SEPSIS KILLS Program

Aim

To improve the recognition and treatment of sepsis and septic shock in NSW healthcare facilities and to reduce their impact, mortality and financial costs.

Benefits

Successful implementation of the SEPSIS KILLS program is providing significant benefits at both clinical and system levels, including:

  • more timely, standardised and effective detection and management of sepsis;
  • reduced mortality, morbidity and bed-stays from sepsis-related conditions;
  • enhanced clinician skills in sepsis recognition and management;
  • enhanced networking opportunities across the system for clinicians and service teams;
  • improved quality and safety of care;
  • a better and safer patient experience.

Summary

Sepsis is a medical emergency just like a heart attack or stroke. It arises when the body’s response to infection causes a generalised inflammatory response that can lead to shock, multiple organ failure and death. Early recognition and prompt treatment is essential to improve survival.

Appropriate recognition and timely management of patients with severe infection and sepsis is a significant problem in NSW hospitals and health care organisations around the world. The Clinical Excellence Commission’s Clinical Focus Report on Recognition and Management of Sepsis (2009) found significant deficits in a range of clinical settings in NSW health care facilities.

Delayed treatment of patients with severe infection and sepsis is associated with high mortality rates and high costs to the health care system. Effective antimicrobial administration within the first hour of documented hypotension is associated with increased survival to hospital discharge in septic shock.

The SEPSIS KILLS program is a quality improvement initiative that has been developed from international evidence-based practice. It is based on three key actions:

  • Recognise risk factors, signs and symptoms of sepsis
  • Resuscitate with rapid intravenous fluids and administer antibiotics within the first hour of diagnosis of sepsis
  • Refer to senior clinicians and teams including retrieval if appropriate

The CEC launched SEPSIS KILLS in May 2011 in emergency departments throughout NSW and the program has been extended to the inpatient wards in 2014. 

Background

Further background information is available at: http://www.cec.health.nsw.gov.au/programs/sepsis

Partnerships

  • HETI
  • NSW Kids and Families
  • Cancer Institute NSW
  • ACI
  • Ambulance Service NSW

