10 Steps to Improve Sepsis Care in Low-Resource Settings.

Area of Science:

• Global Health
• Critical Care Medicine
• Implementation Science

Background:

• Sepsis poses a significant global health challenge, particularly in low-resource settings (LRSs).
• Existing sepsis care guidelines often require adaptation for resource-limited environments.
• A structured approach is needed to improve sepsis outcomes in LRSs.

Purpose of the Study:

• To develop a practical, consensus-based framework of ten actionable steps for improving sepsis care in LRSs.
• To align the framework with the established sepsis chain of survival.
• To leverage global expertise for adaptable implementation strategies.

Main Methods:

• A comprehensive literature review of sepsis in LRSs and international guidelines was conducted.
• A multi-disciplinary Task Force identified key domains for sepsis care improvement.
• An iterative consensus process, including Delphi surveys and stakeholder input, refined the ten steps and implementation strategies.

Main Results:

• Ten nonsequential, actionable steps were developed, covering governance, education, prevention, recognition, intervention, post-sepsis care, data systems, quality improvement, and well-being.
• Each step includes rationale and adaptable implementation strategies for diverse local contexts.
• The framework emphasizes integrated care, equitable access, and the use of technology across the continuum of sepsis care.

Conclusions:

• The ten-step framework offers a consensus-driven roadmap for improving sepsis care globally.
• Implementation of these steps can strengthen the sepsis chain of survival and reduce preventable morbidity and mortality.
• The framework addresses global inequities in sepsis outcomes and promotes a culture of excellence.