A study that implemented and examined a program for the early recognition and treatment of sepsis in all NSW public hospitals in collaboration with the Clinical Excellence Commission and UNSW’s Professor Mary-Louise McLaws has been judged the best research article published in the Medical Journal of Australia in 2016.
The winning article, “SEPSIS KILLS: early intervention saves lives” was the journal’s most highly cited paper in 2016 and followed the 2011 program that transformed the way emergency departments respond to the condition.
It was authored by Professor McLaws (School of Community Medicine and Public Health) with Dr Anthony Burrell, Mary Fullick, Rosemary Sullivan and Dr Doungkamol Sindhusake, all from the NSW Clinical Excellence Commission.
Sepsis is an inflammatory response to infection that can lead to organ failure and death, and is one of the most common reasons for a patient's health to deteriorate in hospital.
The program in 175 hospital emergency departments in NSW promoted the principles “recognise, resuscitate, refer”.
Emergency department staff were educated about the signs and symptoms of sepsis, and how to intervene within 60 minutes of recognition - including taking blood cultures, measuring serum lactate levels, administration of intravenous antibiotics, and fluid resuscitation.
The final step was referring the patient to senior clinicians.
Data for 13,567 patients were recorded by 97 hospitals in the study’s database. The proportion of patients receiving intravenous antibiotics within 60 minutes of triage increased from 29.3% in 2009-2011 to 52.2% in 2013.
Professor McLaws says an immediate 27% reduction in death was achieved and the continuation of the program since the publication has seen a further 4% reduction in the risk of death.
An additional 150 lives are saved each year through following the program by reducing the time before antibiotics are administered and fluid resuscitation is initiated.
The program has been rolled out to 200 hospitals and was awarded the international Global Sepsis Alliance Award. The authors were awarded a $10,000 prize at a ceremony held in Melbourne last week.
In her acceptance speech at the National Australian Medical Association Conference, Professor McLaws said the award showed the value of cooperation between UNSW and the NSW Clinical Excellence Commission.
“At a time when universities are under financial pressures and the cost of health is under scrutiny it’s beneficial to our patients to work together to bring academic rigour and clinical expertise to the mission of patient safety. This award is testimony to the value of such cooperation,” she said.
Picture: Dr Michael Gannon (AMA President) congratulating Professor Mary-Louise McLaws (UNSW) and Ms Mary Fullick (CEC). Pic credit Mary-Louise McLaws