2018 Sepsis Legislative Update

July 26, 2018|11:49 a.m.| ASTHO Staff

Sepsis occurs when a body’s immune system overwhelmingly responds to an infection and triggers widespread inflammation. The inflammation leads to blood clots and leaky vessels which can result in organ damage and death. Sepsis can be caused by a wide range of infections, but those most commonly linked to sepsis are infections found in the lungs, kidneys, skin, and gut. Sepsis can also result from a range of pathogens. Most commonly, however, the specific pathogen is not identified in 30 to 70 percent of patients with sepsis. In addition, sepsis occurs in patients across the lifespan, most commonly in those over 65 and under the age of one. Sepsis is a dangerous and often lethal condition, claiming a quarter million American lives annually, as well as a significant driver of healthcare costs. It is the most expensive hospital condition to treat, accounting for more than $23 billion dollars in healthcare costs annually. In addition, with a growing chronic disease burden that places patients at a greater risk of infections that can lead to sepsis, effective and comprehensive strategies to address sepsis are critical.

Despite the alarming numbers, sepsis remains a relatively unknown condition, with less than a third of adults able to identify the signs and symptoms of sepsis. Considering that each hour sepsis treatment is delayed increases risk of death by four percent, education about sepsis and its symptoms is critical. With that said, efforts are underway to raise awareness about the condition. In 2017, CDC launched Get Ahead of Sepsis, a national campaign targeted at healthcare providers and patients. In addition, lawmakers in Maryland and New York recently passed laws to develop state-based education and outreach campaigns to inform their populations about sepsis.

On October 22, 2017, New York Gov. Andrew Cuomo enacted Rory Staunton’s Law, named in honor of a boy who died from sepsis in 2012 and whose family is a champion for sepsis prevention. The law established an awareness, prevention, and education program in the New York Department of Education, in collaboration with the commissioner of health and other interested parties. According to the law, the program must include age-appropriate curricula, lesson plans, and best practices to educate students, parents, and school personnel about sepsis awareness and prevention. The law also requires that materials be made available to schools for free via the department’s webpage, and that the department proactively reach out to school districts during Sepsis Awareness Month to remind them of available resources. Finally, the law amends educational requirements for physicians, nurses, and other healthcare providers to include sepsis as part of coursework related to infection control. In 2018, this was further amended to more specifically require instruction regarding infections leading to sepsis.

Earlier this year, the Maryland legislature passed and the governor signed SB 574, in which it was recognized that “many different types of infections can lead to sepsis and a majority of patients develop infections outside of the hospital” and that there is a need for a “coordinated and comprehensive campaign to educate the public.” The new law tasks the Maryland secretary of health with establishing a Sepsis Public Campaign Workgroup—a 14-member group that brings together representatives from state and local public health, healthcare professionals from a variety of fields, communication experts, and individuals who have had sepsis or have a family member with the condition to develop a campaign. The law requires the campaign to include a definition of sepsis, risks associated with sepsis, how sepsis occurs, signs and symptoms, what to do if symptoms occur, and methods of prevention. The workgroup will provide a report on the campaign, including cost-effective methods for promotion, to the legislature by Dec. 1.

Improving awareness about the signs and symptoms of sepsis can improve outcomes of individuals suffering from the condition by ensuring prompt access to effective treatment. There is a vital and broader role for public health to champion solutions and build partnerships to address population-level risks and promote systems-based solutions to prevent infections that lead to sepsis. Existing public health efforts to prevent and reduce the burden of chronic diseases can address population-level risks for sepsis, as those with chronic medical conditions are at a greater risk of developing sepsis. In addition, effective vaccination promotion and programs can reduce the likelihood that an infection leading to sepsis will occur. Finally, strengthening data collection and analysis surrounding sepsis cases, treatment, and outcomes provides public health agencies with the ability to improve on what works and identify new opportunities to prevent and treat sepsis. As state policymakers and state and federal health agencies take critical steps to detect and treat sepsis, ASTHO will continue monitor their progress.

Tell us what you think icon that links to an evaluation form for blog post