Adult screening and treatment

Recommendation

• Adopt and implement an evidence-based sepsis screening tool and treatment protocol for adults in the emergency department.

Rationale

• Timely treatment of sepsis is critical to survival – the risk of dying from septic shock increases 7.6 percent for every hour that passes.
• Utilizing a standardized screening tool in the emergency department is an effective strategy to aid in the early recognition of sepsis.
• Use of a standard treatment bundle for patients with severe sepsis and septic shock is effective in reducing mortality.

Tools

• Sepsis response pathway
• ED sepsis screening tool
• Sepsis screening and triage algorithm tool
• Nurse-initiated protocol

Best practices

• Lowell General adopts a nurse-driven protocol for early sepsis treatment (Lowell General Hospital, Lowell)
• Routine procalcitonin testing helps clinicians identify and treat sepsis early (Signature Healthcare Brockton Hospital, Brockton)
• Partnership with local EMS agencies improves early identification of sepsis patients (Baystate Medical Center, Springfield)
• Outreach to nursing homes improves early identification of sepsis (Berkshire Medical Center, Pittsfield)