Healthcare News & Insights

Sepsis measures updated: Best response for hospitals

Besides the switch to ICD-10, hospitals have another looming deadline to worry about in October. That’s when stricter reporting standards for sepsis recognition and treatment will be enforced by the Centers for Medicare & Medicaid Services (CMS). 

200252833-001Hospitals that participate in the inpatient quality reporting program will be expected to report all instances of the condition to CMS, along with the steps taken to diagnose and treat patients with severe sepsis or septic shock.

With the help of the National Quality Forum (NQF), the agency is adopting a new measure called the Severe Sepsis and Septic Shock Management Bundle.

The measure’s already causing controversy, with some providers noting that it redefines what’s typically considered sepsis or septic shock in a clinical setting, making the condition broader, according to an article in MedPage Today. This may require hospitals to screen more patients for sepsis than they would normally, potentially exposing them to unnecessary treatment.

However, supporters of the new measure have stated that because sepsis is such a deadly condition (killing between 20% and 25% of patients who develop it in the hospital), more thorough screening protocols have the potential to save many lives.

5 steps to fight sepsis

Facilities that want to get a jumpstart on what’ll be expected of them with the updated reporting requirements can look to new guidance designed to reduce negative outcomes from sepsis.

The University of Pittsburgh’s School of Medicine just released a list of best practices hospitals can follow to ensure patients with sepsis are treated as thoroughly as possible. It was published in a recent issue of the Journal of the American Medical Association.

Using data from several studies conducted about sepsis treatment, University of Pittsburgh researchers developed a general approach based on what’s worked well in clinical trials over the past few years.

Prompt treatment of sepsis is crucial to positive patient outcomes. However, a surprising result from the University of Pittsburgh analysis was that a rigorous and aggressive one-size-fits-all sepsis approach may not be the best bet.

While there are general best practices providers should follow when diagnosing sepsis, individual assessment and treatment choices still need to be made on a case-by-case basis for each patient.

The five-step process developed by the University of Pittsburgh researchers will help hospitals administer treatment for sepsis as quickly as possible, while still leaving room for personalized decision making from clinical staff:

  1. Identify. Clinical staff should identify the presence of a sepsis infection by looking for the accompanying signs of shock, including low urine output, confusion, and cool and clammy skin.
  2. Administer. Clinicians need to administer antibiotics, IV fluids and blood tests to patients with signs of sepsis as soon as possible to determine how severe the infection’s gotten.
  3. Ultrasound. The next step is for patients to receive a focused ultrasound. Intravenous catheters should also be placed for fluids and blood pressure monitoring.
  4. Vasoactive. Patients need to receive vasoactive medications to bring their blood pressure readings back within normal rates.
  5. Repeat. Providers should repeat assessments of these patients every four to six hours in intensive care.

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