Accelerating Detection and Intervention for Sepsis in Skilled Nursing Facilities Using a Sepsis Pathway

Area of Science:

• Geriatric Medicine
• Infectious Disease Management
• Healthcare Quality Improvement

Background:

• Early sepsis detection is crucial for reducing mortality, yet it is frequently delayed in skilled nursing facilities (SNFs).
• Skilled nursing facilities face challenges in timely sepsis recognition, leading to potential negative patient outcomes and hospital readmissions.

Purpose of the Study:

• To implement and evaluate a standardized sepsis pathway in a skilled nursing facility (SNF) to improve sepsis detection and reduce hospital readmissions.
• The study aimed to assess the impact of a novel SNF sepsis pathway on patient outcomes, including sepsis recognition, treatment, and transfer rates.

Main Methods:

• A pre-/postimplementation study design was employed to evaluate the effectiveness of the SNF sepsis pathway.
• The pathway integrated a sepsis screening tool and a sepsis bundle, supported by comprehensive education for SNF staff.
• Key outcome measures included sepsis detection rates, treatment interventions, length of stay, hospital transfer rates, and mortality.

Main Results:

• Sepsis recognition improved substantially, increasing from 56% to 86% post-implementation (P < .001).
• Sepsis-related hospital transfers decreased from 68% to 44% (P = .07), indicating a positive trend.
• Rates of essential laboratory testing and sepsis intervention significantly increased (P < .001), demonstrating improved clinical management.

Conclusions:

• A modified SNF sepsis pathway effectively accelerated sepsis identification and enhanced clinical outcomes.
• The implementation of a standardized sepsis pathway in SNFs is a viable strategy to improve patient care and reduce hospital readmissions.