Arulkumaran N, Singer M Puerperal sepsis. Best Pract Res Clin Obstet Gynaecol. 2013; 27:(6)893-902

Bamfo JEAK Managing the risks of sepsis in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013; 27:(4)583-95

Begley C, Elliott N, Lalor JG, Higgins A Perceived outcomes of research and audit activities of clinical specialists in Ireland. Clin Nurse Spec. 2015; 29:(2)100-11

Cimino JJ Review paper: coding systems in health care. Methods Inf Med. 1996; 35:(4–5)273-84

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb S, Beale RJ, Vincent JL, Moreno R Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012. Intensive Care Med. 2013; 39:(2)165-228

Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW, 4th edn. Oxford: Oxford University Press; 2015

Friedman LM, Furberg CD, Demets DL, Reboussin DM, Granger CB Data Collection and Quality Control, 5th edn. New York: Springer; 2015

Gray DE, 3rd edn. London: Sage Publications; 2013

Knight M, Tuffnell D, Kenyon S, Shakespeare J, Gray R, Kurinczuk KOxford: National Perinatal Epidemiology Unit; 2015

Moule P, Hek GLondon: Sage Publications; 2011

Paton JY, Ranmal R, Dudley J Clinical audit: still an important tool for improving healthcare. Arch Dis Child Educ Pract Ed. 2015; 100:(2)83-8

London: RCOG; 2012a

London: RCOG; 2012b

Ronsmans C, Graham WJ Maternal mortality: who, when, where, and why. Lancet. 2006; 368:(9542)1189-200

Singh S, McGlennan A, England A, Simons R A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS). Anaesthesia. 2012; 67:(1)12-18

Management of Acute Sepsis in Obstetric Patients.Chichester: Western Sussex Hospitals NHS Foundation Trust; 2013

Impact of a maternal sepsis training package on maternity staff compliance with Trust guidelines

02 February 2017
Volume 25 · Issue 2



Maternal sepsis is the leading cause of direct maternal death in the UK. Cost-effective training for staff is essential in providing safe, high-quality maternity care.


This project aimed to examine the impact of a maternal sepsis training package, provided during the period 1 April – 30 September 2013 (quarters 2–3), on maternity staff's compliance with the Trust's maternal sepsis guideline, as documented in maternity notes.


An audit was undertaken of the staff compliance rates for the Trust's maternal sepsis guideline (on which the training package is based) recorded in maternal notes during the period 1 January – 31 December 2013 (quarters 1–4). Data were analysed to investigate significance.


There was no statistically significant increase in compliance with the guideline from quarter 1 through to quarter 4.


Despite its limitations, this audit suggests the training has not had a significant impact on practice. When an initiative starts to deliver results that are not providing value for money, reassessing services in the interest of quality care must be the priority.

Maternal sepsis is now the leading cause of direct maternal death in the UK (Knight et al, 2015), as well as being a major cause of maternal death and morbidity worldwide (Bamfo, 2013). Arulkumaran and Singer (2013) report that there are more than five million new certified cases of maternal sepsis each year worldwide, with an estimated 62 000 deaths. Historically, it was one of the most prevalent causes of maternal death—known as puerperal fever or childbed fever—and was responsible for more than 50% of maternal deaths in Europe in the 18th and 19th centuries (Ronsmans et al, 2006).

In the UK, the maternal sepsis death rate has increased from 0.85 deaths per 100 000 in the years 2003–05 to 1.56 per 100 000 in the years 2009–13 (Knight et al, 2015). For this reason, a collaboration was established between the Royal College of Obstetricians and Gynaecologists (RCOG) and the Surviving Sepsis Campaign (Dellinger et al, 2013) to address the number of deaths through sepsis in the maternity population. Both organisations outline the need for education and the promotion of teaching an escalation approach as well as triggers and guidelines for intervention. The RCOG divides maternal sepsis into three categories: sepsis, severe sepsis and septic shock (Table 1).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month