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Registration Number: {{org_field_registration_no}}

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Identifying and Managing Sepsis Policy

(In Compliance with CIW Regulations in Wales)

1. Purpose

The purpose of this policy is to ensure that sepsis is identified and managed promptly at {{org_field_name}}, reducing the risk of serious complications or fatalities among residents. Sepsis is a life-threatening medical emergency, requiring early recognition, rapid response, and effective treatment.

This policy aims to:

• Increase staff awareness of sepsis and its early warning signs.
• Implement clear procedures for recognising and responding to suspected sepsis.
• Ensure timely escalation to emergency medical services (999) when sepsis is suspected.
• Provide clear documentation and communication with healthcare professionals.
• Comply with CIW regulations and the latest NHS and NICE guidelines on sepsis management.

2. Scope

This policy applies to:

• All care staff, nursing staff, and managers involved in the care of residents.
• All residents, particularly those with a higher risk of sepsis, including individuals with:
  • Weakened immune systems.
  • Chronic illnesses (diabetes, kidney disease, heart conditions).
  • Recent surgery, wounds, or infections.
  • Catheters, IV lines, or other medical devices.
• Family members and visitors, ensuring they understand sepsis risks and can report concerns.
• External healthcare providers, ensuring effective collaboration and escalation protocols.

3. Related Policies

This policy aligns with the following:

• Infection Prevention and Control Policy (CHW17).
• Safe Care and Treatment Policy (CHW11).
• Medication Management and Administration Policy (CHW21).
• Emergency and Business Continuity Plan (CHW19).
• Risk Management and Assessment Policy (CHW18).

4. What is Sepsis?

Sepsis is a life-threatening reaction to an infection that can lead to organ failure and death if not treated quickly. It occurs when the body’s response to infection damages its own tissues and organs.

Common causes of sepsis include:

• Chest infections (pneumonia, bronchitis).
• Urinary tract infections (UTIs) leading to urosepsis.
• Skin infections (cellulitis, infected wounds, pressure ulcers).
• Abdominal infections (gastrointestinal sepsis).

5. Recognising the Signs of Sepsis

Sepsis can progress rapidly, so it is essential that all staff are trained to recognise the early warning signs.

5.1. Sepsis Early Warning Signs (Sepsis Six Criteria)

A resident may have sepsis if they exhibit any of the following symptoms:

• S – Slurred speech or confusion.
• E – Extreme shivering or muscle pain.
• P – Passing no urine (in a day).
• S – Severe breathlessness.
• I – “I feel like I’m going to die” (reported by resident).
• S – Skin mottled, discoloured, or very pale.

5.2. Additional Symptoms in Older Adults

In elderly residents, signs of sepsis can be subtle and may include:

• Sudden confusion or delirium (which may be mistaken for dementia symptoms).
• Weakness and fatigue, refusal to eat or drink.
• Worsening of an existing condition.
• Unexplained falls.

5.3. Sepsis in Residents with a UTI

Residents with urinary tract infections (UTIs) that turn into urosepsis may show:

• Burning pain when urinating.
• Lower back pain (suggesting kidney involvement).
• Foul-smelling or cloudy urine.
• Fever or sudden chills.

6. Responding to Suspected Sepsis

6.1. Immediate Action (Within the First Hour)

If a resident shows any symptoms of sepsis, staff must:

1. Call 999 immediately and state: “Suspected Sepsis“.
2. Monitor vital signs:
   • Temperature (high or very low).
   • Heart rate (above 90 bpm).
   • Breathing rate (above 20 breaths per minute).
   • Blood pressure (low BP is a sign of shock).
3. Ensure the resident is comfortable and kept warm.
4. Inform the Registered Manager and document symptoms and observations.
5. Prepare medical history to share with emergency services.

6.2. Escalation and Hospital Transfer

• Once paramedics arrive, staff must provide:
  • A summary of symptoms and observations.
  • A list of current medications.
  • Any recent infections, hospital visits, or procedures.
• If the resident deteriorates before paramedics arrive, CPR may be necessary unless a Do Not Resuscitate (DNR) order is in place.

7. Infection Prevention and Risk Reduction

7.1. Preventing Infections

Since sepsis is triggered by infection, preventative measures are key:

• Strict hand hygiene before and after care procedures.
• Regular monitoring of wounds, catheters, and feeding tubes.
• Prompt treatment of minor infections (UTIs, chest infections).
• Vaccination programmes (e.g., flu and pneumonia vaccines).

7.2. Monitoring High-Risk Residents

Residents at higher risk of developing sepsis will have a personalised care plan that includes:

• Frequent temperature and vital sign monitoring.
• Routine urine dipstick tests for residents with recurrent UTIs.
• Wound care checks for residents with pressure sores or surgical sites.

7.3. Staff Training and Awareness

• All care staff receive annual sepsis awareness training.
• Regular competency assessments to ensure staff can identify sepsis symptoms.
• Case studies and scenario-based learning to improve emergency response skills.

8. Documentation and Communication

• All suspected cases of sepsis must be fully documented, including:
  • Date and time of symptoms observed.
  • Vital sign readings.
  • Actions taken (calling 999, informing family, monitoring changes).
  • Outcome (hospital admission, further medical advice).
• Post-incident reviews will be conducted for every suspected sepsis case to improve response times and care quality.

9. Compliance and Monitoring

• Regular internal audits will review how well staff are identifying and responding to sepsis cases.
• CIW inspectors will review training records, sepsis care documentation, and incident reports.
• Lessons learned from incidents will be used to improve policies and training.

10. Policy Review

This policy will be reviewed annually or sooner if:

• NICE or NHS guidelines change.
• CIW regulations require updates.
• An incident highlights areas for improvement.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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