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'Never again': New guidelines introduced after Savita's tragic death

An early warning system in maternity hospitals is to be standardised.

THE DEATH OF Savita Halappanavar and other people in Irish hospitals has led to the introduction of new guidelines.

The Minister for Health, Leo Varadkar, launched three new National Clinical Guidelines today. The three guidelines were recommended by HIQA following the tragic death of Ms Halappanavar.

  • Two of the guidelines promote safety and higher standards in maternity hospitals through standardising an early warning system and clinical handover communication tools.
  • These assist the early identification of deterioration and on-going monitoring of the woman’s condition.
  • The third guideline specifically aims to tackle sepsis for all patients, both adults and children, in the emergency department and in hospital wards.

“I think that the case of Savita Halappanavar and her unnecessary death does show us exactly what happens when sepsis is not detected soon enough and treated soon enough, and the experience of that case and unfortunately other cases too did feed into these guidelines,” Varadkar told reporters at the launch.


Savita Halappanavar vigil Niall Carson Niall Carson

The guidelines were commissioned by the National Clinical Effectiveness Committee (NCEC) working in partnership with the HSE Clinical Programmes, expert clinicians, regulatory bodies, postgraduate training bodies, private hospitals and patients.

They are based on “best available research and are developed using an internationally recognised process”.

The guidelines are to be used “in conjunction with clinical judgement and patient preference when making decisions about what is appropriate for each patient or population of patients”.

The three guidelines being launched today were quality assured by NCEC and were subject to international peer review.

Varadkar noted that sepsis is the 10th leading cause of death worldwide. He said that “the management of severe sepsis and septic shock are considered a time-dependent medical emergency”.

Patient representative Linda Dillon said:

For the loved ones of any patient that has passed away from sepsis to now know that with the National Clinical Guideline – Sepsis Management in place there will be a greater chance of early pick up and therefore recovery will, I am sure, bring great comfort.

Early Warning System

The Irish Maternity Early Warning System (IMEWS) is a standardised bedside tool developed for use in maternity care to assess “basic maternal physiological parameters”.

  • It is used to assist in the identification of women with developing, established or deteriorating critical illness.
  • It prompts frontline clinical staff to request a medical review at specific trigger points

The clinical handover guideline provides a structured communication tool to promote standardisation of clinical handover practice.

The three guidelines form part of a suite of National Clinical Guidelines published by the Department of Health and are mandated for implementation across the entire Irish health service.

The Minister for Health said that the “whole point of national standards is to raise everyone up to the highest standards”.

And we’ve already seen in some hospitals where the implementation of the early warning score has resulted in a decrease of people actually getting a cardiac arrest while they were in hospital, so this is important stuff. It may seem very technical but actually it raises standards and saves lives.

Additional reporting by Hugh O’Connell

Originally published: 5.24pm

Read:Candlelight vigils will mark second anniversary of Savita’s death>

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