2023 -- H 5869 SUBSTITUTE A
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S TATE OF RHODE IS LAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2023
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A N A C T
RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTHCARE FACILITIES
Introduced By: Representatives DeSimone, Shekarchi, Slater, Hull, Kazarian, Cardillo,
and Biah
Date Introduced: March 01, 2023
Referred To: House Health & Human Services
It is enacted by the General Assembly as follows:
SECTION 1. Chapter 23-17 of the General Laws entitled "Licensing of Healthcare 1
Facilities" is hereby amended by adding thereto the following section: 2
23-17-66. Protocols for the early recognition and treatment of patients with 3
sepsis/severe sepsis/septic shock. 4
(a) For purposes of this section, the following words and terms shall have the following 5
meanings: 6
(1) "Sepsis" means a known or suspected infection with at least two (2) or more system 7
inflammatory response syndrome (SIRS) criteria as developed by American College of Chest 8
Physicians/Society of Critical Care Medicine (1991). 9
(2) "Severe sepsis" means a known or suspected infection with at least two (2) or more 10
SIRS criteria and sepsis-related tissue hypoperfusion or organ dysfunction. 11
(3) "Septic shock" means sepsis-induced hypotension persisting despite adequate 12
intravenous (IV) fluid resuscitation and/or evidence of tissue hypoperfusion. 13
(b) On or before February 1, 2024, to the extent allowable by available state and federal 14
funding, the director of the department of health shall in coordination with the department of 15
health's Antimicrobial Stewardship and Environmental Cleaning task force, make available to 16
hospitals, urgent care facilities, freestanding emergency rooms, pediatric practices and EMS 17
agencies, information on best practices for the treatment of patients with sepsis and septic shock. 18
The best practices shall be based on generally accepted standards of care, including, but not limited 19
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to: 1
(1) An evidence-based screening tool that can be used at initial evaluation of adult and 2
pediatric patients in these settings; 3
(2) An evidence-based treatment protocol for adult and pediatric patients that includes 4
time-specific treatment goals; 5
(3) Nurse-driven testing protocols to enable nurses to initiate care for patients with 6
suspected sepsis; 7
(4) Incorporation of sepsis screening and treatment tools into the electronic health record 8
where possible; 9
(5) Mechanisms to prompt escalation of care within these settings, and, when appropriate, 10
to stabilize and transfer to a facility able to provide a higher level of care; 11
(6) Strategies for appropriate hand-offs and communication regarding the care of patients 12
with sepsis and for the reassessments of patients at regular intervals; 13
(7) Hospital specific antibiotic guidelines for use in treating patients with sepsis and a 14
mechanism for reevaluating a patient’s antibiotic treatment based on culture results that provides 15
reassessment and de-escalation of antibiotic treatment when appropriate; and 16
(8) Staff education on sepsis policies and procedures during the onboarding process and at 17
least annually and when new practice guidelines are published or existing standards are updated to 18
ensure that care reflects current standards of practice. 19
(c) In order to enhance patient safety and protection, each hospital licensed in the state shall 20
establish a multi-disciplinary committee to implement policies, procedures and staff education in 21
accordance with the best practices issued by the department of health. 22
(1) The multi-disciplinary committee at each hospital shall be responsible for the 23
collection, use, and reporting of quality measures related to the recognition and treatment of severe 24
sepsis for purposes of internal quality improvement and hospital reporting. Such measures shall 25
include, but not be limited to, data sufficient to evaluate each hospital’s adherence rate to its own 26
sepsis protocols, including adherence to timeframes and implementation of all protocol components 27
for adults and children. 28
(d) Contingent upon the availability of funding, the department of health shall offer 29
continuing education credits and other educational opportunities such as provider briefings for 30
pediatricians and EMS agencies on the early recognition and treatment of patients with sepsis. 31
SECTION 2. This act shall take effect upon passage. 32
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTHCARE FACILITIES
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This act would require the director of the department of health by February 1, 2024, to 1
develop in coordination with the Antimicrobial Stewardship and Environmental Cleaning task 2
force, and make available to health care practitioners, information on best practices for the 3
treatment of patients with sepsis and septic shock. Each hospital and freestanding emergency-care 4
facility would implement procedures and policies in accordance with this section. 5
This act would take effect upon passage. 6
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