The New War on Sepsis

Designated sepsis nurses and coordinators make a difference

At St. Joseph Hospital in Orange, California, nurse Dawn Nagel is the last line of defense against sepsis, according to an article from Kaiser Health News. Her mission: identify and treat sepsis patients quickly to minimize their risk of death. Nagel administers antibiotics, draws blood for testing, gives fluids, and closely monitors her charges—all on a tight timetable.

“We’re here to save lives. If we are not closely monitoring them, they might get sicker and go into organ failure before you know it,” she said.

Sepsis is the leading cause of death in U.S. hospitals, according to the article. More than one million people develop sepsis each year in the U.S, and up to 50% of them die from it. It is also one of the most expensive conditions for hospitals to treat, costing $24 billion annually.

Most hospitals in the U.S. have programs aimed at reducing sepsis, but few have designated sepsis nurses and coordinators like St. Joseph’s.

In 2015, the Centers for Medicare and Medicaid Services began requiring hospitals to measure and report on their sepsis treatment efforts. They must make sure certain steps are completed within the first three hours after sepsis is identified, including obtaining blood cultures, giving intravenous fluids, and starting patients on a broad-spectrum antibiotic.

St. Joseph Hoag Health, an integrated medical system in Orange County, California, that operates St. Joseph and six other hospitals, began employing dedicated sepsis nurses throughout the system in 2015.

The hospitals in the St. Joseph Hoag Health system treat approximately 8,000 cases of sepsis each year, at a cost of $130 million, according to Dr. Andre Vovan, a critical care physician who oversees St. Joseph Hoag’s antisepsis programs.

The health system also created sepsis-care checklists and a mobile app to help coordinate care for patients at risk. But the nurses are at the core of the initiative. They know how to treat sepsis like “the back of their hands,” Vovan said. “Their familiarity allows them to do it faster.”

The St. Joseph Hoag Health effort appears to be working, according to the article. From 2015 to 2016, the death rate for all of its hospitals dropped from 15% to 12% for severe sepsis/shock and from 12% to 9% for all sepsis cases, Vovan said. The length of time patients stay in the health system’s hospitals is also dropping, he said. At St. Joseph Hospital in Orange, the number of patients who went into septic shock fell 50% during the same two-year period.

Source: Kaiser Health News; June 21, 2017.