However, infection remains an issue — the former Southern District Health Board ordered a review of patient care and infection prevention procedures last year, and a fortnight ago the Otago Daily Times reported on a new mother who contracted a nearly fatal case of sepsis at Dunedin Hospital earlier this year.
On Monday the commissioner released a report which found severe fault with the management of a woman who contracted sepsis while at Dunedin Hospital.
That report followed an equally scathing report issued by the commissioner in June when she reported adversely against the SDHB concerning its care in 2019 of a man in his 70s who was admitted with sepsis and later died.
The SDHB (now Te Whatu Ora Health New Zealand Southern) apologised for failing each patient and made changes to its systems.
Chief medical officer David Gow said a senior medical officer had made a presentation to surgical ward nurses on sepsis recognition, an intensive care clinical nurse specialist had provided a further education session to staff on the deteriorating patient focusing on sepsis, and that all ward nursing staff were now required to undertake further training on monitoring deteriorating patients.
In December last year, the SDHB decided to review patient care procedures after a rise in infections and other complications.
A report to the board showed Dunedin and Invercargill hospitals were among the poorest-performing DHBs for all hospital-acquired complications, healthcare-associated infections and medication complications, including sepsis.
At Dunedin 148 infection incidents per 10,000 episodes of care were reported against a benchmark three-year average of 97, while at Invercargill 114 were recorded against a benchmark average of 77.
At Dunedin Hospital, 4.7% of admitted patients suffered a major hospital-acquired complication, against 3.4% of patients for peer hospitals across Australasia, while Invercargill was in line with other hospitals.
The Health Quality and Safety Commission recently released a national stocktake of sepsis management which found 1% of people were affected with sepsis annually, and that from 2015-20 the Accident Compensation Corporation accepted 1250 treatment injury claims for sepsis, at a total cost of $5.9 million.
A national sepsis plan was released a year ago but the commission suspected that there was "significant variation" in how the infection was managed in New Zealand health care facilities and hospitals.
A survey of clinicians, mostly from public hospitals, found varying degrees of auditing practices for sepsis, multiple different methods of trying to prevent infection, and patchy use of sepsis risk management tools. Some departments did not use them at all.
"There are pockets of good work occurring, with unique organisation-led initiatives supporting the response to sepsis, but these are often not implemented widely, or systematically," the stocktake said.
"The current health reforms provide an opportunity to standardise and streamline the response to sepsis regionally, and nationally where appropriate, with national guidance and facilitation of these efforts representing a good starting place."
