11 February 2019

A team of white coats at Shropshire’s two acute hospitals have streamlined their work to ensure patients are given the most effective antibiotics at the earliest opportunity.

The behind-the-scenes work is proving particularly effective in The Shrewsbury and Telford Hospital NHS Trust’s (SaTH) fight against sepsis as it is now possible for patients to receive specially-targeted antibiotics within as little as eight hours of scientists receiving a blood culture.

Sepsis is the immune system’s overreaction to an infection or injury. Normally a person’s immune system fights infection – but sometimes, for reasons we don’t yet understand, it attacks the body’s organs and tissues. If not treated immediately, sepsis can result in organ failure and death. Yet with early diagnosis, it can be treated with antibiotics.

Through its partnership with the Virginia Mason Institute – the USA’s ‘Hospital of the Decade’ – SaTH is doing a major piece of work to increase awareness of sepsis and ensure patients diagnosed with the infection are given a bundle of antibiotics within the all-important ‘golden hour’.

Alan Jackson, Head Biomedical Scientist at SaTH, said: “This ‘scatter-gun’ approach is vital as statistics show that 90% of patients given the bundle of antibiotics within one hour will survive, compared to 50% of patients who receive the antibiotics after a five hour delay.

“The introduction of new tools to help doctors and nurses diagnose sepsis earlier and administer antibiotics within an hour is brilliant and will save lives, so what we have been doing is looking at the next step. We want to we get patients off their bundle of antibiotics as quickly as possible and onto just one targeted antibiotic. This is the most efficient way to stop the infection.”

Karen Gibson, Senior Specialist Biomedical Scientist, has been leading the work within pathology, which has seen the introduction of new state-of-the-art machines in a partnership working between all grades of pathology staff.

Karen Gibson

She said: “We have changed the blood culture bottles to plastic so staff on the ward can use the air tube system at the Royal Shrewsbury Hospital (RSH) and the Princess Royal Hospital (PRH) so staff on the wards can get them delivered quickly to the laboratory.

We’ve had a few issues with this system in the past but we have worked closely with the teams on the ‘shop floor’ to resolve these, meaning we are now getting more than 90% of the bottles onto a Blood Analyser Machine within the four-hour target.

“The Blood Analyser is an incredible machine and we are fortunate enough to now have three of them, so we can look at 480 samples a day. The machines take a reading of a sample every 20 minutes and can detect growth after a minimum of 12 readings (four hours).

“When the machines flag a positive reading it sets off an alarm. The organisms in the blood culture are grown and the sample is then placed in another piece of equipment – a bacteria identification machine – which within 20 minutes tells us which organism is causing the infection.”

Our new Blood Analyser Machines are kept in the reception area of the Pathology Departments at RSH and PRH, making them easily accessible, cutting out delays and allowing our Blood Sciences Team, who work 24-hours-a-day, to upload cultures for examination during traditional out-of-hours working time.”

Alan Jackson added: “We are extremely grateful to the Blood Sciences team for taking on this extra workload. It has had a hugely positive impact as it means we are able to get the right antibiotic administered into patients at the earliest opportunity.”