- The Centers for Disease Control and Prevention (CDC) are putting a spotlight on patient safety in its newest Vital Signs report, which highlights the dangers of sepsis, an often-deadly infection that may be more insidious than previously thought.
Sepsis is often considered one of the most dangerous hospital acquired conditions, taking the lives of up to 30 percent of people who contract it. However, the CDC has found that 80 percent of sepsis cases actually originate outside of the hospital setting, and is most likely to become a serious problem for patients with existing chronic diseases.
“This report is putting a face on sepsis and documenting that it’s still a huge problem and it doesn’t have to be,” said CDC Director Dr. Tom Frieden in a press briefing last week. “Sepsis is an unrecognized killer. Sepsis is a medical emergency. An infection that is getting worse and is not treated can lead to sepsis and it’s scary.”
Frieden, whose son survived a bout of sepsis as an infant, stressed the need for patients and family members to be aware of the signs of the condition – and for clinical staff to be able to recognize and rapidly treat sepsis before it progresses to its severe stages.
But patient safety advocates may not always be looking in the right place, he added.
“We find, and this is surprising to many of the people who work in this field, that sepsis begins outside of the hospital for nearly 80 percent of patients,” he said. “That's new and different.”
“We've been focusing on and making progress reducing sepsis in the hospital. In intensive care units, in volunteer care facilities and elsewhere. We also found that 7 out of 10 patients with sepsis had either recently interacted with healthcare providers or had a chronic disease that required frequent medical care. In other words, healthcare providers are on the frontlines of both sepsis prevention and early recognition.”
Providers should pay special attention to patients at highest risk of contracting sepsis, including those over the age of 65 or under 12 months, those with weakened immune systems, and those with chronic diseases that may increase the likelihood of infection. Patients are most likely to contract sepsis if infections in the lungs, skin, gut, and urinary tract are not treated promptly and monitored closely.
“We as a country can do much more to prevent patients from getting infections that lead to sepsis,” said Frieden. “Prevention can be done for example, by increasing vaccination rates for pneumococcal disease and for influenza because the flu is often followed by bacterial infections. We could also prevent infections by improving handwashing in healthcare facilities as well as in the community.”
Patient and caregiver education is also an important part of improving patient safety, he continued. A survey released by The Sepsis Alliance ahead of Sepsis Awareness Month in September found that only 55 percent of Americans had even heard of sepsis, and just 28 percent could correctly identify its symptoms.
The figures represent a significant increase in awareness over the past decade or so, but the widespread uncertainty about symptoms and reaction protocols may be contributing to the hundreds of thousands of deaths from sepsis each year.
“We are extremely heartened to see the increasing levels of sepsis awareness, which for the first time have crossed the 50 percent threshold,” said Thomas Heymann, Executive Director of Sepsis Alliance. “Sepsis is a medical emergency requiring early detection and rapid response, and as we build upon the increasing awareness, the mandate is clear: we must continue to work with our partners to educate the public on how to identify and respond to sepsis as an emergency, just as the public knows to do for heart attacks or strokes.”
The healthcare system as a whole has significantly reduced hospital acquired conditions and other preventable patient safety issues over the past few years, but sepsis remains a major challenge, especially to larger facilities.
A recent study from Houston Methodist Hospital found that sepsis patients in academic medical centers are about 7 percent more likely to die from the condition than those in community hospitals, although the researchers do note that patients in larger systems may be more complex than those treated in local hospitals.
But since the new CDC data indicates that most sepsis cases incubate outside of the hospital setting, providers and caregivers will have to be extra vigilant across the entire care continuum. The CDC will continue to make patient safety a top priority by expanding its outreach and developing new materials to promote early recognition, Frieden said.
“We'll be launching a sepsis awareness campaign in the coming year this will be a multiyear multimillion dollar campaign we'll host a series of continuing education opportunities for healthcare providers regarding sepsis starting this month,” he stated. “We continue to engage healthcare provider organizations, patients and family members regarding sepsis prevention and sepsis early recognition.”