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The World Health Organization has adopted a resolution on improving the prevention, diagnosis, and management of sepsis. Millions of lives can be saved if politicians, policymakers, health care administrators, researchers, and clinicians take coordinated actions.

Abstract Objective In this study, we aim to describe the post-sepsis syndrome from the perspective of the sepsis survivors. Design and Setting The study is a prospective, observational online international survey. Participants Sepsis survivors enrolled via social media from 13 September 2014 to 13 September 2016. Interventions None. Main Outcome Measures Physiologic, physical and psychological function post-sepsis; and patient satisfaction with sepsis-centered care. Results 1731 completed surveys from 41 countries were analyzed, with 79.9% female respondents, age 47.6 ± 14.4 years. The majority of respondents (47.8%) had sepsis within the last year. Survivors reported an increase in sensory, integumentary, digestive, breathing, chest pain, kidney and musculoskeletal problems after sepsis (all P-value <0.0001). Physical functions such as daily chores, running errands, spelling, reading and reduced libido posed increased difficulty (all P-value <0.0001). Within 7 days prior to completing the survey, the survivors reported varying degrees of anxiety, depression, fatigue and sleep disturbance. Sepsis survivors reported dissatisfaction with a number of hospital support services, with up to 29.3% of respondents stating no social services support was provided for their condition. Conclusions Sepsis survivors suffer from a myriad of physiologic, physical and psychological challenges. Survivors overall reveal dissatisfaction with sepsis-related care, suggesting areas for improvement both in-hospital and post-discharge.

Sepsis is a life-threatening condition which globally claims more lives than cancer. A set of evidence-based clinical practices (sepsis bundles) have been developed to guide early diagnosis and rapid intervention, which are vital to patient survival; however, their use is not widely adopted. A cross-sectional survey was administered in June–July 2022 to understand healthcare practitioner (HCP) knowledge of and adherence to sepsis bundles and identify key barriers to adherence in the UK, France, Spain, Sweden, Denmark and Norway; a total of n=368 HCPs ultimately participated. The results showed that among HCPs, overall awareness of sepsis and the importance of early diagnosis and treatment is high. However, there are indications that adherence to sepsis bundles is well below the standard of care: when asked which steps providers carry out to treat sepsis, only 44% report carrying out all steps in the bundle; and 66% of providers agreed that delays in sepsis diagnosis occur sometimes where they work. This survey also highlighted the possible barriers which are impeding the implementation of optimal sepsis care: particularly high patient caseload and staff shortages. This research highlights important gaps and obstacles in reaching optimal care of sepsis in the surveyed countries. There is a need for healthcare leaders and policy-makers alike to advocate for increased funding for more staff and training to address existing knowledge gaps and improve patient outcomes.

The nation's first government-backed reparations initiative was green lit this week in Evanston, Illinois, a Chicago suburb where about 16 percent of its 75,000 residents are Black. The city council has promised [dollar] 10 million over 10 years. John Yang discusses how the program could serve as a model for the rest of the country with Ron Daniels of the National African American Reparations Commission.

Sepsis is a common cause of serious illness and death. Sepsis management remains challenging and suboptimal. To support rapid sepsis diagnosis and treatment, screening tools have been embedded into hospital digital systems to appear as digital alerts. The implementation of digital alerts to improve the management of sepsis and deterioration is a complex intervention that has to fit with team workflow and the views and practices of hospital staff. Despite the importance of human decision-making and behavior in optimal implementation, there are limited qualitative studies that explore the views and experiences of health care professionals regarding digital alerts as sepsis or deterioration computerized clinician decision support systems (CCDSSs). This study aims to explore the views and experiences of health care professionals on the use of sepsis or deterioration CCDSSs and to identify barriers and facilitators to their implementation and use in National Health Service (NHS) hospitals. We conducted a qualitative, multisite study with unstructured observations and semistructured interviews with health care professionals from emergency departments, outreach teams, and intensive or acute units in 3 NHS hospital trusts in England. Data from both interviews and observations were analyzed together inductively using thematic analysis. A total of 22 health care professionals were interviewed, and 12 observation sessions were undertaken. A total of four themes regarding digital alerts were identified: (1) support decision-making as nested in electronic health records, but never substitute professionals' knowledge and experience; (2) remind to take action according to the context, such as the hospital unit and the job role; (3) improve the alerts and their introduction, by making them more accessible, easy to use, not intrusive, more accurate, as well as integrated across the whole health care system; and (4) contextual factors affecting views and use of alerts in the NHS trusts. Digital alerts are more optimally used in general hospital units with a lower senior decision maker:patient ratio and by health care professionals with experience of a similar technology. Better use of the alerts was associated with quality improvement initiatives and continuous sepsis training. The trusts' features, such as the presence of a 24/7 emergency outreach team, good technological resources, and staffing and teamwork, favored a more optimal use. Trust implementation of sepsis or deterioration CCDSSs requires support on multiple levels and at all phases of the intervention, starting from a prego-live analysis addressing organizational needs and readiness. Advancements toward minimally disruptive and smart digital alerts as sepsis or deterioration CCDSSs, which are more accurate and specific but at the same time scalable and accessible, require policy changes and investments in multidisciplinary research.

