national-patient-safety-office/ncec/national-clinical-guidelines-2-2/c-d/
HSE National Sepsis report 2011-2015 – https://www.hse.ie/eng/about/Who/clinical/natclinprog/sepsis/SEPSIS-REPORTS.PDF
WHO Resolution on Sepsis – http://apps.who.int/gb/ebwha/pdf_files/EB140/B140_R5-en.pdf