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Surviving obstetric sepsis: A multi-facet approach to improving care of obstetric patients with sepsis.
Abstract Number: F-32
Abstract Type: Original Research
Introduction. The 8th Report of Confidential Enquiries into Maternal Deaths in the United Kingdom has shown that sepsis has become the leading direct cause of maternal death1. The Surviving Obstetric Sepsis (SOS) project was devised to explore and improve attitudes, knowledge and skills for dealing with maternal sepsis (S) as an extension to a hospital wide whole systems approach to sepsis care2.
Methods. A multidisciplinary survey of labour suite staff. The 1st survey was conducted in May 2013, with the repeat in January 2014. Interventions carried out in the intervening periods included obstetric seminars, midwife study days and specific delivery of S teaching at doctors’ induction. Additionally posters, treatment stickers and S toolboxes were introduced into the obstetric clinical areas in line with the rest of the hospital.
Results. 50 surveys were issued at each survey, with a 100% response rate. Summarised results are in table1. Performance on the knowledge and treatment questions domains generally improved, however the number of responders confident in treating maternal S dropped by more than a third.
Discussion. Almost all responders knew of the 2011 Confidential Enquiries report, and were able to correctly identify S as the leading direct cause of maternal death, however a significant proportion of responders were not aware of the SOS campaign, nor were they aware they had previously encountered patients with S. Expectedly performance in the survey improved after the educational interventions. Use of posters, treatment stickers and S toolboxes were multipurpose aiming to improve publicity with novel visual and environmental aids, and to act as triggers to examine for and standardise care towards obstetric patients with S. The number of responders confident in dealing with severe S dropped after the intervention period, and it is speculated that the reason for this is increased insight into the nature of severe S in the obstetric population.
This initial study has shown promising improvement using techniques translated from a hospital wide strategy to improve care of patients with severe sepsis when applied to the obstetric population.
1. Wilkinson H. Saving mothers’ lives. Reviewing maternal deaths to make motherhood safer: 2006–2008. BJOG (2011); 118.11 (1402-1403).
2. Simmonds M et al Surviving sepsis beyond intensive care: a retrospective cohort study of compliance with the international guidelines. J Intensive Care Soc (2008):9 (124-127).