BackgroundOver 95% of penicillin allergy labels are inaccurate and may be addressed in low-risk patients using direct oral penicillin challenge (DPC). This study explored the behaviour, attitudes and acceptability of patients, healthcare professionals (HCPs) and managers of using DPC in low-risk patients.MethodsMixed-method, investigation involving patient interviews and staff focus groups at three NHS acute hospitals. Transcripts were coded using inductive and deductive thematic analysis informed by the Theoretical Domains Framework.FindingsAnalysis of 43 patient interviews and three focus groups (28 HCPs: clinicians and managers) highlighted themes of ‘knowledge’, ‘beliefs about capabilities and consequences’, ‘environmental context’, ‘resources’, ‘social influences’, ‘professional role and identity’, ‘behavioural regulation and reinforcement’ and a cross-cutting theme of digital systems. Overall, study participants supported the DPC intervention. Patients expressed reassurance about being in a monitored, hospital setting. HCPs acknowledged the need for robust governance structures for ensuring clarity of roles and responsibilities and confidence.ConclusionThere were high levels of acceptability among patients and HCPs. HCPs recognised the importance of DPC. Complexities of penicillin allergy (de)labelling were highlighted, and issues of knowledge, risk, governance and workforce were identified as key determinants. These should be considered in future planning and adoption strategies for DPC.

If patients continue to remain at home (often for many hours) after they develop respiratory distress, acute confusion, or cutaneous manifestations of shock, then late presentation will hamper attempts to improve outcomes.13 If both a responsibly heightened public awareness and a professional and organisational culture of suspicion of sepsis are developed, then the contribution of time and delays to cohort heterogeneity will reduce, and substantial improvements in outcomes and studies of novel therapeutic strategies yielding reproducible results might occur.

BackgroundSepsis is a life-threatening condition arising when the body’s response to infection causes organ damage. Sepsis affects approximately 250,000 people in the UK every year, claiming 48,000 lives (Daniels, Nutbeam (eds.) The sepsis manual. UK Sepsis Trust. 6th ed., 2022). People living with a terminal diagnosis are at increased risk of sepsis developing (National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. [NG.51], updated 2017). Equipping staff with the knowledge, skills, and tools to screen for sepsis is essential to ensure prompt recognition and treatment of a potentially reversible illness, rather than mistaking this as expected deterioration at end of life or assuming it is untreatable, ensuring that patients have more quality time with the people who are important to them right up to the end of their life. AimTo develop a sepsis screening tool and training package for use by community staff who provide care for people at the end of life in their own home to enable prompt recognition and escalation for treatment of sepsis, taking into consideration advance care plans and discussion with patient and those important to them. MethodJune 2022: Review of UK Sepsis Trust Sepsis Screening Tools (UK Sepsis Trust. Sepsis screening tool telephone triage. 2022). July – October: Development of Community Sepsis tool for end-of-life care, internal consultation. October – January 2023: Development of sepsis training package, internal review. February 2023: Launch of tool and training to healthcare staff in two pilot areas.ResultsTool launched February 2023. Preliminary feedback from staff positive, training evaluations show training takes 60 minutes to complete, easy to follow informative training package. ConclusionPreliminary feedback justifies the development of a sepsis screening tool to support recognition of the signs of sepsis and prompt escalation for treatment by staff caring for patients at the end of life that considers advance care plans, wishes of the patient and those important to them. Work in progress to complete post implementation evaluation, roll out of tool to all community services and develop a sepsis screening tool for hospices.

The importance of early prevention and treatment of sepsis has never been greater. In the UK alone sepsis contributes to more deaths than lung cancer, from bowel cancer and breast cancer combined, and approximately one third of patients who suffer from severe sepsis die. The ABC of Sepsis provides a much needed introduction and an invaluable aid in the increasing efforts to reduce hospital infection and improve patient safety. As growing numbers of junior medical staff experience emergency medicine, critical care and acute medicine as part of the Foundation Programme, there is an increasing need to develop the skills required to treat severe sepsis. The editors are involved with the Survive Sepsis campaign - developed to improve the recognition, diagnosis and treatment of sepsis - and are perfectly placed to guide junior medics, GPs, specialist nurses, critical care nurses and primary care staff through this core aspect of acute medicine.

To address these gaps in insight and encourage vigorous advocacy and efforts to decrease the burden of sepsis worldwide, the Global Sepsis Alliance (GSA) and its founding members--the World Federation of Societies of Intensive and Critical Care Medicine, the World Federation of Paediatric Intensive and Critical Care Societies, the World Federation of Critical Care Nurses, the International Sepsis Forum, and the Sepsis Alliance--took the initiative to create the first World Sepsis Day (WSD) as a launch platform for the World Sepsis Declaration. [...]to succeed will require the engagement of an informed citizenry and health care professionals at all levels of care from physicians to community health care workers and close interdisciplinary collaboration between all stakeholders including public health, community medicine, hygiene, microbiology, infectious diseases, emergency medicine, critical care medicine, and rehabilitation. [...]we implore health professionals to facilitate the creation of interdisciplinary and multiprofessional coalitions both on the national and local levels.