World Sepsis Day: CDC's Sepsis Core Elements Impact on Hospitals at First Anniversary

World Sepsis Day

In August 2023, CDC released the Hospital Sepsis Program Core Elements (Sepsis Core Elements) to help hospitals improve sepsis outcomes. These elements support early recognition, evidence-based management, and recovery.

The CDC included several questions in the National Healthcare Safety Network (NHSN) 2023 Annual Survey to gain insight into the current state of sepsis programs. This information will help us understand how the Sepsis Core Elements function in US hospitals and where we should concentrate our efforts to improve sepsis care. According to the NHSN Annual Survey data, the number of US hospitals with sepsis programs and the resources to support them has increased.

In honor of Sepsis Awareness Month and World Sepsis Day, Infection Control Today^® (ICT^®) interviewed Raymund Dantes, MD, MPH, CDC sepsis medical officer and associate professor in the Department of Medicine at Emory University, Atlanta, Georgia, about the first anniversary of the introduction of the CDC’s Sepsis Core Elements.

CDC also released new and updated sepsis materials today here.

Stay Ahead of Sepsis, September 2024 theme

ICT: One year after introducing the Sepsis Core Elements, what have been the most significant improvements in sepsis recognition and management within hospitals?

Raymund Dantes, MD, MPH: CDC recently started asking about 5300 U.S. hospitals enrolled in the National Healthcare Safety Network about their hospital sepsis program practices. The results of an initial set of questions were published with the release of the Sepsis Core Elements in August 2023. Starting in January 2024, just a few months later, we asked a larger set of questions relating to their sepsis programs during all of 2023, so this most recent survey represents practices both before and after the launch of the Sepsis Core Elements.

Acknowledging these survey limitations, there were some notable improvements. The percentage of hospitals with a sepsis committee increased from 73 to 78%, meaning 300 more hospitals have sepsis committees than the previous year. The percentage of hospitals reporting sufficient dedicated time for their sepsis leaders increased from 55% to 59%, or 217 more hospitals. Finally, the percentage of sepsis committees with antibiotic stewardship support increased from 55% to 66%, representing 629 more hospitals.

ICT: How have the Sepsis Core Elements impacted the integration of Antibiotic Stewardship Programs into sepsis committees, and what role has this played in improving patient outcomes?

RD: As mentioned, the percentage of sepsis committees with antibiotic stewardship support increased from 55% to 66%, meaning 629 more hospitals integrated antibiotic stewardship into their sepsis program than the previous year.

Some have misperceived that antibiotic stewardship may hinder efforts to improve sepsis management. However, rather than hindering effective patient care, antibiotic stewardship programs can play an important role in optimizing the use of antibiotics, leading to better patient outcomes. Hospitals can make simultaneous improvements in sepsis management and antimicrobial stewardship. Thus, we continue to emphasize the importance of the partnership between antibiotic stewardship programs and sepsis programs to optimize patient care.

ICT: Based on the NHSN 2023 Annual Survey data, what are the key challenges hospitals face in fully implementing the Sepsis Core Elements, and how might these be addressed?

RD: The 2023 survey data included many new questions that reflect the complete set of recommendations from the Sepsis Core Elements. Many opportunities exist to strengthen hospital sepsis programs to optimize patient care. These areas include executive sponsorship, evaluating the usability of local sepsis tools, implementing processes to support sepsis recovery, improving education to certified nursing assistants and patient care technicians, implementing processes to support prompt antimicrobial administration, and improving access to key sepsis data.

Implementing these practices will require leadership support and institutional knowledge. In our webinar series hosted by the American Medical Association (AMA) Project Firstline, several hospitals and hospital systems described their experiences advocating for and securing the resources needed to boost their sepsis programs.

ICT: Can you share specific examples or case studies in which the Sepsis Core Elements have led to measurable improvements in sepsis or patient recovery outcomes?

RD: The Sepsis Core Elements are simply a collection of best practices learned from high-functioning sepsis programs. Our AMA Project Firstline webinar series features many great examples of hospitals and hospital systems that have implemented key aspects of the Sepsis Core Elements and improved patient care.

ICT: What areas of sepsis care require further focus or refinement, and how might the CDC’s Sepsis Core Elements evolve to address these needs?

RD: As mentioned, there are still many opportunities to strengthen hospital sepsis programs, such as more evaluation of the usability of local sepsis tools, implementing processes to support sepsis recovery, improving education to certified nursing assistants and patient care technicians, implementing processes to support prompt antimicrobial administration, and improving access to key sepsis data. CDC surveys on sepsis program practices will continue annually, and the priority areas for outreach will adjust to reflect areas of need. Furthermore, the Sepsis Core Elements will be updated as new ideas to improve sepsis programs emerge.