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Revigorating Infection Prevention: Exploring the CDC’s Hospital Sepsis Program Core Elements

Sepsis, a condition characterized by the body’s extreme response to infection, poses a significant challenge to healthcare systems globally, and especially within the United States where it is a leading cause of mortality and hospital admission. It is estimated that annually, sepsis affects approximately 1.7 million people, resulting in roughly 350,000 deaths within the U.S. alone.

Taking cognizance of the fact that quality improvement programs can drastically impact the rates of mortality and length of hospital stay, the Center for Disease Control (CDC) on August 24, 2023, published the Hospital Sepsis Program Core Elements guideline to streamline and refine the approach to sepsis management.

This document includes essential metrics for sepsis broken down into seven sections: hospital leadership commitment, accountability, multi-professional expertise, action, tracking, reporting, and education. An assessment of this document will be conducted in light of the CDC’s accompanying survey on hospital sepsis programs, conducted in 2022.

In its 34-page document, the CDC recommends an in-depth analysis of existing sepsis programs by each institution. Their 2022 survey highlighted that around 73-95% of hospitals had sepsis monitoring committees in place, and hospitals with more than 251 beds were more inclined to have this program. Every hospital with a sepsis program is advised to conduct a thorough evaluation of their methods to identify any gaps, utilizing the assessment tool provided in the CDC document.

For the minority of hospitals that yet lack a sepsis program, a ‘getting started tool’ is available. This includes identifying leaders for the sepsis program, securing administrative support, performing an analysis of requisite regulations or reporting requirements, and establishing initial goals.

The document underscores the need for the Chief Medical Officer and Chief Nursing Officer to champion the cause of sepsis programs and reinforce its importance to the rest of the staff. It also stresses the designation of 1 or 2 committed program leaders to ensure hands-on execution of duties.

This guideline notes the requirement of a diverse and capable team for program success. Although the document does not provide precise recommendations for sepsis recognition tools, it encourages the use of order sets to guide sepsis management, which includes antimicrobial selection, source control, fluid resuscitation, and the vital narrowing and cessation of antimicrobial use.

For improved outcomes, infectious disease consultation is advocated even where sepsis bundles are utilized. It also promotes prompt initiation of antimicrobials and the establishment of ‘Code Sepsis’ rapid response teams. Key elements of the CDC’s Core Sepsis Elements include tracking, reporting, and education, all of which require ample IT support. The guidelines recommend sharing comprehensive data with individual hospital units and treating physicians and integrating sepsis-specific training within the staff induction process.

In conclusion, while the CDC’s Core Sepsis Elements serves as a robust framework for assessing and initiating sepsis programs, future iterations should flesh out the specifics of sepsis screening and treatment measures.

Source: https://www.contagionlive.com/view/cdc-presents-core-elements-for-sepsis-programs

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