Abrashkin KA, Poku A, Ramjit A Community paramedics treat high acuity conditions in the home: a prospective observational study. BMJ Support Palliat Care. 2019; 0:1-8

Allen G. Think, could this be sepsis?. InnovAiT. 2018; 11:(10)576-582

Bain H, Moggach A. Supporting the district nurse to consolidate advanced clinical skills. Br J Community Nurs. 2019; 24:(4)

Baker E, Facultad JL, Slade H, Lee G. A new tool to measure acuity in the community: a case study. Br J Community Nurs. 2021; 26:(10)482-492

Brangan E, Banks J, Brant H, Pullyblank A, Le Roux H, Redwood S. Using the National Early Warning Score (NEWS) outside acute hospital settings: a qualitative study of staff experiences in the West of England. BMJ Open. 2018; 8:(10)

Burdick H, Pino E, Gabel-Comeau D Effect of a sepsis prediction algorithm on patient mortality, length of stay and readmission: a prospective multicentre clinical outcomes evaluation of real-world patient data from US hospitals. BMJ Health Care Inform. 2020; 27:(1)

Dondorp AM, Dünser MW, Schultz MJ. Sepsis management in resource-limited settings, 1st ed. Cham: Springer; 2019

Edward PJ, Ridd MJ, Sanderson E, Barnes RK. Safety netting in routine primary care consultations: an observational study using video-recorded UK consultations. Br J Gen Pract. 2019; 69:(689)e878-e886

Edwards PJ, Bennett-Britton I, Ridd MJ, Booker M, Barnes RK. Factors affecting the documentation of spoken safety-netting advice in routine GP consultations: a cross-sectional study. Br J Gen Pract. 2021; 71:(712)e869-e876

Feist B. Screening for sepsis: SIRS or qSOFA? A literature review. Emerg Nurse. 2019; 27:(6)13-18

Floer M, Ziegler M, Lenkewitz B, Auer A, Meister T. Out-of-hospital sepsis recognition by paramedics improves the course of disease and mortality: a single center retrospective study. Adv Clin Exp Med. 2021; 30:(11)1115-1125

Hantrakun V, Somayaji R, Teparrukkul P, Boonsri C, Rudd K, Day NPJ, West TE, Limmathurotsakul D. Clinical epidemiology and outcomes of community acquired infection and sepsis among hospitalized patients in a resource limited setting in Northeast Thailand: a prospective observational study (Ubon-sepsis). PLoS One. 2018; 13:(9)

Hunt A. Sepsis: an overview of the signs, symptoms, diagnosis, treatment and pathophysiology. Emerg Nurse. 2019; 27:(5)32-41

Husabø G, Nilsen RM, Flaatten H Early diagnosis of sepsis in emergency departments, time to treatment, and association with mortality: an observational study. PLoS One. 2021; 16:(3)

Inada-Kim M, Knight T, Sullivan M The prognostic value of national early warning scores (NEWS) during transfer of care from community settings to hospital: a retrospective service evaluation. BJGP Open. 2020; 4:(2)

Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010; 304:(16)1787-1794

Iwashyna TJ, Cooke CR, Wunsch H, Kahn JM. Population burden of long-term survivorship after severe sepsis in older Americans. J Am Geriatr Soc. 2012; 60:(6)1070-1077

Jabaley CS, Blum JM, Groff RF, O'Reilly-Shah VN. Global trends in the awareness of sepsis: insights from search engine data between 2012 and 2017. Crit Care. 2018; 22:(1)

Kabi A, Mohanty A, Kumar SK, Singh V, Jha MK, Gupta P. Clinical spectrum and risk factors for hospital-acquired septicemia in a tertiary care centre of North-East India. J Family Med Prim Care. 2020; 9:(8)3949-3954

Kim HI, Park S. Sepsis: early recognition and optimized treatment. Tuberc Respir Dis (Seoul). 2019; 82:(1)6-14

Kopczynska M, Sharif B, Cleaver S Red-flag sepsis and SOFA identifies different patient population at risk of sepsis-related deaths on the general ward. Medicine (Baltimore). 2018; 97:(49)

Lin Y. Effectiveness of the sepsis six bundle in the management of acute adult sepsis in the UK. Emerg Nurse. 2021; 29:(2)26-29

Marshall H, Sprung S. Community nurse's knowledge, confidence and experience of the Mental Capacity Act in practice. Br J Community Nurs. 2016; 21:(12)615-622

Massey D, Chaboyer W, Anderson V. What factors influence ward nurses' recognition of and response to patient deterioration? An integrative review of the literature. Nurs Open. 2017; 4:(1)6-23

