Table 2.

Composite example of steps involved in Sepsis Six, observed in fieldwork

1. Administer high flow oxygen  • Find a doctor, get oxygen prescribed  • Assess for COPD  • Gather together equipment  • Wash hands  • Explain the reason for the procedure & gain consent  • Administer O2 and check for comfort  • Document 2. Take blood cultures  • Find a doctor/nurse/phlebotomist who can take the bloods  • Gather the equipment  • Explain the procedure to the patient & gain consent  • Wash hands/gloves  • Carry out the procedure  • Leave the patient comfortable  • Send off the samples  • Document 3. Give IV antibiotics  • Find a doctor—get the antibiotics prescribed and check for any allergies  • Find a nurse with IV certificate, wash hands and prepare the medication  • Ensure the medication is checked by two nurses  • Gloves  • Take the medication to the patient with the drug record  • Explain the procedure and gain consent  • Check the patient’s identity at point of administration  • Administer the medication and observe for any adverse effects  • Document

4. Start IV fluid resuscitation  • Find a doctor/nurse who can cannulate, get IV access  • Gather equipment  • Wash hands  • Check the prescription and the fluids and set up the infusion  • Explain the procedure to the patient and gain consent  • Gloves  • Connect and commence the fluids  • Ensure patient comfort  • Remember the PVC care bundle 5. Measure serum lactate  • Find a doctor or a nurse who can take a venous lactate  • Gather equipment  • Wash hands/ Gloves  • Explain the procedure and gain consent  • Obtain the sample  • Ensure patient comfort  • Find a lactate machine  • Get the result, inform the doctor and document 6. Monitor urine output  • Explain why and ask the patient to pass urine  • Wash hands  • Assist them to the toilet/commode  • Help the patient back to bed, remember to save the sample!  • Wash hands/gloves  • Go back and get sample, measure it, test it and send off sample  • Find a fluid balance chart and record