News: CDC offers new hospital guidelines for sepsis care and management

The Centers for Disease Control and Prevention (CDC) has issued a new set of guidelines for the management and treatment of sepsis, according to MedPage Today.

The guidelines come at a time of increased concern over sepsis mortality. According to one study cited in the report, there are an estimated 1.7 million adult sepsis hospitalizations annually, of which 350,000 result in death or discharge to hospice care.

Recent studies cited in the report have also concluded that hospitals’ improvement initiatives and coordination efforts with respect to sepsis have been severely lacking. According to one study, five factors must be strengthened to improve the delivery of recommended sepsis practices:

1. Deeper provider understanding regarding sepsis
2. Staff knowledge with respect to the benefits and risks of certain treatments
3. Strong team collaboration
4. Empowered and institutionally supported healthcare workers
5. Adequate staffing

To this end, the CDC set forth the Hospital Sepsis Program Core Elements, which further elaborates upon these organizational principles, and supplements them with concrete examples. The Core Elements document is comprised of seven parts.

Here are the core elements from the guidelines:

• Hospital leadership commitment: Successful hospital sepsis programs have been hampered by a “lack of engagement” from hospital clinicians, staff, as well as a lack of sufficient resources. Therefore, the CDC recommends providing additional resources to existing programs, including data analytics, information technology support, and sepsis-related performance evaluation.
• Accountability: According to the CDC, sepsis programs require a “clear delineation of responsibilities and expectations.” For programs that run systemwide, “point persons” need to be identified to perform key facilitating roles. This will allow for effective leadership, management, and communication across departments, and improve sepsis programs.
• Multi-professional expertise: The CDC recommends having a dedicated sepsis coordinator for overseeing the implementation of the day-to-day aspects of the sepsis program. Clinicians across hospital domains (emergency departments, inpatient wards, intensive care units [ICU], etc.) should be “fully engaged” in the hospital’s sepsis program. The CDC insists that this type of participation and collaboration is important to “ensure [the] coordination of sepsis care throughout the institution.”
• Action: Implementing a standardized process for sepsis screening is critical for ensuring the early administration of sepsis treatment, according to the CDC. In addition, creating and maintaining a set of hospital guidelines or “standardized care pathways” for sepsis management will allow for clear and enhanced recommendations for healthcare staff in caring for septic patients.
• Tracking: The CDC recommends tracking sepsis epidemiology metrics in order to understand a given hospital’s case-mix. Sepsis management metrics (antimicrobial timing, fluid administration, etc.) and sepsis outcomes metrics (mortality, ICU admission, length of hospitalization) are also important for understanding the management of sepsis.
• Reporting: Regular reports to hospital, unit, and clinical leadership with information regarding unit-level data, trends over time, and comparative/benchmarking data are crucial for keeping all parties informed about the progress of the sepsis program, according to the CDC.
• Education: Providing sepsis-specific training, education, and information during the hiring and on-boarding process is important to get healthcare staff and trainees educated early. Moreover, providing written and verbal educational materials on sepsis for patients and families will allow for the best care after discharge.

Editor’s note: To read the MedPage Today’s coverage, click here. To read the CDC Core Elements Program, click here.