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 despite advances in healthcare, 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.
Due to the diagnostic challenge associated with identifying the root cause of such illness, NICE guidance (CG160) recommends measuring temperature, heart rate, respiratory rate and capillary refill rate as part of the routine assessment.
This quality improvement 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.
The tool will identify all children in the practice under the age of five who have presented with a feverish illness in the past three months. Clinicians will then be able to quickly identify compliance with NICE guidance, opportunities for improvement and examine individual patient cases where desired.
In addition to the quality improvement 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 quality improvement 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 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.
Please contact PRIMIS if you wish to discuss obtaining this tool
GRASP-Fever quick guide
Any CCG (only) staff who require access to the CCG comparative report in CHART Online for any PRIMIS' tools should complete and submit the form on the following page:
CCG request access to COL
This tool includes the option to upload data to CHART Online. This allows GP practices and CCGs to compare and benchmark practice data both locally and nationally.
"A complaint was raised in practice by a concerned parent that a child presenting with a fever was not taken seriously enough during consultant. This tool allowed us to review and confirm that the GP had recorded every one of the recommended procedures lain out in the NICE guidelines and so we were able to reassure the parent that the GP had taken the child’s symptoms very seriously"
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