Sepsis pathways

The adult, maternal, neonatal and paediatric sepsis pathways support clinicians to identify sepsis risk factors, signs and symptoms, escalate to a senior clinician and commence treatment rapidly. They align with the Between the Flags (BTF) Standard Observation Charts and are integral to the NSW Deteriorating Patient Safety Net System.

What's new?

The sepsis pathways have been revised (February 2024) to align with the national Sepsis Clinical Care Standard and current evidence-based guidelines.

The CEC is holding a number of webinars to support the use of the updated pathways and invites NSW Health clinicians to register.

Improvements were recommended by NSW clinicians and expert working groups and overseen by a Sepsis Pathway Expert Advisory Group. A statewide consultation process with the Local Health Districts and Specialty Health Networks was conducted prior to release.

The CEC is collaborating with eHealth to make the pathways accessible in the eMR and a digital sepsis solution will be developed in the Single Digital Patient Record.

Adult: use for patients 16 years or older in any clinical setting
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Maternal: use for all pregnant women and up to six weeks post pregnancy, including any perinatal loss, in any
clinical setting
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Neonatal: use for neonates (babies up to 28 days corrected age) in any
clinical setting
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Paediatric: use for patients from 28 days corrected age to 16 years in any clinical setting
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The CEC can provide permission to non-NSW or private health service organisations to use the sepsis pathways under copyright. All requests require completion of a formal copyright request form.

NSW Health staff can order and print forms via Finsbury Green and more information is available on the NSW Health sharepoint site.

CatalogueDescription NSW Health Reference Unit of issue
NH700131 Paediatric Sepsis Pathway (For babies from 28 days corrected age and children up to 16 years) SMR060.399 Pad x 100
NH700066 Adult Sepsis Pathway (For patients 16 years and older) SMR060.400 Pad x 100
NH700107 Maternal Sepsis Pathway (For pregnant women and up to six weeks post-pregnancy, including any perinatal loss) SMR060.402 Pad x 100
NH700108 Neonatal Sepsis Pathway (For babies up to 28 days corrected age) SMR060.403 Pad x 100

Implementation resources

Resources are available to support local implementation of the revised pathways:

The Sepsis toolkit provides information, resources and quality improvement tools for managers and clinicians to improve sepsis care in NSW health services. The toolkit uses general improvement principles that can be applied to any of the sepsis pathways and the resources can be adapted locally for pathway implementation or to review and improve current practice.

Clinician resources

Clinician resources which can be used in conjunction with the sepsis pathways.

Neonatal Early-Onset Sepsis Calculator

The Neonatal Early-Onset Sepsis Calculator can be used by clinicians to calculate the risk of early-onset sepsis in babies < 24 hours old AND ≥ 34 weeks gestation.

Emergency care assessment and treatment protocols

Emergency Care Assessment and Treatment (ECAT) Sepsis protocols (Adult and Paediatric) were developed by the Emergency Care Institute to support nurses to initiate emergency care according to scope of practice.

Antimicrobial guidance

Guidance on antimicrobial therapy for patients with suspected or confirmed sepsis is available:

Blood culture guidance

Select the relevant blood culture guidance for determining when and how to take blood cultures:

Adult
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Neonatal
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Paediatric
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Lactate information sheet

Lactate is a non-specific marker of illness severity in acutely ill patients. Lactate levels greater than 2mmol/L are significant in sepsis (excluding neonates). For more information see the Lactate in the Deteriorating Patient information sheet and video.

Improving sepsis management

Further develop your sepsis awareness and knowledge by engaging with resources on the sepsis education page.  Or you can contact us at CEC-sepsis@health.nsw.gov.au