Introduction and rationale Severe sepsis is common in children and the incidence is rising. (estimated prevalence of 0.89/1000 children/year in US population) It is associated with significant morbidity and mortality. Improved survival and reduced length of stay in hospital for children severe sepsis has been associated with greater compliance with existing guidelines from the American College of Critical Care Medicine (ACCM-PALS). However, compliance with existing guidelines is poor: 38% in a UK PICU audit. Reasons for poor compliance are multi-factorial.
Sepsis Six is an adult initiative shown to have improved survival and adherence to Surviving Sepsis Campaign guidelines. Learning from this experience, the authors and other colleagues formed the UK Paediatric Sepsis Group, and developed the Paediatric Sepsis Six – a simplified and easily deliverable sepsis bundle for children.
Outline of quality improvement initiative Like Sepsis Six, the Paediatric Sepsis Six initiative is a quality improvement program. It comprises a delivery toolkit and an educational program to facilitate prompt recognition of severe sepsis, and delivery of six simple elements of care in a time-critical manner. The initial target user groups are medical and nursing staff in Emergency Departments and Acute Paediatric Assessment Units. Included in the initiative is an integrated monitoring system for recording compliance.
Paediatric Sepsis Six does not replace existing ACCM-PALS guidance; it is an operational solution to improve compliance with these guidelines. It is designed to empower frontline medical and nursing staff to recognise sepsis early and initiate treatment rapidly. The aim through education is to engender a culture where sepsis is an emergency requiring urgent intervention. Our vision is to pilot Paediatric Sepsis Six by region, with subsequent implementation throughout the UK as a quality improvement program.
We invite interested groups to join the paediatric sepsis six initiative.