MSQC Sepsis Resources Toolkit
The Sepsis Resources Toolkit has been compiled by MSQC for your use in developing a Sepsis recognition and reduction plan at your hospital site. Sepsis has been recognized as a potentially life-threatening complication of infection which may affect post-surgical patients with devastating results unless recognized quickly and treated urgently. We hope to add more components to this Toolkit, but in the meantime, we want to make this pool of Resources available to you now.
TOOLS: A collection of posters, algorithms, and order sets which can be utilized in their current format or adapted to fit your hospitals’ purposes.
RESOURCES: A comprehensive set of Sepsis resources, including websites, videos and articles.
SHARING OF BEST PRACTICES WITHIN THE COLLABORATIVE: This portion of the toolkit represents a collection of resources and tools currently used in clinical practice that have been developed by MSQC member hospitals. These documents have been made available for widespread use across the collaborative to facilitate the sharing of best practices with respect to Sepsis and its related initiatives.
This collection of posters, algorithms, and order sets may be utilized in their current format or adapted to fit your hospitals’ purposes.
- Hemodynamic Support Table
- IHI Severe Sepsis Bundles
- Initial Resuscitation Table
- Other Supportive Therapy
- Seeing Sepsis Act Fast Poster
- Seeing Sepsis Early Detection Graphic Tool
- Sepsis Change Package
- Sepsis Pathway
- Sepsis Practice Alert
- Surviving Sepsis Campaign Bundle
- SSC Implementation Guide
- SSC Statements Sepsis Definitions
- Seeing Sepsis Toolkit
- Think sepsis. Time matters.
A comprehensive set of Sepsis resources, including websites, videos and articles.
Centers for Disease Control and Prevention
This site is required reading for information on resources for patients as well as healthcare providers. Patients can be provided with downloadable one-page sheets regarding basic information, fact sheets and sepsis Q & A. Providers can find clinical guidelines, bundles and screening tools, in addition to links to education and training content, some for CME credit. The data reports provided by the National Center for Health Statistics (NCHS) and the Agency for Healthcare Research and Quality (AHRQ) will serve as a foundation for your development of sepsis reports and presentations for possible QI projects.
Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality’s (AHRQ) mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used. The site has a searchable resource library that provides information for patients, professionals and policymakers. Sepsis materials include statistics about sepsis in various populations (racial, gender, age, etc.), clinical guidelines and toolkits, a library of sepsis resources and education and training.
The Surviving Sepsis Campaign is a joint collaboration of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine committed to reducing mortality from severe sepsis and septic shock worldwide. Initiated in 2002, the Campaign progressed via publication of 3 editions of evidence-based guidelines, implementation of a performance improvement program, and analysis and publication of data from more than 30,000 patient charts collected around the world. Now recommitted to increasing the number of hospitals contributing data to 10,000 worldwide, to applying the guidelines to 100% of patients in whom the diagnosis is suspected, and to developing a strategy to improve the care of septic patients in under-resourced areas, the Campaign invites you to download the Surviving Sepsis Declaration and share it with the team at your hospital. This website provides guidelines, bundles, and other resources to begin or enhance your hospital’s work on detecting and treating sepsis.
Clinical Excellence Commission
The Clinical Excellence Commission (CEC) is responsible for leading safety and quality improvement in the New South Wales (NSW), Australia public health system. It was established in 2004 to promote and support improved clinical care, safety and quality across NSW. The CEC is guided by NSW Health values of Collaboration, Openness, Respect and Empowerment. The website contains Sepsis tools such as antibiotic, blood culture and IV resuscitation guidelines, publications and educational materials, such as an ‘Adult Sepsis Pathway for Inpatients’. You will also find implementation guidelines, videos, evaluation resources, and a newsletter. This is an excellent website!
This site contains a wealth of information and resources for understanding Sepsis. It is also a rich resource for developing materials related to Sepsis, such as the article that was written as a result of the critical care task force that proposed the new definitions for sepsis and septic shock and the newly developed SOFA score as a method of identifying patients with sepsis (JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287). The site also contains many related articles and multi-media links.
University of Pittsburgh Department of Critical Care Medicine: quick SEPSIS RELATED ORGAN FAILURE ASSESSMENT (qSOFA)
This site was developed by University of Pittsburgh Department of Critical Care Medicine, as a resource of research and data sources for the qSOFA.
Sepsis Alliance is a charitable organization run by a team of dedicated laypeople and healthcare professionals who share a strong commitment to battling sepsis. The organization was founded in 2007, by Dr. Carl Flatley, whose daughter Erin died of sepsis when she was 23 years old. Sepsis Alliance was created to raise sepsis awareness among both the general public and healthcare professionals. The website is a source of information and educational material to help the general public become aware of this often deadly condition, and for professionals who can then help the public learn about sepsis when it does strike. The material includes the information available on the website, brochures (also available in Spanish), and videos. There are resources geared to medical professionals which contains a section on speaking to patients, with links to one page handouts entitled, “What is Sepsis”, “Sepsis: Understanding Risk”, “and “Sepsis Treatment: A Glossary of Terms”.
