Friday, November 15, 2024

RHODE ISLAND HOSPITALS’ SEPSIS PROTOCOLS

Cumberland, Warwick families gather for signing of law requiring sepsis protocols at hospitals.

The families of Layla Charette of Cumberland, Emily Otrando of Cumberland, and Gianna Cirella of Warwick, who all died of sepsis, pose with Sen. Ryan W. Pearson and Rep. Anthony J. DeSimone, who sponsored legislation requiring sepsis protocols in hospitals, along with Gov. Dan McKee, who signed the bill into law.

STATE HOUSE — The families of two Cumberland girls and a Warwick girl who died of sepsis gathered in Gov. Dan McKee’s office Thursday afternoon as he ceremonially signed legislation introduced by Senate Majority Leader Ryan W. Pearson (D-Dist. 19, Cumberland, Lincoln) and Rep. Anthony J. DeSimone (D-Dist. 5, Providence) that requires hospitals to adopt sepsis protocols.

For the families of Layla Charette of Cumberland, who died in 2017, Emily Otrando of Cumberland, who died in 2014, and Gianna Cirella of Warwick, who died in 2017, the ceremony helped to provide a little closure as they continue to mourn the loss of their daughters.

GOVERNOR DAN MC KEE

The new law (2023-S 0283A2023-H 5869A) requires the director of the Department of Health to develop in coordination with the Antimicrobial Stewardship and Environmental Cleaning Task Force information on best practices for the treatment of patients with sepsis and septic shock. Each hospital and freestanding emergency-care facility is now required to implement procedures and policies in accordance with this information.

“Sepsis exacts a significant toll on human life,” said Senator Pearson. “It has been sudden, tragic and devastating for families that have quickly lost an otherwise healthy family member. There is some pretty compelling evidence that these protocols work in the states that have established them, and it’s time to bring them to Rhode Island.”

Sepsis, an extreme reaction to infection that spreads via the bloodstream, kills between 250,000 and 500,000 people in the U.S. annually — more than AIDS, breast and prostate cancers, and stroke combined. Yet fewer than half of Americans have heard of it, according to the National Conference of State Legislatures.

“There have been several tragic deaths of children in this state due to sepsis, and it’s among the most common causes of death for children in Rhode Island,” said Representative DeSimone. “Some of these deaths can be avoided by adopting common sense-based sepsis protocols for our hospitals and primary care givers.”

Under the new law, the Director of Health will make information on best practices for the treatment of patients with sepsis and septic shock available to health care practitioners. This includes:

 An evidence-based screening tool that can be used at initial evaluation of adult and pediatric patients in the emergency department

An evidence-based treatment protocol for adult and pediatric patients that includes 19 time-specific treatment goals

Nurse-driven testing protocols to enable nurses to initiate care for patients with suspected sepsis

 Incorporation of sepsis screening and treatment tools into the electronic health record where possible

Mechanisms to prompt escalation of care within the facility, and, when appropriate, to stabilize and transfer to a facility able to provide a higher level of care

 Strategies for appropriate hand-offs and communication regarding the care of patients with sepsis and for the reassessments of patients at regular intervals

Hospital specific antibiotic guidelines for use in treating patients with sepsis and a mechanism for reevaluating a patient’s antibiotic treatment based on culture results that provides reassessment and de-escalation of antibiotic treatment when appropriate.

Staff education on sepsis policies and procedures during the onboarding process and at least annually and when new practice guidelines are published or existing standards are updated to ensure that care reflects current standards of practice.