New national sepsis standard is a game-changer

In February, Burgess, 79, became rapidly unwell with the life-threatening condition. After waking up one morning feeling nauseated, weak and drowsy, he went downhill within hours. Due to his wife's insistence, he was rushed to hospital and found himself in the intensive care unit at Royal Perth Hospital.

"Crucially, the graveness of my condition was recognised early by the medical team. Even though I didn't know I had an infection, they recognised the signs of sepsis and started antibiotics straight away," he said.

Today (June 30), Burgess has welcomed the new national Sepsis Clinical Care Standard, launched by the Australian Commission on Safety and Quality in Health Care, which will improve early recognition of sepsis and lead to better outcomes for survivors.

He is an advocate for the Australian Sepsis Network and supporter of the national standard.

"The source of my infection remains a mystery, but I'm so relieved that the medical team at Royal Perth Hospital diagnosed me with sepsis quickly and started me on antibiotics almost immediately. I was in hospital for about eight days, with four of those in ICU, which was incredibly scary.

"It's interesting that I had never heard of sepsis, and I now know that more than 8000 Australians die every year from this preventable condition, often within a matter of a day or two. Many of these deaths are among older people or very young children."

Burgess is so grateful he survived the ordeal, that he wants to warn others who may find themselves in a similar situation to be careful not to dismiss the warning signs if they are unwell.

He also wants to ensure that follow-up care for sepsis patients is improved.

"Even though I was critically ill, I recovered well because my condition was recognised and treated early. I am lucky my wife insisted I go to hospital and called an ambulance. But I know that not everybody who has sepsis receives rapid treatment," he said.

"Despite getting timely treatment, I'm now struggling with post-sepsis syndrome which means I have severe fatigue, weakness, a foggy mind and sleep disturbances. I also have an increased risk of getting sepsis again and discomforts that can take months or years to resolve.

"I've returned to life as a Perth radio show host for 6iX, and as each day goes by, I feel a little stronger. However, I often lack energy and run out of steam earlier than I used to."

Burgess said that ongoing symptoms prevent sepsis survivors from returning to a normal family life, work, physical and academic interests, and social engagements, which are all part of daily living.

"From my lived experience of this disease, and my conversations with other people who have had sepsis, I realise that survivors need proactive coordinated care and support in the community. I'm so pleased that the new national Sepsis Clinical Care Standard will improve awareness of post-sepsis effects and help to ensure a smooth transition for people when they are discharged from hospital and return to the community.

"Like me, all sepsis survivors want to return to a productive and fulfilling life and this clinical care standard will promote greater awareness and support for our journey."

Each year more than 8700 Australians die from sepsis, a condition that is triggered by an infection and can turn into a deadly disease if undetected.

Sepsis is the body's extreme response to an infection, causing damage to its own tissues and organs. It affects more than 55,000 Australians of all ages every year. Many of these people are normally healthy, but those who survive sepsis often experience prolonged after-effects or will have a lifelong disability.

Sepsis also has a tangible impact on our healthcare system, with $700 million in direct hospital costs, and indirect costs of more than $4 billion each year.

Launched today, the National Sepsis Program is being implemented to halt the devastating impact of sepsis on Australian patients and their families.

The Australian Commission on Safety and Quality in Health Care (the Commission) has released the national Sepsis Clinical Care Standard, in partnership with The George Institute for Global Health.

It is an achievement that Australia has reached broad consensus across the health sector, to become one of the first countries to release a nationally agreed quality framework for the recognition and management of sepsis.

The standard outlines optimal care for patients in hospital with suspected sepsis - from the onset of signs and symptoms, through to discharge from hospital and follow-up care.

Dr Carolyn Hullick, Clinical Director at the Commission and Emergency Physician in Hunter New England Health NSW, said sepsis is a medical emergency that can elude even the most astute doctors.

"Sepsis is complex, and it can be difficult to diagnose because the signs and symptoms can be subtle. Older patients may have delirium. They may be on medicines that impact on their body's response to sepsis. Sepsis can also mimic other health conditions like gastro or heart disease," said Dr Hullick.

"Yet the consequences of missing sepsis are dire, leading to multiple organ failure, disability or death.

"As an ED doctor, I know that diagnosing sepsis can be challenging, particularly when you're treating a high volume of critical patients in a busy emergency department. It can be especially difficult with older people or very young children, she said.

Dr Hullick said the clinical care standard will help ensure timely recognition of sepsis and provide a framework for healthcare services to create local systems for treatment.

"The new standard requires healthcare services to implement systems that flags people who may have sepsis, assess them urgently, and if necessary, escalate to a higher level of care. Rapid treatment is vital. If we delay sepsis treatment even by a few hours, it can have deadly consequences.

"To deliver antimicrobials to someone who has sepsis within 60 minutes, we need systems in place so that everyone in the ED team knows what they need to do," she said.

Evidence is growing that some sepsis survivors experience long-term health problems, which are poorly recognised and treated. To address this, another key focus of the standard is the planning for care after the patient leaves hospital, in recognition of the ongoing effects of sepsis and 'post-sepsis syndrome'.

Professor Simon Finfer, intensivist and Professorial Fellow in the Critical Care Division at The George Institute for Global Health, described sepsis as the most common preventable cause of death and disability.

"The Sepsis Clinical Care Standard is a game changer that will ensure healthcare workers recognise sepsis as a medical emergency and provide coordinated high-quality care to all Australians.

"If a patient is acutely ill or deteriorating rapidly - and there is no other obvious cause - we must consider sepsis as a possible diagnosis," Prof Finfer said. "If you suspect sepsis, either as a clinician or a patient, escalate your concerns to a healthcare professional who is skilled in managing sepsis. You must ask, 'Could this be sepsis?'."

Prof Finfer is an avid supporter of having dedicated sepsis coordinators to oversee care for people with sepsis, in a similar way to trauma and cancer patients.

"Patients with sepsis are cared for by a range of specialist doctors and nurses with frequent transfers between teams. By recommending that hospitals need a dedicated sepsis care coordinator, the Sepsis Clinical Care Standard will help to ensure a comprehensive and holistic approach to this complex and devastating condition," he explained.

"Up to 50 per cent of people who suffer sepsis and survive have ongoing medical problems which affect their physical, psychological and cognitive wellbeing. Unlike other conditions such as heart attack and stroke, there is no coordinated care or rehabilitation for sepsis survivors. The standard is a huge step forward."

The Sepsis Clinical Care Standard was informed by leading clinical experts and consumers and translates evidence into clinical practice to reduce preventable death or disability caused by sepsis.