Regions launches program to prevent deadly hospital infections
Regions Hospital, which already has one of the lowest mortality rates for sepsis in the nation, is implementing a new rapid intervention program to further increase the number of lives saved. Sepsis is a serious infection that can, within a few hours or even minutes, become life-threatening. It is among the top 10 leading causes of death in the U.S. An estimated 30-50 percent of patients with severe sepsis die.
Regions Hospital has been implementing initiatives since 2005 to prevent death from sepsis as part of the Five Million Lives Campaign, an initiative from the Institute for Healthcare Improvement to significantly reduce death from illness and medical errors. As a result of these efforts, the number of deaths among patients with sepsis has decreased by more than 60 percent; falling from 33 percent to 12 percent.
“Hospitals can save more lives if we have the same sense of urgency to identify and treat patients with sepsis as we do with patients who have heart attacks or traumatic injuries,” said HealthPartners physician Dr. Richard Mahr, who is the medical director for quality and safety at Regions.
Pilot program in ER
Regions implemented a pilot sepsis program in the Emergency Department in November because about 70 percent of patients with sepsis are admitted through the ER. Although patients usually have the infection when they arrive in the ER, it can be difficult to diagnose in early stages because of non-specific signs like fast pulse or rapid breathing. For some illnesses, rapid intervention is not as critical and treatment can safely begin after a patient is admitted. Patients with sepsis should begin receiving antibiotics within three hours or less, often before they can be admitted. Regions new rapid intervention program is designed to help ED staff recognize sepsis as early as possible after arrival.
Automatic alerts in the EMR
A key element of the rapid intervention program provides automatic computerized alerts in the electronic medical record. Triage nurses receive an alert to consider sepsis if two or more of a patient’s four vital signs are abnormal (temperature, heart rate, blood pressure or respiratory rate). The nurse can call a Code Red, alerting a physician to arrive within a few minutes.
If the physician confirms sepsis, automatic order sets provide the most up-to-date evidence-based guidelines of care. The guidelines include administering the following steps within six hours of diagnosis of severe sepsis:
- Test lactate levels
- Obtain blood cultures
- Administer antibiotics within three hours of ER admission
- Administer fluids
- If the patient is in septic shock, deliver intravenous medications to improve circulation
Regions rapid intervention program is based on guidelines and recommendations developed by the Surviving Sepsis Campaign; an international coalition to reduce deaths worldwide from severe sepsis or septic shock by 25 percent.