Key Dates

Pilot Sites

Central Coast Local Health DistrictGosford Hospital
Wyong Public Hospital
Far West Local Health DistrictBroken Hill Base Hospital
Balranald District Hospital
Wilcannia Multi-Purpose Service
Hunter New England Local Health DistrictBarraba Multi Purpose Service
Belmont Hospital
Boggabri Multi-Purpose Service
Armidale Rural Referral Hospital
Calvary Mater Newcastle
Cessnock District Hospital
Dungog Community Hospital
Glen Innes District Hospital
Gloucester Soldiers Memorial Hospital
Gunnedah District Hospital
Guyra Multi Purpose Service
Inverell District Hospital
John Hunter Hospital
Kurri Kurri Hospital
The Maitland Hospital
Manilla Health Service
Manning Rural Referral Hospital (Taree)
Moree District Hospital
Muswellbrook Hospital
Narrabri District Hospital
Quirindi Community Hospital
Scott Memorial Hospital, Scone
Tamworth Rural Referral Hospital
Tomaree Community Hospital
Vegetable Creek Hospital
Walcha Multi Purpose Service
Wee Waa Community Hospital
Werris Creek Community Hospital
Wilson Memorial Community Hospital, Murrurundi
Singleton District Hospital
Tingha Multi Purpose Service
Bulahdelah Community Hospital
Bingara Multi Purpose Service
Denman Multi Purpose Service
Merriwa Multi Purpose Service
Tenterfield Community Hospital
Illawarra Shoalhaven Local Health DistrictMilton Ulladulla Hospital
Shellharbour Hospital
Shoalhaven Hospital
Wollongong Hospital
Mid North Coast Local Health DistrictCoffs Harbour Base Hospital
Kempsey District Hospital
Macksville District Hospital
Port Macquarie Base Hospital
Dorrigo Multi-Purpose Service
Wauchope District Memorial Hospital
Murrumbidgee Local Health DistrictBoorowa District Hospital
The Cootamundra Hospital
Griffith Base Hospital
Murrumburrah-Harden District Hospital
Wagga Wagga Base Hospital
Wyalong Hospital
Young District Hospital
Tumbarumba Multi Purpose Service
Tumut District Hospital
Urana Health Service
Tocumwal Hospital
Temora Hospital
Henty Residential Aged Care
Berrigan War Memorial Hospital
Batlow/Adelong Multi Purpose Service
Barham Koondrook Soldiers Memorial Hospital
Coolamon-Ganmain Health Service
Finley Hospital and Community Health Centre
Culcairn Health Service
Narrandera District Hospital
Lockhart and District Hospital
Lake Cargelligo District Hospital
Leeton District Hospital
Gundagai District Hospital
Junee District Hospital
Jerilderie Health Service
Hay District Hospital
Hillston District Hospital
Holbrook District Hospital
Deniliquin Hospital
Nepean Blue Mountains Local Health DistrictBlue Mountains District ANZAC Memorial Hospital
Nepean Hospital
Lithgow Integrated Health Service
Northern NSW Local Health DistrictCasino and District Memorial Hospital
Grafton Base Hospital
Kyogle Memorial Hospital
Lismore Base Hospital
Nimbin Multi-Purpose Service
The Tweed Hospital
Urbenville Health Service
Maclean District Hospital
Murwillumbah District Hospital
Mullumbimby and District War Memorial Hospital
Bonalbo Hospital
Byron District Hospital
Ballina District Hospital
Northern Sydney Local Health DistrictHornsby Ku-ring-gai Hospital
Manly Hospital
Mona Vale Hospital
Royal North Shore Hospital
Ryde Hospital
South Eastern Sydney Local Health DistrictPrince of Wales Hospital
St George Hospital
Sutherland Hospital and Community Health Service
Sydney Hospital and Sydney Eye Hospital
Royal Hospital for Women
South Western Sydney Local Health DistrictBowral Hospital
Bankstown Lidcombe Hospital
Camden Hospital
Campbelltown Hospital
Fairfield Hospital
Liverpool Hospital
Southern NSW Local Health DistrictBateman's Bay District Hospital
Bega District Hospital
Cooma Hospital and Health Service
Crookwell District Hospital
Goulburn Base Hospital
Moruya District Hospital
Pambula District Hospital
Yass District Hospital
Braidwood Multi Purpose Service
Bombala District Hospital
Delegate Multi-Purpose Service
Queanbeyan District Hospital
St Vincent's Health NetworkSt Vincent's Hospital
Sydney Children's Hospital NetworkSydney Children's Hospital
The Children's Hospital at Westmead
Sydney Local Health DistrictCanterbury Hospital
Concord Repatriation General Hospital
Royal Prince Alfred Hospital
Balmain Hospital
Western NSW Local Health DistrictBathurst Base Hospital
Cobar District Hospital
Dubbo Base Hospital
Forbes District Hospital
Warren Multi-Purpose Health Service
Gilgandra Multi-Purpose Health Service
Gulargambone Multi-Purpose Service
Gulgong Health Service
Grenfell Multi-Purpose Service
Lightning Ridge Multi Purpose Health Service
Mudgee Health Service
Narromine Hospital and Community Health
Molong Health Service
Parkes District Hospital
Peak Hill Health Service
Nyngan Multi- Purpose Service
Oberon Health Service
Orange Health Service
Cowra District Hospital
Condobolin District Hospital
Coolah Multi-Purpose Health Service
Eugowra Memorial Multi Purpose Service
Dunedoo Health Service
Coonabarabran District Hospital
Coonamble Health Service
Collarenebri Health Service
Canowindra Soldiers Memorial Hospital
Blayney District Hospital
Bourke District Hospital
Brewarrina Multi-Purpose Service
Baradine Multi- Purpose Service
Walgett Health Service
Wellington Health Service
Rylstone District Hospital
Tottenham Hospital
Trangie Multi- Purpose Health Service
Tullamore Health Service
Western Sydney Local Health DistrictAuburn Hospital and Community Health Services
Blacktown Mount Druitt Hospital (Blacktown Campus)
Blacktown Mount Druitt Hospital (Mount Druitt Campus)
Westmead Hospital

Implementation Sites

The SEPSIS KILLS program has been successfully implemented since May 2011 in all medium and large emergency departments across NSW. Small rural and remote emergency departments are progressively joining the program.

