By Marijke Vroomen Durning, RN (Director of Content, Sepsis Alliance)
Earlier this year, the World Health Organization (WHO) declared sepsis to be a global health priority. In doing so, they adopted a resolution to prevent sepsis, and to improve its diagnosis and management. Sepsis Alliance welcomed this declaration. Each year in the United States alone, over 258,000 people die from sepsis. Thousands more are left with life-changing effects, such as amputations, organ dysfunction, or post-traumatic stress disorder (PTSD).
Healthcare providers can change this landscape through education, earlier detection, and management. Much like the golden hour for heart attacks or strokes, sepsis also has a golden hour. For patients with severe sepsis, chances of survival drop by almost 8% every hour treatment is delayed. We know that when identified early, sepsis can often be treated with fluids and antibiotics.
Reducing sepsis rates
Infection prevention is the first obvious step to reducing the number of patients who develop sepsis. Healthcare-acquired infections remain a significant contributor to sepsis numbers. According to the WHO, “HAI continues to account for complications in 5-10% of admissions to acute-care hospitals. For example, in the U.S. alone there are at least 80,000 fatalities each year (about 200 deaths/day) from HAI.” Infection prevention programs, including the basics like frequent and thorough hand washing must be in place and followed by all those who come in contact with patients.
Other ways to reduce sepsis rates include:
- Implementing and updating sepsis protocols throughout hospital systems. Implementation of a sepsis protocol in all facilities will affect sepsis rates. However, these protocols must be maintained and updated for them to remain effective.
- Following campaigns such as Choosing Wisely. The campaign addresses some infection-related issues. For example, the Society of Hospital Medicine recommends that urinary catheters not be inserted or left in place for urinary incontinence or for monitoring intake and output among non-critically ill patients. This mindset should also be in place when working with patients who have any type of invasive devices, including IVs. Every invasive procedure or device has a potential for infection.
- Encouraging patient education about infections and sepsis. Patient education regarding sepsis risk is a major factor in sepsis prevention. This ranges from educating oncology patients undergoing treatment to parents who deal every day with children’s cuts and scrapes. As many as 92% of sepsis cases come from the community, but if people don’t know about sepsis, they can’t know what to watch for.
- Listening to patients or their caregivers. This is also a vital part of sepsis prevention. Faces of Sepsis, a hallmark section of the Sepsis Alliance website has over 700 stories of sepsis survival or loss. There is an underlying theme among several stories of patients or their loved ones feeling that the healthcare system failed them by not listening to them. Parents know their children well, adult children know their elderly parents well, and patients know themselves – so it is vital that the healthcare professionals listen to their histories and complaints when they present with possible sepsis symptoms.
- Say the word. Everyone knows someone who has been hospitalized or who has died from sepsis. But because the healthcare community doesn’t use the word, these people don’t know it. They hear terms like complications of pneumonia, infection, complications of cancer, and so on. Even death certificates often don’t list “sepsis” as the cause of death. But if people don’t hear the word, if they don’t know what it means, they don’t know how serious it is and they don’t seek help in a timely fashion.
Sepsis cannot always be prevented. Patients may present to their physician or an emergency department with sepsis and a silent, undiagnosed infection, or they may be receiving treatment for an infection, but sepsis still develops. But the numbers can be significantly reduced. The solution is education for everyone involved. Suspect Sepsis. Save Lives.
Marijke Vroomen Durning is a registered nurse. She has been Director of Content for Sepsis Alliance, the nation’s leading sepsis advocacy organization, for the past seven years.