Preventing Hospital-Acquired Sepsis: Best Practices and Quality Improvement Initiatives

Preventing Hospital-Acquired Sepsis: Best Practices and Quality Improvement Initiatives

By Dr. Joni Grace, BHMS, PGDCR, Strategic Case Management Consultant, Jhpiego (Johns Hopkins Program for International Education in Gynecology and Obstetrics)

Sepsis is a serious and potentially life-threatening medical condition characterized by a dysregulated systemic response to infection. It is a major global health concern, accounting for a significant number of hospital admissions, prolonged stays, and mortality rates worldwide.

Hospital-acquired sepsis occurs when an infection develops after admission to a healthcare facility, such as a hospital or long-term care facility. It typically arises due to the introduction of pathogens into the patient’s bloodstream through invasive procedures, contaminated medical devices, surgical sites, or poor hygiene practices. Common causative organisms include Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Candida species.

The global burden of sepsis is difficult to ascertain, although a recent scientific publication estimated that in 2017 there were 48.9 million cases and 11 million sepsis-related deaths worldwide, which accounted for almost 20% of all global deaths. In 2017, almost half of all global sepsis cases occurred among children, with an estimated 20 million cases and 2.9 million global deaths in children under five years of age. 

Hospital-acquired sepsis poses a significant threat to patient safety and health outcomes. It is essential for healthcare centers and providers to be proactive to prevent the occurrence of sepsis and any other hospital-acquired infection.

Hospital Acquired Sepsis

 Here are some best practices and quality improvement initiatives that have shown promising results in preventing hospital-acquired sepsis:

  1. Providing high standards of care especially to vulnerable populations such as pregnant or recently pregnant women, neonates, hospitalized patients, patients in intensive care units, people with HIV, liver cirrhosis, Cancer, tuberculosis, cancer, autoimmune conditions, etc.. without compromise in maintaining proper sanitation.
  2. Hand washing and sanitation must be followed at all times of contact with the patient and their surroundings. Implementing comprehensive hand hygiene programs, including education, regular monitoring, and feedback to healthcare providers, has been shown to reduce the transmission of pathogens.
  3. Catheter-associated infection can be prevented by following and upholding sterile methods in the insertion and removal of catheters, regular monitoring for signs of infection, and early removal when not necessary. 
  4. Provide early access to recommended vaccines especially for the vulnerable population thereby helping them become less susceptible to hospital-acquired infections, especially sepsis.
  5. Routinely disinfect and clean healthcare facilities to prevent and limit microbial transmission. Routine sterilization of surgical instruments and utilization of appropriate cleaning agents will help reduce the risk of sepsis by minimizing pathogen colonization and transmission.
  6. Empower designated infection control teams, especially in long-term health care facilities to supervise the process to avoid medical negligence of any sort and to aid in early detection and treatment which helps in reducing the risk of disease escalation and also preventing mortality due to sepsis or other hospital-acquired infections.
  7. Take full advantage of telehealth services whenever applicable especially for the high-risk population so as to limit their exposure to potential pathogens. Telehealth reduces the need for in-person visits, allowing vulnerable individuals to receive care from the safety and comfort of their own homes, thereby minimizing their exposure to potential sources of infection.
  8. Providing timely antibody treatment when initial signs of sepsis are noted so that prevent further deterioration of the disease. Australian studies suggest sepsis pathways implemented across multiple hospitals can significantly (p < 0.05) improve care and outcomes. Safer Care Victoria’s “Think sepsis. Act fast” collaboration reduced inpatient sepsis-related mortality by 50%, from 11.4% to 5.8%.
  9. Educating both the patient and the healthcare teams that are in direct contact with the patient about sepsis including but not limited to recognizing early signs of sepsis for early detection and management, and teaching preventive measures such as handwashing will help reduce the incidence and outcomes of hospital-acquired sepsis.

Preventing hospital-acquired sepsis requires a multifaceted approach involving various evidence-based practices and quality improvement initiatives.  Time is of the utmost essence in the prevention and treatment of hospital-acquired sepsis as it is a determining factor between the survival or mortality of the patient. Implementing these best practices and quality improvement initiatives can significantly enhance patient safety, improve outcomes, and mitigate the burden of sepsis in healthcare settings.

To learn more about sepsis management and sepsis quality improvement efforts, the recent 4th World Sepsis Congress is a wealth of information. Clinicians can even receive continuing medical education credits for participating


Dr. Joni GraceDr. Joni Grace is a dedicated and versatile medical professional with a background in clinical research and homeopathy. She is also a UNICEF trainer who empowers mothers and promotes child nutrition. With experience in remote regions and collaboration across sectors both national and international, she helped bring down maternal mortality and raise health awareness among indigenous communities. Recognized for her contributions to society through local media and to the national health officials from the prime minister of India’s cabinet, Dr. Grace continues to make a difference by bridging gaps in medical care in India and nurturing communities.

 

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