Aim of the Course

This course aims to strengthen nurses’ ability to recognise suspected sepsis, evaluate the risk of severe illness, initiate an appropriate structured response and escalate without avoidable delay.

It develops clinical reasoning beyond simple screening by examining atypical presentation, organ dysfunction, physiological trends, high-risk groups, diagnostic uncertainty, treatment priorities and ongoing reassessment.

The course also reinforces antimicrobial stewardship: urgent treatment must not be delayed in people at high risk, but antibiotics should not be given indiscriminately whenever infection is suspected.

Scope of the Course

This course is suitable for:

1. Registered adult nurses
2. Registered nursing associates, within their scope of practice
3. Nurses working in care homes and nursing homes
4. Community and primary-care nurses
5. Hospital and urgent-care nurses
6. Nurses supporting adults with complex comorbidities
7. Clinical educators and practice assessors
8. Senior nurses responsible for deterioration pathways

The primary clinical focus is adults aged 16 or over who are not pregnant and have not recently been pregnant. Paediatric, maternity and neonatal sepsis require population-specific pathways and guidance.

This course does not independently establish competence to:

1. Diagnose sepsis
2. Prescribe or independently select antimicrobial treatment
3. Cannulate or obtain blood cultures
4. Interpret blood gases or laboratory results
5. Administer intravenous antibiotics or fluid boluses
6. Initiate oxygen therapy outside an authorised pathway
7. Undertake advanced clinical assessment or treatment

These activities require appropriate professional authority, practical training, local authorisation, equipment competence and workplace assessment.

Nurses must follow current NICE guidance, local antimicrobial policy, approved sepsis and deterioration pathways, escalation arrangements and their professional scope of practice.

What This Course Covers

The course covers:

1. Contemporary understanding of sepsis
2. Infection, sepsis, organ dysfunction and septic shock
3. Sources of infection and risk factors
4. Atypical and non-specific presentations
5. Structured ABCDE assessment
6. Complete physiological observations
7. NEWS2 application and limitations
8. Baseline, trends and clinical concern
9. Indicators of hypoperfusion and organ dysfunction
10. Respiratory, cardiovascular and neurological deterioration
11. Acute kidney injury and urine-output changes
12. Lactate, blood gases and laboratory investigations
13. Blood cultures and microbiological sampling
14. Risk stratification across different care settings
15. Immediate escalation and emergency transfer
16. Oxygen, antimicrobials and intravenous fluids
17. Source identification and source control
18. Antimicrobial stewardship
19. Sepsis mimics and diagnostic uncertainty
20. High-risk and clinically vulnerable groups
21. Treatment response and repeated reassessment
22. Communication, documentation and handover
23. Human factors, delayed recognition and safety-netting
24. Post-sepsis needs and learning from incidents

Learning Outcomes

By the end of the course, learners should be able to:

1. Define sepsis accurately and distinguish it from uncomplicated infection.
2. Explain how infection can contribute to organ dysfunction and shock.
3. Identify common and less obvious sources of infection.
4. Recognise factors increasing vulnerability to sepsis.
5. Identify atypical presentations in older or clinically vulnerable adults.
6. Conduct a structured ABCDE assessment within their competence.
7. Recognise respiratory, cardiovascular, neurological and renal dysfunction.
8. Identify clinical indicators of impaired perfusion.
9. Obtain and interpret complete physiological observations appropriately.
10. Calculate NEWS2 accurately where trained and authorised.
11. Explain why NEWS2 does not diagnose or exclude sepsis.
12. Integrate physiological trends, baseline information and clinical concern.
13. Apply the appropriate sepsis-risk pathway for the care setting.
14. Explain the significance and limitations of lactate measurement.
15. Describe the purpose of cultures and other initial investigations.
16. Prioritise immediate nursing actions for suspected sepsis.
17. Escalate high-risk presentations without avoidable delay.
18. Explain safe principles for oxygen administration.
19. Describe current principles governing timely antimicrobial treatment.
20. Apply antimicrobial-stewardship safeguards during urgent care.
21. Identify risks associated with intravenous fluid administration.
22. Monitor and evaluate the person’s response to treatment.
23. Recognise when deterioration or failure to improve requires further escalation.
24. Consider alternative or coexisting diagnoses.
25. Provide a concise structured clinical handover.
26. Document assessment, treatment, escalation and reassessment accurately.
27. Recognise human factors that contribute to delayed sepsis care.
28. Support appropriate post-sepsis communication and follow-up.
29. Work within professional competence and local clinical governance.
30. Explain why course completion does not confer practical clinical competence.

Further Reading and References

1. NICE NG253: Suspected sepsis in people aged 16 or over — the current NICE guideline for recognising, evaluating and managing suspected sepsis in non-pregnant people aged 16 or over; it replaced NG51 in November 2025.
2. Royal College of Physicians: National Early Warning Score 2 — the authoritative NEWS2 report, charts and supporting implementation resources.
3. Resuscitation Council UK: The ABCDE Approach — structured guidance for assessing deteriorating or critically ill people, addressing immediate threats and reassessing treatment response.
4. NHS England: Managing acute physical deterioration through the PIER approach — a system-wide framework covering prevention, identification, escalation and response to deterioration