Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May;30(1):e100743.
doi: 10.1136/bmjhci-2023-100743.

Prevalence of electronic screening for sepsis in National Health Service acute hospitals in England

Kate Honeyford  1 , Amen-Patrick Nwosu  2 , Runa Lazzarino  3 , Anne Kinderlerer  4 , John Welch  5 , Andrew J Brent  6   7 , Graham Cooke  4   8   9 , Peter Ghazal  10 , Shashank Patil  11 ; DiAlS Co-investigators; Ceire E Costelloe  12   13
Affiliations

Prevalence of electronic screening for sepsis in National Health Service acute hospitals in England

Kate Honeyford et al. BMJ Health Care Inform. 2023 May.

Abstract

Sepsis is a worldwide public health problem. Rapid identification is associated with improved patient outcomes-if followed by timely appropriate treatment.

Objectives: Describe digital sepsis alerts (DSAs) in use in English National Health Service (NHS) acute hospitals.

Methods: A Freedom of Information request surveyed acute NHS Trusts on their adoption of electronic patient records (EPRs) and DSAs.

Results: Of the 99 Trusts that responded, 84 had an EPR. Over 20 different EPR system providers were identified as operational in England. The most common providers were Cerner (21%). System C, Dedalus and Allscripts Sunrise were also relatively common (13%, 10% and 7%, respectively). 70% of NHS Trusts with an EPR responded that they had a DSA; most of these use the National Early Warning Score (NEWS2). There was evidence that the EPR provider was related to the DSA algorithm. We found no evidence that Trusts were using EPRs to introduce data driven algorithms or DSAs able to include, for example, pre-existing conditions that may be known to increase risk.Not all Trusts were willing or able to provide details of their EPR or the underlying algorithm.

Discussion: The majority of NHS Trusts use an EPR of some kind; many use a NEWS2-based DSA in keeping with national guidelines.

Conclusion: Many English NHS Trusts use DSAs; even those using similar triggers vary and many recreate paper systems. Despite the proliferation of machine learning algorithms being developed to support early detection of sepsis, there is little evidence that these are being used to improve personalised sepsis detection.

Keywords: decision support systems, clinical; delivery of health care; electronic health records; medical records systems, computerized.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Timeline showing the development of sepsis guidelines and incentives in the NHS in England. NEWS2, National Early Warning Score version details of NICE guidelines and quality Standards are available at: www.nice.org.uk/guidance/conditions-and-diseases/infections/sepsis, details of CQUINs are available at: www.england.nhs.uk/nhs-standard-contract/cquin/, details of NHS standard contract are available at: www.england.nhs.uk/nhs-standard-contract/previous-nhs-standard-contracts/. CQC, Care Quality Commission; CQUIN, Commissioning and Quality Innovation; ED, emergency department.; NICE, National Institute of Clinical Excellence; NHS, National Health Service
See this image and copyright information in PMC

References

    1. Evans L, Rhodes A, Alhazzani W, et al. . Executive summary: surviving sepsis campaign: international guidelines for the management of sepsis and septic shock 2021. Crit Care Med 2021;49:1974–82. 10.1097/CCM.0000000000005357 - DOI - PubMed
    1. Rudd KE, Johnson SC, Agesa KM, et al. . Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet 2020;395:200–11. 10.1016/S0140-6736(19)32989-7 - DOI - PMC - PubMed
    1. Commission CQ . The state of care in NHS acute hospitals: 2014-2016. Care Quality Commission [Internet]. 2017. Available: http://www.cqc.org.uk/sites/default/files/20170302b_stateofhospitals_web...
    1. Singer M, Deutschman CS, Seymour CW, et al. . The third International consensus definitions for sepsis and septic shock (sepsis-3). JAMA 2016;315:801. 10.1001/jama.2016.0287 - DOI - PMC - PubMed
    1. Alberto L, Marshall AP, Walker R, et al. . Screening for sepsis in general hospitalized patients: a systematic review. J Hosp Infect 2017;96:305–15. 10.1016/j.jhin.2017.05.005 - DOI - PubMed