Regions Hospital in St. Paul, Minn., which has one of the lowest sepsis mortality rates, is implementing a new rapid intervention program to further increase the number of lives saved. Sepsis is a serious infection that can quickly become life-threatening. Among the top 10 leading causes of death in the U.S., an estimated 30 percent to 50 percent of patients with severe sepsis die.
Regions Hospital has been implementing initiatives since 2005 to prevent death from sepsis as part of the Institute for Healthcare Improvements Five Million Lives Campaign. As a result, the number of deaths from sepsis has decreased by more than 60 percent; falling from 33 percent to 12 percent.
Hospitals can save more lives if we have the same sense of urgency to identify and treat patients with sepsis as we do with patients who have heart attacks or traumatic injuries, says HealthPartners physician Dr. Richard Mahr, who is the medical director for quality and safety at Regions.
Regions implemented a pilot program in the Emergency Department last November because about 70 percent of patients with sepsis are admitted through the ER. Sepsis is difficult to diagnose in early stages because of non-specific signs like fast pulse or rapid breathing. For some illnesses, rapid intervention is not as critical and treatment can safely begin after a patient is admitted. Patients with sepsis should begin receiving antibiotics within three hours or less, often before they can be admitted.
The rapid intervention program provides sepsis alerts in the electronic medical record if two or more vital signs are abnormal. Automatic order sets provide the most up-to-date evidence-based guidelines which include administering the following steps within six hours of diagnosis of severe sepsis:
Test lactate levels
Obtain blood cultures
Administer antibiotics within three hours of ER admission
If the patient is in septic shock, deliver intravenous medications to improve circulation
Regions' rapid intervention program is based on guidelines developed by the Surviving Sepsis Campaign; an international coalition to reduce deaths from severe sepsis or septic shock by 25 percent.