Sepsis is a word every healthcare provider fears, it sends chills up your spine, right? We have been trained to be alert to signs and symptoms of sepsis and follow the recommendations of the CDC. That said, there are many experts in the field of infectious disease who disagree with the quality measure known as “Severe Sepsis and Septic Shock: Management Bundle (SEP-1)“.
This measure was first endorsed in 2013 by the National Quality Forum (NQF) and implemented by the Centers for Medicare & Medicaid Services (CMS) in October 2015. The measure was re-endorsed by NQF at a virtual appeals board hearing on April 29. Many emergency room physicians feel the measure is too restrictive and encourages excessive fluids and antibiotic use. Another concern is that while forcing the sepsis measure to be implemented in emergency rooms, it limits physicians from investigating other serious conditions.
We have discussed the sepsis controversy before, however, it makes you wonder, are your emergency room physicians initiating the sepsis measure (a long, seven-element process) at the cost of identifying other serious conditions? Are they initiating broad-spectrum antibiotics within 3 hours (per the measure) and if so, is it in conflict with antibiotic stewardship? Clearly, sepsis kills many seniors every year and hopefully, the experts have figured this out! Stay the course, stay well and stay informed!