Stopping the Chain of Infection: Strategies for Preventing Sepsis in Long Term Care September 20, 2016

Transcription

1 Stopping the Chain of Infection: Strategies for Preventing Sepsis in Long Term Care September 20, 2016

2 VHQC 1. Private, nonprofit healthcare consulting firm 2. Virginia s QIO since 1984; now the Quality Innovation Network QIO (QIN-QIO) for Maryland and Virginia 3. Experienced team members & consultants 4. For more information on Sepsis contact Candace Hamner: chamner@vhqc.org 5. For more information on VHQC visit: 2

3 Stopping Sepsis in Long Term Care: Why Sepsis? 3

4 Severe Sepsis: A Significant Health Care Challenge

5 Startling Facts From the Literature Public awareness of Sepsis is poor Higher incidence of Sepsis during winter months Appears to be highest in African-American Males More cases of Sepsis occur in the winter Sepsis mortality rates in Maryland acute care hospitals has been as high as 30% Sepsis and C. diff have two of the highest readmission rates in Maryland and across the nation Some facts courtesy of Texas Gulf Coast Sepsis network

6 Startling Facts From the Literature 1) Patients over 65 account for close to 60% of severe sepsis cases and are: a. 13 times more likely to develop sepsis b. 2 times more likely to die c. Frequent readmission to acute care hospital d. At higher risk if they are residents in LTC facility i. Nosocomial infections in LTC increase risk 2) Enteritis and other GI associated infections, along with Pulmonary infections, have the HIGHEST mortality rate!

7 Sepsis Mortality In Maryland

8 Sepsis in our Residents Sepsis in our residents often stems from these common infectious syndromes: a. Skin/soft tissue infections b. Pneumonia/respiratory c. Urinary tract- device exchange, obstructive stone disease d. Enteritis- C. diff

9 Residents at Risk Urinary tract is the most common source of nosocomial infection and can lead to sepsis Gastrointestinal and pulmonary sources have the highest mortality rates C. diff/pseudomembranous Colitis have seen a marked increase in NH over the last 15 years and have become a high risk for sepsis and septic shock

10 Residents at Risk Residents at highest risk for sepsis progression often have: Pressure wounds, diabetic wounds, skin infections, drains End stage COPD, vented, Respiratory illnesses such as bronchitis /Flu/colds, aspiration UTI, catheters, recent device exchange, obstructive stone disease C. diff, enteritis, invasive colitis, Weakened immune systems, chronic diseases, recent hospitalizations

11 Residents at Risk Sepsis is the primary cause of death from infection, especially if not recognized and treated promptly Resident survival is highly correlated to how quickly the resident receives appropriate treatment during the initial hours 11

12 Early Recognition > Survival All residents in a Long Term Care facility have an increased risk for Sepsis due to age, comorbid conditions and the potential for the spread of nosocomial infection: Teach ALL staff that Time is Tissue sepsis spreads quickly and the likelihood of death increases with every hour of delay in treatment Implement tools such as interact, seeing sepsis, SBAR and ensure nurses are educated on how to screen for possible sepsis

13 Recognition + Intervention = Survival Know your residents Admission assessment identifies those at high risk Know your resident s wishes for treatment Utilize high risk rounding tool to monitor changes Raise Awareness Train ALL staff to recognize potential signs & symptoms of infection/pending sepsis Inform residents, family members and public How is the resident acting today? Is anything different? Report changes to Nurse 13

14 Recognition + Intervention = Survival Utilize tools to help staff Visual aids Posters and signs on medication carts, in break rooms Seeing Sepsis 100 Pocket cards Training programs Interact and AMDA Seeing Sepsis in LTC Assess your infection control program 14 Evaluate policies and practices CDC infection control assessment

15 Recognition + Intervention = Survival Partner with your acute care hospital Collaboration, communication and sharing Potential for additional learning opportunities Make sepsis a standing agenda item Know your data and share results Medical staff meetings Quality & Infection Control meetings Nursing staff meetings 15

16 Also Available Online communities Educational Programs with talking points Resident and Family Sepsis Brochure Educating Staff on tools Communication techniques Past webinars Additional tools a. SBAR b. IHI 16

17 17 Questions

18 VHQC Online Community Join the VHQC online community by visiting

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