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Patient safety and medicines
Sepsis and the Deteriorating Patient
Recognising, escalating and treating sepsis early in hospitals, primary care and the community in Aotearoa New Zealand
- 3hours (estimated)
- 10sections
- 20final questions
- 80%pass mark
- PDFcertificate
- Online and self-paced, on any device
- Reflective account template
- Knowledge checks in every section
- Instant certificate of completion
What you will learn
- Define sepsis and septic shock using the definitions in the national clinical guide, and explain why sepsis is time-critical.
- Describe the burden of sepsis in Aotearoa, including the higher risk for Māori and Pacific peoples, and the obligations this creates under Te Tiriti o Waitangi and the Code of Rights.
- Use NZEWS, MEWS and PEWS correctly, including red and blue zones, mandatory escalation, worry as a trigger and complete observation sets.
- Apply the Raise the Flag hospital and community sepsis pathways, including the screening question, red and amber flags, the Sepsis Six within one hour and reassessment.
- Recognise the common thinking traps behind missed sepsis, such as reliance on fever, attribution to other causes and normalising abnormal results.
- Escalate a patient with suspected sepsis clearly and persistently, including making a rapid response call yourself when a pathway requires it.
- Treat whānau concern as clinical information, use Kōrero mai, and give culturally safe information about sepsis during care and at discharge.
- Manage suspected sepsis and meningococcal disease safely in primary care, telephone triage, rural hospitals and during transfer.
- Explain how the Health and Disability Commissioner, responsible authorities and the Director of Proceedings respond to sepsis-related failures by individuals and organisations.
- Build a reflective account and remediation plan that shows insight into a sepsis or deterioration concern in your own practice.
Who this course is for
Doctors, nurses, midwives, paramedics, pharmacists, dental practitioners and allied health practitioners registered under the HPCA Act 2003, working in hospitals, general practice, urgent care, rural health services, aged residential care or telephone triage.
Doctors (MCNZ) Nurses (Nursing Council) Midwives (Midwifery Council) Dental professions (Dental Council) Pharmacists (Pharmacy Council) Other HPCA Act professions
After a concern
Structured learning and a written reflection to show insight after a complaint, an investigation or a responsible authority inquiry.
Routine CPD
Focused learning on a core standard of practice, with a certificate and reflection for your portfolio.
About this course
This course teaches health practitioners in New Zealand how to recognise sepsis and clinical deterioration early and act on it without delay. It works through the national tools you use every day: the adult vital signs chart with the New Zealand Early Warning Score (NZEWS), the maternity and paediatric early warning systems (MEWS and PEWS), Kōrero mai patient, family and whānau escalation, and the Raise the Flag national sepsis pathways released by Te Tāhū Hauora Health Quality & Safety Commission and Sepsis Trust NZ in 2025, including the Sepsis Six bundle and the community and pre-hospital pathways.
It is written for doctors, nurses, midwives, paramedics, pharmacists, dental practitioners and allied health practitioners registered under the Health Practitioners Competence Assurance Act 2003, in hospitals, general practice, urgent care, rural health centres, aged residential care and on the telephone. It focuses on the thinking traps behind missed sepsis: waiting for a fever, explaining away abnormal vital signs, incomplete observations, mandatory escalations that are not made, antibiotics held back for tests, and whānau concerns that are not heard.
Missed and delayed sepsis is one of the most common themes in Health and Disability Commissioner opinions about deterioration, and Māori and Pacific peoples carry a heavier burden of the disease. The course analyses real HDC decisions about afebrile neutropenic sepsis, urosepsis, a child with pneumococcal septicaemia, meningococcal disease in a student and a toddler, and patients whose early warning scores reached the highest band without a rapid response call. It shows what the Commissioner, the responsible authorities and the Director of Proceedings did with these cases, and how a practitioner can show insight and lasting change if a concern about sepsis care is raised about them.