Central Coast Local Health DistrictGosford Hospital
Wyong Public Hospital
Far West Local Health DistrictBroken Hill Base Hospital
Balranald District Hospital
Wilcannia Multi-Purpose Service
Ivanhoe Hospital
Menindee Health Service
Tibooburra Hospital
Hunter New England Local Health DistrictBarraba Multi Purpose Service
Belmont Hospital
Boggabri Multi-Purpose Service
Armidale Rural Referral Hospital
Calvary Mater Newcastle
Cessnock District Hospital
Dungog Community Hospital
Glen Innes District Hospital
Gloucester Soldiers Memorial Hospital
Gunnedah District Hospital
Guyra Multi Purpose Service
Inverell District Hospital
John Hunter Hospital
Kurri Kurri Hospital
The Maitland Hospital
Manilla Health Service
Manning Rural Referral Hospital (Taree)
Moree District Hospital
Muswellbrook Hospital
Narrabri District Hospital
Quirindi Community Hospital
Scott Memorial Hospital, Scone
Tamworth Rural Referral Hospital
Tomaree Community Hospital
Vegetable Creek Hospital
Walcha Multi Purpose Service
Wee Waa Community Hospital
Werris Creek Community Hospital
Wilson Memorial Community Hospital, Murrurundi
Singleton District Hospital
Tingha Multi Purpose Service
Bulahdelah Community Hospital
Bingara Multi Purpose Service
Denman Multi Purpose Service
Merriwa Multi Purpose Service
Tenterfield Community Hospital
Warialda Multi Purpose Service
Wilson Memorial Community Hospital, Murrurundi
Wingham Community Hospital
Illawarra Shoalhaven Local Health DistrictMilton Ulladulla Hospital
Shellharbour Hospital
Shoalhaven Hospital
Wollongong Hospital
Bulli Hospital
Mid North Coast Local Health DistrictCoffs Harbour Base Hospital
Kempsey District Hospital
Macksville District Hospital
Port Macquarie Base Hospital
Dorrigo Multi-Purpose Service
Wauchope District Memorial Hospital
Bellingen River District Hospital
Murrumbidgee Local Health DistrictBoorowa District Hospital
The Cootamundra Hospital
Griffith Base Hospital
Murrumburrah-Harden District Hospital
Wagga Wagga Base Hospital
Wyalong Hospital
Young District Hospital
Tumbarumba Multi Purpose Service
Tumut District Hospital
Urana Health Service
Tocumwal Hospital
Temora Hospital
Henty Residential Aged Care
Berrigan War Memorial Hospital
Batlow/Adelong Multi Purpose Service
Barham Koondrook Soldiers Memorial Hospital
Coolamon-Ganmain Health Service
Finley Hospital and Community Health Centre
Culcairn Health Service
Narrandera District Hospital
Lockhart and District Hospital
Lake Cargelligo District Hospital
Leeton District Hospital
Gundagai District Hospital
Junee District Hospital
Jerilderie Health Service
Hay District Hospital
Hillston District Hospital
Holbrook District Hospital
Deniliquin Hospital
Berrigan War Memorial Hospital
Batlow/Adelong Multi Purpose Service
Barham Koondrook Soldiers Memorial Hospital
Nepean Blue Mountains Local Health DistrictBlue Mountains District ANZAC Memorial Hospital
Nepean Hospital
Lithgow Integrated Health Service
Northern NSW Local Health DistrictCasino and District Memorial Hospital
Grafton Base Hospital
Kyogle Memorial Hospital
Lismore Base Hospital
Nimbin Multi-Purpose Service
The Tweed Hospital
Urbenville Health Service
Maclean District Hospital
Murwillumbah District Hospital
Mullumbimby and District War Memorial Hospital
Bonalbo Hospital
Byron District Hospital
Ballina District Hospital
Northern Sydney Local Health DistrictHornsby Ku-ring-gai Hospital
Manly Hospital
Mona Vale Hospital
Royal North Shore Hospital
Ryde Hospital
South Eastern Sydney Local Health DistrictPrince of Wales Hospital
St George Hospital
Sutherland Hospital and Community Health Service
