A new audit tool enabling practices to audit their management of feverish illness in children under five is now freely available to all PRIMIS Hub members.
The Feverish Illness in Children under Five audit tool has been developed by PRIMIS and delivered in partnership with NHS England.
This new audit tool enables practices to review their clinical management of young children presenting with a fever. It will help to increase the use of the traffic light system for identifying risk of serious illness recommended by NICE, leading to improvements in care, better identification of those at risk of serious infection and improved assessment of cases for admission.
NICE guidance (CG160) recommends measuring temperature, heart rate, respiratory rate and capillary refill rate as part of the routine assessment. This audit tool highlights the presence (or otherwise) of these key criteria and provides an easy-to-read visual dashboard of results, which can be broken down by clinician or for the practice.
Early use of this audit tool has also identified medico-legal benefits to practices. One early adopter practice commented:
“A complaint was raised in practice by a concerned parent that a child presenting with a fever was not taken seriously enough during consultation. This audit tool allowed us to review and confirm that the GP had recorded every one of the recommended procedures outlined in the NICE guidelines and so we were able to reassure the parent that the GP had taken the child’s symptoms very seriously.”
In addition to the audit tool, GP system supplier templates are available to support data capture and improve the quality of patient records. Uploading data to CHART Online allows GPs to benchmark their practice and work collaboratively as part of a whole systems approach to better management of feverish illness and sepsis.
This audit tool was developed as one part of NHS England’s commitment to improve outcomes for patients with sepsis. This includes helping practices to audit and improve their management of feverish illness, as it can be a precursor to sepsis. It is an important part of NHS England's cross system action plan 'Improving outcomes for patients with sepsis', which was published in December 2015.
Sepsis is a common and potentially life-threatening condition where the body’s immune system goes into overdrive in response to an infection, setting off a series of reactions that can lead to widespread inflammation, swelling and blood clotting. This can lead to a significant decrease in blood pressure, which can mean the blood supply to vital organs such as the brain, heart and kidneys is reduced. Estimates suggest around 37,000 deaths are associated with sepsis each year.
Many people develop sepsis outside of secondary care, so it is vital that clinicians across all care settings can recognise the symptoms that can lead to sepsis and respond quickly.
Feverish illness is a common occurrence in young children, often signalling an underlying infection. It is frequently a cause for concern for parents and carers and infections remain the leading cause of death in children under the age of five years. In most cases the illness is due to a self-limiting viral infection however fever can also indicate serious bacterial infections such as sepsis.
This audit tool is free to use for any practice that is a member of the PRIMIS Hub membership scheme, including free basic membership.
Please sign up for basic Hub membership or find out details about the benefits of full (subscription) Hub membership.
Please first visit the PRIMIS Hub to request access, view and sign the Data Sharing Agreement and then the audit tool will become available for your use in 'Check for Updates' within CHART.
Go to the Feverish Illness request page (you will need to log in to Hub)
Applied Health Research Building University Park University of Nottingham Nottingham, NG7 2RD