Mulders MCF, Loots FJ, van Nieuwenhoven J, Ter Maaten JC, Bouma HR. Use of sepsis-related diagnostic criteria in primary care: a survey among general practitioners. Fam Pract. 2021; 38:(5)617-622

National Confidential Enquiry into Patient Outcome and Death. Just say sepsis! A review of the process of care received by patients with sepsis. 2015. (accessed: 29/11/2021)

Olander A, Bremer A, Sundler AJ, Hagiwara MA, Andersson H. Assessment of patients with suspected sepsis in ambulance services: a qualitative interview study. BMC Emerg Med. 2021; 21:(1)

Prescott HC, Angus DC. Enhancing recovery from sepsis: a review. JAMA. 2018; 319:(1)62-75

Pullyblank A, Tavaré A, Little H, Redfern E, le Roux H, Inada-Kim M, Cheema K, Cook A. Implementation of the National Early Warning Score in patients with suspicion of sepsis: evaluation of a system-wide quality improvement project. Br J Gen Pract. 2020; 70:(695)e381-e388

Raleigh M, Allan H. A qualitative study of advanced nurse practitioners' use of physical assessment skills in the community: shifting skills across professional boundaries. J Clin Nurs. 2017; 26:(13-14)2025-2035

Rudd KE, Johnson SC, Agesa KM Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet. 2020; 395:(10219)200-211

Rumbus Z, Matics R, Hegyi P Fever is associated with reduced, hypothermia with increased mortality in septic patients: a meta-analysis of clinical trials. PLoS One. 2017; 12:(1)

Schroeder K, Chan W, Fahey T. Recognizing red flags in general practice. InnovAiT. 2011; 4:(3)

Scott HF, Greenwald EE, Bajaj L, Deakyne Davies SJ, Brou L, Kempe A. The sensitivity of clinician diagnosis of sepsis in tertiary and community-based emergency settings. J Pediatr. 2018; 195:220-227.e1

Singer M, Deutschman CS, Seymour CW The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016; 315:(8)801-810

Torsvik M, Gustad LT, Mehl A, Bangstad IL, Vinje LJ, Damås JK, Solligård E. Early identification of sepsis in hospital inpatients by ward nurses increases 30-day survival. Crit Care. 2016; 20:(1)

Tucker G, Lusher A. The use of early warning scores to recognise and respond to patient deterioration in district nursing. Br J Community Nurs. 2018; 23:(2)76-79

Vincent JL. The clinical challenge of sepsis identification and monitoring. PLoS Med. 2016; 13:(5)

Wiewel MA, Harmon MB, van Vught LA Risk factors, host response and outcome of hypothermic sepsis. Crit Care. 2016; 20:(1)

Improving sepsis recognition through use of the Sepsis Trust's community screening tool

02 February 2022
Volume 27 · Issue 2


Sepsis is associated with high levels of morbidity and mortality. All healthcare professionals have a responsibility to ensure they have sufficient knowledge to effectively screen patients for signs and symptoms of sepsis. In the community setting, screening for sepsis can be challenging, due to the complexity within the patient population and difficulties associated with observation for changes in the patient's condition. The Sepsis Trust community nursing sepsis screening tool provides decision-making support to community healthcare professionals, enabling them to make a rapid assessment for risk factors for sepsis, ensuring a proportionate, consistent and appropriate response. Through implementation of a decision-support tool within the clinical setting, it is likely that patients at risk of sepsis will be identified earlier, and patients will be escalated in a more consistent manner. This process of improving consistency in practice can improve patient outcomes, including mortality, morbidity and overall patient experience.

Sepsis remains a significant cause of morbidity and mortality across all high-, middle- and low-income countries despite increasing education for healthcare professionals and growing awareness from the public (Hantrakun et al, 2018; Jabaley et al, 2018; Dondorp et al, 2019; Rudd et al, 2020). Sepsis is defined as a dysregulated host response to an infection, which is mediated by the immune system, causing a physiological cascade that results in organ dysfunction, multi-organ failure and potential death (Singer et al, 2016; Feist, 2019; Kim and Park, 2019). Septic shock is a term that describes a later stage in this physiological cascade, whereby there is profound circulatory, cellular and metabolic abnormality, which is associated with increased subsequent mortality rates. Patients with sepsis often have acute and critical care needs and, therefore, require definite treatment and monitoring within the acute secondary care setting (Singer et al, 2016; Hunt, 2019; Lin, 2021).

Register now to continue reading

Thank you for visiting Community Nursing and reading some of our peer-reviewed resources for district and community nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month