Communication, handover and documentation

Clear communication can change the outcome. Clinicians and call handlers need to know the numbers and what has changed from the resident's normal presentation.

Information to have ready

• Situation: why you are worried now and whether you suspect sepsis.
• Baseline: how the resident normally communicates, moves, eats, drinks, urinates, breathes and behaves.
• Change: what is different, when it started, whether it is worsening and what family or staff have noticed.
• Possible infection source: cough, urine, catheter, wound, pressure ulcer, skin infection, abdomen, recent surgery or recent hospital stay.
• Observations: temperature, pulse, breathing rate, blood pressure, oxygen saturation, alertness, urine output and any local score if available.
• Risks: age, frailty, immunosuppression, cancer treatment, steroids, diabetes, chronic lung disease, catheter, wounds, allergies and current medicines if known.
• Plans: advance care plan, treatment escalation plan, DNACPR decision, best-interests decision or family contact arrangements.
• Action: what has already been done, who has been informed and what you need now.

SBARD can structure the call: Situation, Background, Assessment, Recommendation and Decision. Even if your service uses a different format, be concise, factual and clear about urgency.

Good escalation says what changed, why it worries you, what you have found and what help is needed now.