Sepsis is a medical emergency and thus reliant on timely diagnosis and prompt treatment. In a large quality improvement project, Northwell Health, a multihospital health care provider, implemented a 3-hour sepsis treatment bundle for every patient admitted with signs of sepsis (1). This bundle included early sepsis recognition and treatment with time-sensitive collection of blood cultures, measurement of lactate levels, and administration of IV fluids and antibiotics within the first three hours of treatment to prevent further organ injury. A recent evaluation of this 3-hour-sepsis bundle, which was published in the Journal “Critical Care Medicine”, showed that in three independent, prospective cohorts of nearly 15,000 severe sepsis patients comparing quarterly data on sepsis outcomes from 2014 to 2016, compliance with the 3-hour sepsis bundle was associated with lower in-hospital mortality (2). Above that, lower critical care utilization and length of stay was observed in bundle compliant cases. In two cohorts, compliance to these sepsis bundles was also associated with substantial cost savings. Extrapolating these savings to a US-wide scale with a conservative estimation of 1,000,000 annual sepsis cases, more than $1.5 billion USD could possibly be saved in the United States every year. These results prove quality improvement in sepsis care save lives, hence this project may serve as role model for other health care providers. The GSA congratulates Northwell Health for their successful efforts to fight sepsis and decrease the high number of preventable deaths from this silent global killer.

To read the full research paper, please click here.
 

References:

(1) Doerfler ME, D’Angelo J, Jacobsen D, et al: Methods for reducing sepsis mortality in emergency departments and inpatient units. Jt Comm J Qual Patient Saf 2015; 41:205–211

(2) Leisman DE1 Doerfler ME, Ward MF, Masick KD, Wie BJ, Gribben JL, Hamilton E, Klein Z, Bianculli AR, Akerman MB, D'Angelo JK, D'Amore JA. Survival Benefit and Cost Savings From Compliance With a Simplified 3-Hour Sepsis Bundle in a Series of Prospective, Multisite, Observational Cohorts. Crit Care Med. 2017 Mar;45(3):395-406.

Idelette Nutma presented her book Sepsis and afterwards to the Global Sepsis Alliance Executive Board at the World Sepsis Day Supporter Meeting on March 22nd, 2017.

Sepsis is a life threatening illness, resulting in ICU admission for many people. Even without ICU admission, recovery can be a long-term process for those affected. This book wants to spare them the lonely quest for explanations and guidance. Sepsis and afterwards combines important information and stories from personal experience with the latest developments and insights. Physical and mental aspects are highlighted, together with practical tips that can really make a difference. Sepsis and afterwards provides former patients and their relatives with a clear lead, and offers eye-openers to professionals. It is a helpful guide during hospital admission and after discharge. 

Having suffered from a septic shock herself, Idelette Nutma, former nurse, has devoted her energies to improving aftercare and raising awareness of sepsis. In 2012, she published the book ‘Septische shock’ (Septic shock) and launched the website ‘Sepsis en daarna’. Apart from giving information and guidance, as seen from the patient’s perspective, Idelette gives lectures and hosts workshops. Furthermore, she is co-founder of the Dutch website www.opeenicliggen.nl and key member of the Family and Patient Centered Intensive Care Foundation. You can find more information on her website.

We are delighted to welcome Minister Tiefensee as Ambassador of World Sepsis Day. During his visit to the Thuringian Ministry of Economics, Science and Digital Society, Prof. Konrad Reinhart and Minister Tiefensee discussed not only the goals of the World Sepsis Day Movement but also the potential of the many sepsis and infection related research institutions in Jena such as the Center for Sepsis Control and Care, the Centre for Innovation Competence Septomics, the InfectControl 2020 Consortium and the Research Campus InfectoGnostics – all of them aiming at contributing to an increased awareness of sepsis, and improvement of sepsis prevention and the quality of sepsis management. 

Today, the Global Sepsis Alliance launches its newest initiative, GSA Advance.

GSA Advance is a coalition of sepsis supporters around the world with the aim of advancing the mission of the GSA.

GSA Advance includes several platforms, one of which is the Trainees’/Junior Faculty Platform, for which we accept applications starting today. The purpose of this platform is to bring the future generation of sepsis champions to the forefront of GSA activities, broadening their scope and impact.

GSA Advance members will help advocate, represent, and promote the various goals and efforts of the GSA. They will have the opportunity to join the various initiatives of the GSA, contributing to World Sepsis Day, World Sepsis Congress, the activities on social media, fundraising, and much more.