Minnesota Hospital Association
This site offers a wealth of resources such as webinar recordings, videos, toolkits and long term care resources that are available free. A ‘Safer Care Sepsis Road Map’ is a short audit checklist that provides an action plan for beginning and maintaining core strategies for early detection and treatment of sepsis/septic shock. The ‘Seeing Sepsis’ toolkit contains posters and algorithms for detecting and treating sepsis, as well as sepsis simulation tools. This website is invaluable!
This is a fun way to test your knowledge by challenging you to score points by correctly treating 8 patients!
World Sepsis Day is a concept developed by the Global Sepsis Alliance, and operated as a collaborative effort with other organizations and individuals. The Global Sepsis Alliance is a non-profit organization supporting the efforts of over 1 million caregivers in more than 70 countries as they seek to better understand and combat what many experts believe to be the leading cause of death worldwide: sepsis. Their mission is educating medical professionals, informing policymakers, and creating awareness among the general public and the website provides materials for all of these groups. Posters, fact sheets and other materials to promote initiatives related to sepsis can be downloaded for use. The World Sepsis Day newsletter is another resource that is accessed on the website with updates on campaigns, reports, initiatives and journal articles related to sepsis.
Consensus Definitions for Sepsis and Septic Shock
Published on Feb 26, 2016 by JAMA (Length 2:43)
This video presents updated definitions of and clinical criteria for diagnosing sepsis and septic shock based on recommendations from an expert task force.
Update on sepsis! New definitions for sepsis and septic shock 2016
Published on Apr 10, 2016 by the Department of Internal Medicine Indiana University (Length 5.54)
The new definitions for sepsis and septic Shock (Sepsis-3) based on the new article published in JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287. This updated explanation includes current terminology related to Sepsis.
SEPSY BACK | Kern Medical Center
Published on Jun 8, 2015 (Length 4:52)
Written and developed by Kern Medical Center’s 2014-2015 Sepsis Crew to “Sexy Back,’ this medical parody promotes sepsis awareness and adherence to best practice. This is a humorous way to learn some of the signs and symptoms of sepsis, and also can inspire your Sepsis crew to develop teaching materials in a creative way.
Published on Jun 2, 2014 by the Sepsis Alliance (Length 12.01)
Sepsis: Emergency lifts the veil off sepsis, one of the leading killers in America. This call to action video targets the public with statistics, terminology and simple explanation of the physiological process of sepsis and the treatment required.
What is sepsis?
Published on Sep 22, 2015 (Length 1:26)
Sepsis is a life threatening medical condition that arises when the body’s attempt to fight an infection results in the immune system damaging tissues and organs. In this film you get the basics about sepsis. Sepsisfonden is a foundation engaged in fund-raising to aid sepsis research in Sweden as well as raising public awareness and knowledge around sepsis. This is an explanation of sepsis that is simplified for use for patient education.
The Changing Epidemiology and Definitions of Sepsis Jordan A. Kempker MD, MSc and Greg S. Martin MD, MSs, Clinics in Chest Medicine, 2016-06-01, Volume 37, Issue 2, Pages 165-179 doi: 10.1016/j.ccm.2016.01.002
Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)Seymour, Christopher W, Liu, Vincent X, Iwashyna, Theodore J, Brunkhorst, Frank M, Rea, Thomas D, Scherag, André, Rubenfeld, Gordon, Kahn, Jeremy M, Shankar-Hari, Manu, Singer, Mervyn, Deutschman, Clifford S, Escobar, Gabriel J, Angus, Derek C, JAMA.2016:315(8):762-774. doi:. 10.1001/jama.2016.0288
New Definitions for Sepsis and Septic Shock, Edward Abraham, JAMA.2016;315(8):757-759. doi:10.1001/jama.2016.0290.
Sepsis MandatesColin R. Cooke, Theodore J. Iwashyna, JAMA.,2014;312(14):1397-1398. doi:.10.1001/jama.2014.11350.
Postoperative Sepsis, JAMA.2016;315(8):824. doi:.10.1001/jama.2015.17075.
Lactate in Sepsis,Hernando Gomez, John A. Kellum, JAMA.2015;313(2):194-195. doi:.10.1001/jama.2014.13811.
Declining Case Fatality Rates for Severe Sepsis, Theodore J. Iwashyna, Derek C. Angus, JAMA.2014;311(13):1295-1297. doi:.10.1001/jama.2014.2639.
Treatment of Sepsis-Related Organ Dysfunction,Jesús Rodríguez-Baño, JAMA. 2012;308(12):1204-1209. doi:10.1001/2012.jama.11262.
Immunosuppression and Secondary Infection in Sepsis, Derek C. Angus, Steven Opal, JAMA.2016;315(14):1457-1459. doi:.10.1001/jama.2016.2762.
New Sepsis Diagnostic Guidelines Shift Focus to Organ Dysfunction, Julie A. Jacob, JAMA.2016;315(8):739-740. doi:.10.1001/jama.2016.0736.
