WES MOORE, Governor Ch. 923
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Chapter 923
(Senate Bill 332)
AN ACT concerning
Hospitals and Urgent Care Centers – Sepsis Protocol
(Lochlin’s Law)
FOR the purpose of requiring, on or before a certain date, each hospital and urgent care
center in the State to implement a certain protocol for the early recognition and
treatment of a patient with sepsis, severe sepsis, or septic shock; requiring hospitals
and urgent care centers to require periodic training in the implementation of the
protocol for certain staff; and generally relating to sepsis protocols in hospitals and
urgent care centers.
BY adding to
Article – Health – General
Section 19–310.4
Annotated Code of Maryland
(2023 Replacement Volume)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
19–310.4.
(A) (1) ON SUBJECT TO PARAGRAPHS (1) AND (2) OF THIS SUBSECTION ,
ON OR BEFORE JANUARY 1, 2025, EACH HOSPITAL A ND URGENT CARE CENTE R IN
THE STATE SHALL IMPLEMENT AN EVIDENCE–BASED PROTOCOL FOR T HE EARLY
RECOGNITION AND TREA TMENT OF A PATIENT W ITH SEPSIS, SEVERE SEPSIS, OR
SEPTIC SHOCK THAT IS BASED ON GENERALLY A CCEPTABLE STANDARDS OF CARE.
(2) THE EVIDENCE –BASED PROTOCOL IMPLEMENT ED FOR
HOSPITALS UNDER PARA GRAPH (1) OF THIS SUBSECTION S HALL COMPLY WITH THE
CENTERS FOR DISEASE CONTROL AND PREVENTION SEPSIS GUI DELINES.
(3) A HOSPITAL THAT IS A S PECIALTY PSYCHIATRIC HOSPITAL SHALL
ESTABLISH A PROCESS FOR THE SCR EENING AND EARLY REC OGNITION OF A
PATIENT WITH SEPSIS , SEVERE SEPSIS, OR SEPTIC SHOCK , AND PROCEDURES TO
TRANSFER THE PATIENT TO THE APPROPRIATE S ETTING.
(2) THE PROTOCOL SHALL : Ch. 923 2024 LAWS OF MARYLAND
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(I) INCLUDE COMPONENTS SP ECIFIC TO THE IDENTI FICATION,
CARE, AND TREATMENT OF ADULTS AND CHILDREN ; AND
(II) FOR A HOSPITAL , CLEARLY IDENTIFY WHE RE AND WHEN
THE COMPONENTS WILL DIFFER FOR ADULTS AN D CHILDREN SEEKING T REATMENT
IN THE EMERGENCY DEP ARTMENT OR AS AN INP ATIENT.
(3) THE COMPONENTS REQUIR ED UNDER PARAGR APH (2) OF THIS
SUBSECTION SHALL INC LUDE:
(I) A PROCESS FOR THE SCRE ENING AND EARLY RECO GNITION
OF A PATIENT WITH SE PSIS, SEVERE SEPSIS, OR SEPTIC SHOCK ;
(II) A PROCESS TO IDENTIFY AND DOCUMENT INDIVID UALS
APPROPRIATE FOR TREA TMENT THROUGH SEPSIS PROTOCOLS, INCLUDING
EXPLICIT CRITERIA DE FINING WHICH PATIENT S SHOULD BE EXCLUDED FROM THE
PROTOCOL, SUCH AS A PATIENT WI TH CERTAIN CLINICAL CONDITIONS OR A PATI ENT
WHO HAS CHOSEN PALLI ATIVE CARE;
(III) GUIDELINES FOR HEMODY NAMIC SUPPORT WITH E XPLICIT
PHYSIOLOGIC AND TREA TMENT GOALS , METHODOLOGY FOR INVA SIVE OR
NONINVASIVE HEMODYNA MIC MONITORING , AND TIME FRAME GOALS ;
(IV) FOR INFANTS AND CHILD REN, GUIDELINES FOR FLUID
RESUSCITATION CONSIS TENT WITH CURRENT , EVIDENCE–BASED GUIDELINES FOR
SEVERE SEPSIS AND SEPTIC SH OCK WITH DEFINED THE RAPEUTIC GOALS FOR
CHILDREN;
(V) IDENTIFICATION OF THE INFECTIOUS SOURCE AN D
DELIVERY OF EARLY BR OAD–SPECTRUM ANTIBIOTICS WITH TIMELY REEVALUA TION
TO ADJUST TO NARROW –SPECTRUM ANTIBIOTICS TARGETED TO IDENTIFI ED
INFECTIOUS SOURCES ; AND
(VI) CRITERIA FOR USE , BASED ON ACCEPTED EV IDENCE OF
VASOACTIVE AGENTS .
(B) A HOSPITAL THAT SUBMIT S SEPSIS DATA TO THE CENTERS FOR
MEDICARE AND MEDICAID SERVICES HOSPITAL INPATIENT QUALITY REPORTING
PROGRAM IS PRESUMED T O MEET THE REQUIREMENTS OF SUBSECTION (A) OF THIS
SECTION.
(C) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L: WES MOORE, Governor Ch. 923
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(1) REQUIRE PERIODIC TRAI NING IN THE IMPLEMEN TATION OF THE
SEPSIS PROTOCOL REQU IRED UNDER SUBSECTIO N (A) OF THIS SECTION FOR
PROFESSIONAL STAFF W ITH DIRECT PATIENT CARE R ESPONSIBILITIES AND , AS
APPROPRIATE , FOR STAFF WITH INDIR ECT PATIENT CARE RES PONSIBILITIES,
INCLUDING LABORATORY AND PHARMACY STAFF ; AND
(2) ENSURE THAT THE STAFF RECEIVE UPDATED TRAI NING IF THE
HOSPITAL OR URGENT C ARE CENTER MAKES A SUBSTANTIVE CHANGE T O THE
SEPSIS PROTOCOL .
(D) EACH HOSPITAL AND URG ENT CARE CENTER SHAL L COLLECT AND USE
QUALITY MEASURES REL ATED TO THE RECOGNIT ION AND TREATMENT OF SEVERE
SEPSIS FOR THE PURPO SE OF INTERNAL QUALI TY IMPROVEMENT .
(E) ON REQUEST , A HOSPITAL OR AN URGEN T CARE CENTER SHALL
PROVIDE THE PROTOCOL REQUIRED UNDER SUBSE CTION (A) OF THIS SECTION TO
THE DEPARTMENT .
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2024.
Approved by the Governor, May 16, 2024.