Healthcare News & Insights

Study: Early treatment protocols improve sepsis outcomes

Sepsis is one of the leading causes of death in hospitals across the county. As a way to improve patient outcomes, more healthcare pros are arguing in favor of early detection testing once the illness is suspected. There’s been some debate on whether this was effective – until now. 

A comprehensive study in the New England Journal of Medicine confirms what some have said for decades: Finding sepsis early saves people’s lives.

The study specifically focused on patients at 149 hospitals in New York state.

New York has stringent requirements for sepsis testing. As discussed in an article from STAT News, this is, in part, due to the death of a young boy. Rory Staunton was 12 when he contracted the illness in 2012. An arm scrape quickly put his body in septic shock, and doctors didn’t test Rory for his illness until it was too late.

Since his death, Rory’s parents have rallied for better sepsis detection protocols in hospitals. The attention they helped bring to the illness inspired state lawmakers to adopt “Rory’s Regulations,” which made New York the first state to require all hospitals to screen patients using checklists and standard sepsis protocols, and to document their results.

In New York, any patient who is suspected of having sepsis must undergo treatment right away, including receiving a dosage of antibiotics within the first hour of diagnosis.

Although no other states have mandated the use of these protocols, the Centers for Medicare & Medicaid Services (CMS) has started requiring hospitals to track how well they’re adhering to standard sepsis-management protocols. Critics have said these protocols haven’t been tested for their effectiveness.

However, the New England Journal of Medicine study puts some of those objections to rest. It looks at the effectiveness of New York state’s “three-hour bundle” sepsis protocols, which closely mirrors the guidelines for sepsis treatment endorsed by CMS. Clinicians start by getting a blood culture to measure the level of serum lactate in the blood, then putting patients with high levels on IV antibiotics.

The findings supported the importance of early detection and treatment for suspected sepsis. For every hour that clinicians didn’t complete the sepsis protocols, mortality rates grew anywhere from 3% to 4%.

While several factors affected patients’ chances of dying from sepsis, including age and other pre-existing conditions, implementing treatment protocols right away still reduced death rates.

More mandates in the future?

The success in New York may inspire other states to get on the bandwagon and make sepsis-management protocols mandatory. Only New York and Illinois have laws on the books for mandatory sepsis protocols. (The Illinois law, Gabby’s Law, was also created after the death of a young child from the condition.)

Right now, hospitals in other areas aren’t sticking to the feds’ recommended guidelines like they should be. The best estimates suggest that clinicians only follow established sepsis protocols between 60% and 70% of the time – meaning many patients are developing sepsis who shouldn’t be.

Whether your facility is mandated to do so or not, it’s important to have a plan in place for sepsis screening and treatment for patients. Not only does it boost outcomes, which is critical as hospitals are judged on value and quality, it can also decrease readmission rates for patients, giving your hospital a key advantage among its competition.

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