Downplay Sepsis at Your Peril

“Our findings may help guide physicians and hospital administrators toward changes in practices where even modest improvements could have a high impact in patient safety and in more efficient, less costly healthcare,” says Shah. “For instance, focusing quality improvement efforts on reducing postoperative sepsis and infection due to medical care could create large cost savings and reduction in length of hospitalization. Additional studies should focus on determining specific safety measures and practices that pediatric hospitals can implement in the most appropriate areas.”

Shah adds that such quality improvement programs are all the more important in light of a recent decision by the Centers for Medicare and Medicaid Services (CMS) to begin denying payments to hospitals for patients who develop preventable complications during hospitalization.

Innovative Solutions and Global Campaigns

Sepsis is beginning to garner a lot of attention, says Levy. “The Surviving Sepsis Campaign, a global initiative for reducing mortality in sepsis, is associated with two ‘sepsis bundles’, similar to the approach used for prevention of ventilator-associated pneumonia (VAP). Several states (including Rhode Island and New Jersey) now have statewide initiatives targeted at reducing mortality in sepsis. The attention to sepsis is likely to increase as the results of these efforts are made public,” Levy adds.

The campaign is currently in 30 countries and 250 hospitals, with 18,000 patients in the SSC database, he continues. For more information about the management of sepsis, including the most recent 2008 Surviving Sepsis Campaign guidelines, visit the following site: http://www.survivingsepsis.org/

One study from Spanish researchers demonstrated the efficacy of the campaign; a national educational effort in Spain to promote appropriate care for severe sepsis and septic shock has shown an association with a lower rate of sepsis deaths in hospitals and improved guideline adherence, although the improvement in compliance with some resuscitation procedures diminished after one year, according to a study in the May 21, 2008, issue of JAMA.

“Sepsis is one of the most prevalent diseases and one of the main causes of death among hospitalized patients. Severe sepsis accounts for 1 in 5 admissions to intensive care units (ICUs) and is a leading cause of death in non-cardiac ICUs,” the authors write.