Members will have a unique access to the largest professional sepsis network worldwide and will gather valuable experience. The GSA can also issue a certificate and a letter of recommendation.

Membership is open to everyone who is 5 years or less into their faculty position, or is a student, resident, or fellow. Junior Faculty & Trainees from all backgrounds and disciplines are welcome to participate. Participation is not limited to those with medical backgrounds. There is no compensation for becoming a part of GSA Advance.

For more information and to apply, please click here.

The full invitation letter by Imrana Malik, GSA Advance Coordinator, can be downloaded here. Please feel free to share this post and the letter within your network.

On Wednesday, March 22nd 2017, the GSA held its biannual Supporter Meeting at the ISICEM congress in Brussels. Over 40 people from over 15 countries participated, learned about the progress of the World Sepsis Day Movement, the resolution on sepsis and what it means, the successes of the UK Sepsis Trust, and shared their experiences from World Sepsis Day last year.

You can download all presentations and the minutes here (Zip-Folder, 18 MB).

Are you interested in improving the quality of care in healthcare facilities? With almost 40% of healthcare facilities in low and middle income countries lacking a basic water service, and 20% without basic sanitation, this issue is among the most pressing facing health professionals.

As part of the Healthy Start Campaign, our friends from WaterAid invite you to join an expert panel of speakers operating at facility, policy implementation and research levels to find out what the challenges are in overcoming this crisis and how progress is being made.

This event will look at how improving quality of care for mothers and newborns can be enhanced through integrating water, sanitation and hygiene within healthcare facilities. Participants will discuss both the practical interventions and policy changes required to make progress happen and examine the wider implications including the importance of WASH for delivering effective infection prevention and control and tackling the rise of antimicrobial resistance.

The free webinar takes place on Friday May 5 at 11am BST/London, click here to secure your place and get more information.

The members of the Quality Improvement Committee of the Global Sepsis Alliance have composed a statement regarding the operationalization of the proposed diagnostic criteria for the Sepsis-3 definition

The committee is supportive of the updated definition and wish for it to be implemented in such a way that the practice of early recognition and treatment, which has been shown to be effective in reducing sepsis associated mortality, can be balanced by identifying the patients at risk and minimizing overtreatment.

Recently published articles assessing qSOFA, in particular, use the terms ‘diagnostic’ and ‘prognostic’ interchangeably in describing its potential applicability in clinical practice. Our concern is to bring clarity to the available published data and for the safe and appropriate use of the new definition and its proposed diagnostic criteria. In particular, that the clinical context in which the criteria are tested is made very clear so that a prudent assessment of the generalizability of the information can be made and the possibility of harm avoided.

Please click here to read or download the full statement.

The new definitions of sepsis as recommended by the “Sepsis-3” taskforce include the quick Sepsis-related Organ Failure Assessment (qSOFA) score as a screening tool for high-risk patients outside the intensive care unit setting and if laboratory testing is unavailable (1). In case of a positive qSOFA score, clinicians should “initiate or escalate therapy as appropriate, and (…) consider referral to critical care or increase the frequency of monitoring, if such actions have not already been undertaken”. In a recent large-scale retrospective study in the US, Churpek and colleagues (2) compared the prediction for hospital mortality and ICU transfer of qSOFA outside the ICU to other early warning scores such as the Modified Early Warning Score (MEWS) (3), the National Early Warning Score (NEWS) (4) and the SIRS criteria (5), which are part of the former sepsis definitions. They found that although qSOFA was more accurate than the SIRS criteria in predicting adverse outcomes of sepsis in patients on regular wards and the emergency department, it was less accurate than the other early warning scores. The NEWS was the most accurate in predicting adverse outcomes. They also observed that less than 20% of patients with adverse outcomes had a positive qSOFA by the time of infection suspicion, underlining the need of qSOFA recalculation during the course of treatment. In conclusion, general early warning scores hold an important position in the screening and risk-stratification of patients with suspected infectious diseases. Thus, patients may not benefit from replacing early warning scores by qSOFA.

References:
(1) Singer M et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 2016;315:801-810.
(2) Churpek M et al. qSOFA, SIRS, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients Outside the ICU. AJRCCM 2016 Sep 20.
(3) Subbe CP et al. Validation of a modified early warning score in medical admissions. QJM : monthly journal of the Association of Physicians 2001;94:521-526.
(4) Smith GB et al. The ability of the national early warning score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Resuscitation 2013;84:465-470.
(5) Bone RC et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992;101:1644-1655.