Quality statement 5: Information for people at low risk of severe illness or death | Sepsis | Quality standards

Quality statement

People with suspected sepsis who have been stratified as at low risk of severe illness or death are given information about symptoms to monitor and how to access medical care.

Rationale

Sepsis cannot always be ruled out for people who have been assessed as being at low risk of severe illness or death from sepsis. They need to know which symptoms to look out for and how to access medical care urgently if these symptoms develop. This awareness will mean rapid management if symptoms become worse.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that information about symptoms to monitor and how to access medical care if needed is available to people with suspected sepsis who have been stratified as being at low risk of severe illness or death.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, using electronic hospital records and local primary care systems.

Process

Proportion of people with suspected sepsis who have been stratified as being at low risk of severe illness or death who are given information about symptoms to monitor and how to access medical care.

Numerator – the number in the denominator who are given information about symptoms to monitor and how to access medical care.

Denominator – the number of people with suspected sepsis who have been stratified as being at low risk of severe illness or death.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, using electronic hospital records and local primary care systems.

Outcome

Levels of awareness of symptoms in people with suspected sepsis.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, using local patient surveys.

What the quality statement means for different audiences

Service providers (such as primary and secondary care services) ensure that information is available about symptoms to monitor and how and when to access medical care for people with suspected sepsis who have been stratified as being at low risk of severe illness or death from sepsis.

Healthcare professionals (such as GPs and healthcare professionals working in emergency departments) give information about which symptoms to monitor and how and when to access medical care to people stratified as being at low risk of severe illness or death from sepsis; they also discuss this information with them.

Commissioners ensure that they commission services with protocols in place to provide information about symptoms to monitor and how to access medical care for people who have been stratified as being at low risk of severe illness or death from sepsis. They also ensure that services have healthcare professionals who can stratify and treat symptoms of sepsis when people are concerned about these.

People with symptoms that suggest they have a low risk of life-threatening illness from sepsis are given information about what to do if they still feel unwell, important signs to look out for and when and where to get urgent help if they are worried about their condition.

Source guidance

Sepsis: recognition, diagnosis and early management. NICE guideline NG51 (2016), recommendation 1.5.3 and 1.11.5

Definitions of terms used in this quality statement

Suspected sepsis

Suspected sepsis is used to indicate people who might have sepsis and require face-to-face assessment to determine whether they need urgent intervention.

Symptoms of sepsis can include, but are not limited to:

high body temperature or low body temperature
fast heartbeat/breathing
feeling dizzy or faint/loss of consciousness
a change in mental state, for example, confusion or disorientation
diarrhoea/nausea and vomiting
slurred speech
severe muscle pain
breathlessness
reduced urine production
cold, clammy and pale or mottled skin.

People with sepsis may have non-specific, non-localised presentations, for example, they may feel very unwell, and may not have a high temperature. [NICE's guideline on sepsis and expert opinion]

Low risk of severe illness or death from sepsis

People with suspected sepsis who do not currently meet any high or moderate to high risk criteria of severe illness or death from sepsis. [NICE's guideline on sepsis, recommendations 1.4.4, 1.4.7 and 1.4.10]

Equality and diversity considerations

Information about symptoms to monitor and how to access medical care should be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people (including families and carers) who do not speak or read English. People should have access to an interpreter or advocate if needed.