Sydney Hospital and Sydney Eye Hospital
Royal Hospital for Women
South Western Sydney Local Health DistrictBowral Hospital
Bankstown Lidcombe Hospital
Camden Hospital
Campbelltown Hospital
Fairfield Hospital
Liverpool Hospital
Southern NSW Local Health DistrictBateman's Bay District Hospital
Bega District Hospital
Cooma Hospital and Health Service
Crookwell District Hospital
Goulburn Base Hospital
Moruya District Hospital
Pambula District Hospital
Yass District Hospital
Braidwood Multi Purpose Service
Bombala District Hospital
Delegate Multi-Purpose Service
Queanbeyan District Hospital
St Vincent's Health NetworkSt Vincent's Hospital
Sydney Children's Hospital NetworkSydney Children's Hospital
The Children's Hospital at Westmead
Sydney Local Health DistrictCanterbury Hospital
Concord Repatriation General Hospital
Royal Prince Alfred Hospital
Balmain Hospital
Western NSW Local Health DistrictBathurst Base Hospital
Cobar District Hospital
Dubbo Base Hospital
Forbes District Hospital
Warren Multi-Purpose Health Service
Gilgandra Multi-Purpose Health Service
Gulargambone Multi-Purpose Service
Gulgong Health Service
Grenfell Multi-Purpose Service
Lightning Ridge Multi Purpose Health Service
Mudgee Health Service
Narromine Hospital and Community Health
Molong Health Service
Parkes District Hospital
Peak Hill Health Service
Nyngan Multi- Purpose Service
Oberon Health Service
Orange Health Service
Cowra District Hospital
Condobolin District Hospital
Coolah Multi-Purpose Health Service
Eugowra Memorial Multi Purpose Service
Dunedoo Health Service
Coonabarabran District Hospital
Coonamble Health Service
Collarenebri Health Service
Canowindra Soldiers Memorial Hospital
Blayney District Hospital
Bourke District Hospital
Brewarrina Multi-Purpose Service
Baradine Multi- Purpose Service
Walgett Health Service
Wellington Health Service
Rylstone District Hospital
Tottenham Hospital
Trangie Multi- Purpose Health Service
Tullamore Health Service
Trundle Multi-Purpose Service
Goodooga Health Service
Western Sydney Local Health DistrictAuburn Hospital and Community Health Services
Blacktown Mount Druitt Hospital (Blacktown Campus)
Blacktown Mount Druitt Hospital (Mount Druitt Campus)
Westmead Hospital

Evaluation

The CEC Sepsis Data Collection provides an on-line tool to collect and analyse data, to monitor improvement in the recognition and management of sepsis in the NSW health system.

The key program measures are the time taken from triage to start the first dose of intravenous antibiotics and the amount of bolus intravenous fluid administered within 60 minutes of sepsis recognition (adults and paediatrics).

The NSW state median time from triage to administration of antibiotics has been significantly reduced from 4 hours at the commencement of the program to consistently less than 60 minutes in 2013/14 which meets international benchmarks. Individual emergency departments are able to monitor their performance and benchmark with other facilities in the local health district and with statewide aggregated results. Six monthly reports are provided to LHDs.

Linkage with the NSW Health Information Exchange is underway to demonstrate clinical outcome benefits. 

Related Initiatives

The SEPSIS KILLS program has direct links to other quality and safety initiatives including:

Further Details

For further information visit: www.cec.health.nsw.gov.au/programs/sepsis

Contact

Mary Fullick
Sepsis Program Lead
mary.fullick@health.nsw.gov.au
02 9269 5542

Page Top | Added: 6 November 2013 | Last modified: 5 February 2015