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PRACTICUM SUMMARY REPORT
Name: Laura Clapham
Team Members: Laura Clapham, Julie Allison, Dr Clerihew
Project Title: Implementing the Paediatric Sepsis Six to effectively manage a child with septic shock
University/Organization Name: University of Dundee
Health System Sponsor Name: University of Dundee (Dr Linda Clerihew)
Aim of project (1-2 sentences)
All clinically appropriate elements of the Paediatric Sepsis Six bundle will be completed in >95% of
paediatric patients with septic shock in less than 60 minutes of recognition of shock by July 6th 2013.
Planned changes tested (2-3 sentences)
Education of staff, ward simulation using the Paediatric Sepsis Six Bundle, modifying the wording of the bundle,
having all appropriate investigations appearing automatically on ICE, creating a sepsis six box and a ward
simulation using the sepsis six box.
Predictions (2-3 sentences)
It is expected that early recognition and treatment of sepsis will improve the outcome for the paediatric
patient. Length of hospital stay should reduce, admissions to PICU should reduce and there should be
reduced complications as a result of septic shock. We are unable to demonstrate improved outcomes in
our short term involvement in the project and therefore predict improvement with compliance in process
measures only.
Results
Present your results with a graph(s).
Summary of results (3-4 sentences):
Although the target of 60 minutes to i.v. antibiotics has not been reached, the results have started to cluster
around the median since the introduction of the Paediatric Sepsis Six. However the median time has not
decreased.
Learning (4-5 sentences)
Comparison of questions, predictions, and analysis of data:
Results have started to cluster around the median since the introduction of the Paediatric Sepsis Six bundle to the
ward. Therefore there has been some reduction in the time to iv. antibiotics, although the target of a median time
of 60 minutes has not yet been reached. During the 8 week data collection, we had relatively few cases and
therefore would be unable to clearly demonstrate improvement by run chart rules.
Impact on systems (3-4 sentences)
Discuss the project’s significance on the local system and any findings that may be generalizable to other systems:
The SSAA in tayside Children’s Hospital is the pilot testing ward of the Paediatric sepsis 6. Once reliable we
anticipate spread to Emergency Departments and Assessment units across the UK. The development of the bundle
is a national programme.
Conclusions (3-5 sentences)
Summarize the outcome of the project. Is this project sustainable? What are the requirements for sustainability?
Although the target of 60 minutes to i.v. antibiotics has not been reached, the bundle has been introduced and the
staff are now aware of it. The bundle has since been modified to reflect problems that we encountered. It is
thought that triaging and staffing levels are contributors to the fact that the target time has not yet been reached.
This is something that the project within the ward will take further in order to try and reach the target time of 60
minutes.
Reflections/Discussions (5-7 sentences)
Discuss the factors that promoted the success of the project and that were barriers to success. What did you learn from
doing this project? What are your reflections on the role of the team?
Ward simulations were useful exercises for us to identify further tests of change and for staff to feedback which
aspects of the sepsis six bundle and the sepsis box were good and those which were not. Making only small
changes at a time was a good way for us to determine how well changes were working. Staff are always resistant
to change and this is something that would always be a barrier when making changes in healthcare. We were also
able to see the difficulty in making changes within such a large organisation as the NHS, as although the duration of
our project was 4 weeks, the Paediatric Sepsis Six project had been running for 18months prior to this and will
continue after the end of our project.
By signing this document (electronic signature is acceptable), I attest that the information provided by the learners in
this project is accurate.
LEARNER(S):
Signature:
Signature:
Printed Name: Laura Clapham
Printed Name:
Area of Study: Medical Student
Area of Study:
Signature:
Signature:
Printed Name:
Printed Name:
Area of Study:
Area of Study:
Signature:
Signature:
Printed Name:
Printed Name:
Area of Study:
Area of Study:
FACULTY SPONSOR:
Printed Name: Dr Linda Clerihew
Signature:
Institution: Consultant Paediatrician
Printed Name:
HEALTH SYSTEM SPONSOR (if different from faculty sponsor):
Institution:
Signature:
AUTHORIZATION
Do the learners, faculty sponsor, and health system sponsor authorize this project for publication at www.ihi.org?
☐ Yes
☐ No