Course details
- Learning time
- Approximately 3 hours (estimated learning time including knowledge checks, reflection and assessment)
- Standards covered
- Code of Health and Disability Services Consumers' Rights (Rights 4, 5 and 6); Te Tāhū Hauora patient deterioration programme (adult vital signs chart and NZEWS, maternity early warning system, paediatric early warning system, Kōrero mai patient, family and whānau escalation); Raise the Flag national sepsis pathways and Clinical guide to sepsis management (September 2025); community and pre-hospital sepsis pathways; Immunisation Handbook guidance on meningococcal disease; Healing, learning and improving from harm: National adverse events policy 2023; MCNZ Good medical practice; Nursing Council standards of competence (six pou); Midwifery Council Code of Conduct
- Format
- Self-paced, gated lessons with knowledge checks, case studies and reflection
- Assessment
- 20 scenario-based questions, 80% to pass (16 of 20)
- Outcome
- Certificate of completion and a written reflection for your CPD record
- Alignment
- Mapped to the Code of Rights, the clinical competence and communication standards of the Medical, Nursing, Midwifery, Paramedic, Pharmacy and Dental Councils, and Te Tāhū Hauora deterioration and sepsis programmes
Course curriculum
10 sections · 24 lessons · 3 hours (estimated) · 20-question final assessment
-
1Sepsis in Aotearoa: what it is and why it matters3 lessons
- What sepsis is, and why every hour counts
- The burden of sepsis in Aotearoa, and who carries it
- The legal and professional framework for sepsis care
-
2The national toolset: early warning systems and Raise the Flag3 lessons
- NZEWS and the adult vital signs chart
- MEWS and PEWS: maternity and children
- Raise the Flag: the national sepsis pathways
-
3Recognising sepsis at the bedside: the traps behind missed cases3 lessons
- Waiting for a fever: afebrile and atypical sepsis
- Explaining it away: attribution and anchoring
- Numbers that must not be ignored: results, blood pressure and incomplete sets
-
4Responding: mandatory escalation, the first hour and senior review3 lessons
- Mandatory escalation pathways and why they fail
- The first hour: delivering the Sepsis Six without delay
- Making the call: words that get a response
-
5Whānau concern, communication and life after sepsis3 lessons
- Whānau as a safety net: Kōrero mai and persistent concern
- Culturally safe communication about sepsis
- Discharge, safety-netting and recovery
-
6Beyond the ward: primary care, telephone triage, meningococcal disease and rural transfer3 lessons
- Sepsis in general practice, urgent care and the community
- Meningococcal disease and the telephone
- Rural hospitals, small units and transfer
-
7When sepsis care goes wrong: accountability, learning and insight3 lessons
- What happens after a missed or delayed sepsis diagnosis
- Individual and system responsibility in sepsis cases
- Showing insight and building a remediation plan
-
8Conclusion and key points1 lesson
- Conclusion and key points
-
9References and further reading1 lesson
- References and further reading
-
10Your reflective account1 lesson
- Your reflective account
Assessment and certificate
Final assessment
20scenario-based questions
- Pass mark 80%: 16 correct out of 20
- Knowledge checks in each section as you go
- Tests whether you can apply the standards, not recall a page
- Not passed yet? Review the sections and retake it
Certificate of completion
A certificate of completion for your learning portfolio.
- Your name, the course title and the estimated learning time (record the time you actually spend)
- Completion date and a unique certificate ID that can be verified
- Ready to download as a PDF as soon as you complete the course
Fitness To Practice
Certificate of Completion
This certifies that
Your Name
has successfully completed
Sepsis and the Deteriorating Patient
3hours (estimated)
Continuing professional development record — New Zealand
Your reflective account
The course includes a structured reflective account template: guided prompts to record what you learned, how you will apply it and how the change will show in your practice. It gives you written evidence of insight after a concern, and a ready record for your CPD portfolio.
Write it in your own words and leave out anything that could identify a patient, a colleague or a case. If you have an open complaint or case, talk to your adviser before reflecting on it in writing.
Questions about this course
Does the sepsis course use the Raise the Flag pathways?
Yes. It covers the 2025 national sepsis pathways for hospital and community care, published by Te Tāhū Hauora and Sepsis Trust NZ, including the screening question, red and amber flags, the Sepsis Six within one hour and reassessment. Worked cases show the pathway applied in an emergency department and on a general ward.
What thinking traps lead to missed sepsis?
Holding out for a fever, rationalising abnormal vital signs, partial sets of observations, required escalations that never happen, antibiotics delayed while tests are awaited, and whānau worries that go unheard. The course uses real HDC decisions to show each trap and the habit that counters it.
Is the sepsis course relevant outside hospital?
Yes. A full section covers primary care, telephone triage, meningococcal disease, rural hospitals and transfer, and the course suits every regulated profession that might meet a deteriorating patient, from GPs and nurses to paramedics, pharmacists and dental teams, in every setting including aged residential care. The same thinking traps appear in every setting.
How does the course cover early warning scores?
It teaches correct use of NZEWS for adults, MEWS in maternity and PEWS for children, including red and blue zones, mandatory escalation, worry as a trigger, complete observation sets and making a rapid response call yourself when a pathway requires it.
Is this sepsis course a clinical certification?
No. It gives 3 hours (estimated), a 20-question test and a certificate for NZ$139.
How this course was built
Official sources only
Every legal and regulatory point comes from primary sources: the HPCA Act 2003, the responsible authorities' standards and the Code of Health and Disability Services Consumers' Rights. Anything we cannot confirm is left out.
Original, edition by edition
Lessons, scenarios and assessment questions are written by us for each edition separately, then checked for accuracy, teaching quality and fair assessment before publication.
Reviewed when rules change
When a code, standard or law changes, the affected courses are reviewed and updated. Reported errors in legal or regulatory facts are corrected first.
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