Preventing Sepsis in Aged Care: A Daily Checklist Every Care Team Can Use

Sepsis develops when the body's immune response to an infection begins to damage its own tissues and organs. It can progress from a minor infection to a life-threatening emergency in hours, not days. Sepsis is a high-risk condition and one of the most serious complications of infection in older residents. While not every case can be prevented, many of the infections that lead to sepsis can be reduced through effective infection prevention, early recognition, and timely escalation.

This blog is for IPC Leads, nurses, care workers, and facility managers across Australia and New Zealand who want a practical, everyday framework to reduce sepsis risk. You'll learn why residents in residential aged care facilities (RACFs) are especially vulnerable, what early warning signs to watch for, and nine simple actions - from hand hygiene and catheter checks to skin assessments and nutrition monitoring - that your team can integrate into every shift. These actions align with the Strengthened Aged Care Quality Standards and NZS 8134:2021, and they don't require extra resourcing, just consistency. When it comes to sepsis, the earlier you act, the better the outcome.

And some good news: most of the infections that lead to sepsis in aged care are ones your team already manages every day. A structured, consistent approach to prevention makes a measurable difference.

Ageing weakens the immune response, so infections that a younger person would easily fight off can escalate quickly in an older resident. Several factors compound this risk

Sepsis symptoms in older people are often subtle and easy to miss. A resident may not have a high fever; instead watch for:

• New or worsening confusion, drowsiness, or a sudden change in behaviour.
• A fall, sudden weakness, or a noticeable decline in mobility.
• Reduced appetite, poor fluid intake, vomiting, or diarrhoea.
• Low blood pressure, fast heart rate, rapid breathing, or shortness of breath.
• Fever, chills, or a low temperature, noting that fever may be absent in older residents.
• Skin that is cold, clammy, mottled, unusually pale, or has a new rash.
• Reduced or no urine output.
• A resident simply not being themselves, especially when infection is suspected.

Early recognition and escalation save lives, and this proactive mindset is essential for every care team rather than waiting for a resident to deteriorate visibly.

Prevention comes down to consistency. These tenactions, completed every day for every resident, close the pathways that infection uses to take hold and progress to sepsis.

Use this as a quick shift check. If any item raises concern, escalate early rather than waiting for obvious deterioration.

1. Hand hygiene — Wash hands before and after each resident contact. This remains the single most effective infection-prevention action available to your team.
2. Catheter check — Ask whether a catheter is still necessary, check for signs of infection, and keep the site clean. Unnecessary catheters are among the most preventable sepsis risks in aged care.
3. Skin assessment — Check for pressure injuries, cuts, and rashes at every care interaction. Broken skin is an open door to infection.
4. Swallowing observation — Watch for coughing during meals and other signs of aspiration. Aspiration is a leading cause of pneumonia among aged care residents.
5. Nutrition — Confirm the resident is eating and drinking adequately. Malnutrition weakens the immune system and slows recovery from infection.
6. Hydration Monitoring - Encourage and monitor adequate fluid intake where clinically appropriate. Dehydration can contribute to infection risk, delayed recovery, and clinical deterioration.
7. Mobility — Encourage movement and avoid prolonged bed rest. Mobility supports circulation, lung function, and skin integrity.
8. Oral hygiene — Provide regular mouth care to reduce the risk of aspiration pneumonia.
9. Wound care — Keep wounds clean and dry, and note any changes in drainage, colour, or odour promptly.
10. Catheter removal — Remove catheters as soon as medically appropriate. The longer a catheter remains in place, the higher the risk of infection.

None of these actions are new to your team. What changes outcomes is doing all nine every day for every resident, not just when a resident already looks unwell.

Under the Strengthened Aged Care Quality Standards (effective 1 November 2025), infection prevention and control is a core clinical governance requirement, not an optional extra. In New Zealand, NZS 8134:2021 Ngā Paerewa Health and Disability Services Standard sets equivalent expectations for safe, resident-centred care. A daily sepsis-prevention checklist provides your facility with a simple, auditable way to demonstrate this. Each completed checklist is a record that your team is actively managing risk, not merely responding to it after the fact.

Print this checklist, laminate it, and place it where your team will see it; on the medication trolley, in the handover folder, or at the nurses' station. Integrate it into shift handover so every incoming team member knows what's already been checked and what still needs attention.

Ageing weakens immune defences, and chronic conditions, catheters, reduced mobility, and malnutrition often overlap in a single resident, therefore compounding the risk.

Watch for new confusion, a fall, reduced appetite, low blood pressure, a fast heart rate, or a resident simply "not being themselves" — fever is often absent.

Hand hygiene, catheter checks, skin assessment, swallowing observation, nutrition monitoring, mobility, oral hygiene, wound care, and timely catheter removal — completed for every resident, every day.

Read more of our blogs on the IPS website, the HUB. 

For a regular snippet of news, we are on LinkedIn and Facebook. Like us and share the post with others