Department of Health publishes the National Clinical Effectiveness Committee’s National Clinical Guideline No. 26 Sepsis Management for Adults (including maternity)

Today (Monday), on World Sepsis Day, the Minister for Health, Stephen Donnelly TD, has welcomed the publication of a new and fully updated National Clinical Guideline to help healthcare professionals recognise and treat sepsis and septic shock patients.

This initiative was led by a group from the Health Service Executive’s (HSE) National Clinical Programme on Sepsis and supported by the department’s Clinical Effectiveness Unit. The guideline was quality assured by the National Clinical Effectiveness Committee (NCEC). The clinical guideline is based on best research evidence and developed in line with international best practice.

Sepsis is a potentially life-threatening complication of most common infections that can affect anyone, and which is frequently under-diagnosed at the early stages when it is potentially reversible. Prompt identification and treatment are vital.

The Minister for Health Stephen Donnelly said:

Welcoming the publication of the guideline, the Chief Medical Officer, Dr Tony Holohan said:

Noting the role of healthcare professionals in using the guideline in practice, the Chief Nursing Officer, Rachel Kenna said:

Minister Donnelly congratulated the HSE National Sepsis Programme and the Sepsis Guideline Development Group for the completion of the guideline and the associated resources.

The National Clinical Effectiveness Committee (NCEC) provides leadership for clinical effectiveness through prioritisation and quality assurance of National Clinical Guidelines and National Clinical Audit. Twenty-five NCEC National Clinical Guidelines on a range of conditions and healthcare processes have already been published. Extending and implementing the suite of NCEC guidelines remains a priority of national health policy.

Sepsis Management for Adults (including maternity)

National Clinical Effectiveness Committee (NCEC)

Clinical effectiveness is a key component of patient safety. The integration of best evidence in service provision, through clinical effectiveness processes, promotes healthcare that is up to date, effective and consistent. Clinical effectiveness processes include guidelines, audit and practice guidance.

NCEC Terms of Reference

• provide strategic leadership for the national clinical effectiveness agenda
• contribute to national patient safety and quality improvement agendas
• publish standards for clinical practice guidance
• publish guidance for National Clinical Guidelines and National Clinical Audit
• prioritise and quality assure National Clinical Guidelines and National Clinical Audit
• commission National Clinical Guidelines and National Clinical Audit
• align National Clinical Guidelines and National Clinical Audit with implementation levers
• report periodically on the implementation and impact of National Clinical Guidelines and the performance of National Clinical Audit
• establish sub-committees for NCEC work-streams
• publish an Annual Report

Further information about the NCEC and National Clinical Guidelines is available at: https://www.gov.ie/en/publication/90221b-clinical-effectiveness/

Information on Sepsis

Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. International estimates of incidence vary and despite declining age-standardised incidence and mortality, sepsis remains a major cause of health loss worldwide. In 2017, there were 48.9 million cases of sepsis resulting in 11 million deaths worldwide, confirming that the actual rates are double than previously estimated, and that 20 per cent of global deaths are due to this under-reported but deadly medical condition.

In Ireland, in 2019, sepsis or septic shock was documented in 12,908 non-pregnant adults and these patients had a mortality rate of 19.7%. There has been over all age-adjusted decrease in mortality from sepsis and septic shock of 2.9% from 2018. Patients with a diagnosis of sepsis spend longer in hospital than those that had a diagnosis of infection.

The National Sepsis Outcome Report is published by the HSE and describes the burden of sepsis on the Irish healthcare system is being published today. The fifth (2019) report shows a 26.5% reduction in age-adjusted mortality from sepsis and septic shock since 2011 in Ireland. This shows the positive impact that the National Sepsis Programme has had on the care of patients with sepsis in the Irish healthcare system.

Sepsis has considerable impact on the quality of life in survivors of sepsis, their families, and carers. In addition, Sepsis has an economic and social burden. Economic work to consider the impact of the 2014 guideline on patients admitted to ICU with sepsis showed a decrease in average length of stay and a reduction in the direct cost per patient. In 2014 the National Clinical Effectiveness Committee (NCEC) was requested by the then Minister for Health to commission the first Sepsis NCG which arose from a significant patient safety matter. The National Clinical Guideline is intended to be relevant to all healthcare staff involved in the care of patients with sepsis and the suspicion of sepsis in Ireland.

The 2014 National Clinical Guideline No.6 Sepsis Management will now be retired from the suite of NCEC National Clinical Guidelines. It is replaced by National Clinical Guideline No. 26 Sepsis Management in Adults (including Maternity).

This new and updated National Clinical Guideline is being launched at the HSEs webinar World Sepsis Day event along with the National Implementation Plan for the International Guidelines for the Management of Septic Shock & Sepsis-Associated Organ Dysfunction in Children and the 2019 National Sepsis Report.