Sepsis, Julie A. Bastarache, Eric J. Seeley, Clinics in Chest Medicine, 2016-06-01, Volume 37, Issue 2, Pages xv-xvi doi: 10.1016/j.ccm.2016.04.001
Preventing sepsis,Bermejo-Martin, JF, Andaluz-Ojeda, D, Almansa, R, Eiros, JM,Tamayo, LANCET INFECTIOUS DISEASES Vol. 15, Issue 11. Date: 11/2015 Pages: 1259-1260. doi: 10.1016/S1473-3099(15)00374-6
Targeting sepsis as a performance improvement metric: Role of the Nurse,Kleinpell R, Schorr CA., AACN Adv Crit Care, 2014;29:179-186 doi: 10.1097/NCI.0000000000000015
The use of an early alert system to improve compliance with sepsis bundles and to assess impact on mortality.Larosa JA, Ahmad N, Feinber M, et al, Crit Care Res Pract. 2012;98:369. doi: 10.1155/2012/980369
Goal-directed resuscitation for patients w early septic shock,ARISE Investigator and the ANZICS Clinical Trials Group. NEJM. 2014;371;1496-1506 doi: 10.1056/NEJMoa1404380
Surviving sepsis campaign: associated between performance metrics and outcomes in a 7.5 year study., Levy MM, Rhodes A, Phillips GS, et al., Crit Care Med 2015;43:3. doi: 10.1097/CCM.0000000000000723
Benchmarking the incidence and mortality of severe sepsis in the US.,Gaieski D, Edwards M, Kallan M, et al., Crit Care Med 2013;41:1167. doi: 10.1097/CCM.0b013e31827c09f8
Trial of early, goal directed resuscitation for septic shock.,Mouncey PR, Osborn TM, Power GS, et al for the ProMISe trial Investigators., NEJM. 2015;1301. doi: 10.1056/NEJMoa1500896
A randomized trial of protocol based care for the early septic shock.,ProCESS Investigator, Yearly DM, Kellum JA, Juang ST, et al, NEJM. 2014;18;1683-1693 doi: 10.1056/NEJMoa1401602
Two decades of mortality trends among patients with severe sepsis: A comparative Meta-Analysis.,Stevenson E, Rubenstein A, et al., Crit Care Med 2014;42:625. doi: 10.1097/CCM.0000000000000026
Developing a New Definition and Assessing New Clinical Criteria for Septic Shock – For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), Manu Shankar-Hari, MD, MSc et al ; for the Sepsis Definitions Task Force
JAMA. 2016;315(8):775-787. doi: 10.1001/jama.2016.0289
Increased fluid administration in the first three hours of sepsis resuscitation is associated with reduced mortality: a retrospective cohort study.
Lee SJ, Ramar K, Park JG, Gajic O, Li G, Kashyap R.
Chest. 2014 Oct;146(4):908-15. doi: 10.1378/chest.13-2702
Multicenter Implementation of a Treatment Bundle for Patients with Sepsis and Intermediate Lactate Values
Vincent X. Liu et al
American Journal of Respiratory and Critical Care Medicine, Vol. 193, No. 11 | Jun 01, 2016 doi: 10.1164/rccm.201507-1489OC
Association of Fluid Resuscitation Initiation Within 30 Minutes of Severe Sepsis and Septic Shock Recognition With Reduced Mortality and Length of Stay
Daniel Leisman, BS, et al
Annals of Emergency Medicine, Volume 68, Issue 3, September 2016, Pages 298–311, doi: 10.1016/j.annemergmed.2016.02.044
Sharing of Best Practice within MSQC
This portion of the toolkit represents a collection of resources and tools currently used in clinical practice that have been developed by MSQC member hospitals. These documents have been made available for widespread use across the collaborative to facilitate the sharing of best practices with respect to Sepsis and its related initiatives.
Sepsis Bundle Checklist
This checklist was developed by staff at Garden City Hospital as a comprehensive, consolidated cue sheet for timely screening, ongoing assessment and as a hand-off tool to document recognition and treatment of sepsis, and is intended to be added to the patient’s chart.
Sepsis Data Collection Form
This form serves as a worksheet to evaluate if sepsis bundle compliance has met all criteria of this CORE measure. This form was created by the staff at Garden City Hospital.
Zero Sepsis Rauen – MSQC Annual
The content in this presentation was created and presented by Carol Rauen at the April 2015 MSQC Annual conference to raise awareness of the seriousness and incidence of sepsis.
Dr. James O’Brien’s presentation
The content in this presentation was created by Dr. James O’Brien and presented by him at the MSQC Collaborative Meeting on March 11, 2016
Resident Sepsis Education
This is a customizable presentation that was developed by staff at Garden City Hospital as tool to educate medical residents in documentation and compliance with processes of early recognition and treatment of sepsis.
These documents have been made available with the sole intent of assisting sites with the initiation and development of a Sepsis recognition and reduction program. In the interest of improving surgical care, favorably affecting patient outcomes, and wide promotion of best practices, MSQC has made these documents accessible with minimal restriction. Please be respectful of their use, and refrain from reproducing or using these documents outside of their intended purpose. Policies regarding the use of documents (tools, articles, etc.) that are obtained from other sites whose links are provided within this toolkit, must be adhered to.