| 28 | | - | (1) "Sepsis" means a known or suspected infection with at least two (2) or more system 7 |
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| 29 | | - | inflammatory response syndrome (SIRS) criteria as developed by American College of Chest 8 |
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| 30 | | - | Physicians/Society of Critical Care Medicine (1991). 9 |
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| 31 | | - | (2) "Severe sepsis" means a known or suspected infection with at least two (2) or more 10 |
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| 32 | | - | SIRS criteria and sepsis-related tissue hypoperfusion or organ dysfunction. 11 |
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| 33 | | - | (3) "Septic shock" means sepsis-induced hypotension persisting despite adequate 12 |
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| 34 | | - | intravenous (IV) fluid resuscitation and/or evidence of tissue hypoperfusion. 13 |
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| 35 | | - | (b) On or before February 1, 2024, to the extent allowable by available state and federal 14 |
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| 36 | | - | funding, the director of the department of health shall in coordination with the department of 15 |
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| 37 | | - | health's Antimicrobial Stewardship and Environmental Cleaning task force, make available to 16 |
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| 38 | | - | hospitals, urgent care facilities, freestanding emergency rooms, pediatric practices and EMS 17 |
|---|
| 39 | | - | agencies, information on best practices for the treatment of patients with sepsis and septic shock. 18 |
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| 40 | | - | The best practices shall be based on generally accepted standards of care, including, but not limited 19 |
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| 28 | + | (1) "Sepsis" means a life-threatening organ dysfunction caused by a dysregulated host 7 |
|---|
| 29 | + | response to infection. 8 |
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| 30 | + | (2) "Septic shock" means sepsis with persisting hypotension and having a serum lactate 9 |
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| 31 | + | level>2 mmol/L despite adequate volume resuscitation. 10 |
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| 32 | + | (b) On or before February 1, 2024, the director of the department of health shall develop 11 |
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| 33 | + | in coordination with the Antimicrobial Stewardship and Environmental Cleaning task force, and 12 |
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| 34 | + | make available to health care practitioners, information on best practices for the treatment of 13 |
|---|
| 35 | + | patients with sepsis and septic shock. The best practices shall be based on generally accepted 14 |
|---|
| 36 | + | standards of care, including, but not limited to: 15 |
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| 37 | + | (1) An evidence based screening tool that can be used at initial evaluation of adult and 16 |
|---|
| 38 | + | pediatric patients in the emergency department; 17 |
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| 39 | + | (2) An evidence based treatment protocol for adult and pediatric patients that includes time-18 |
|---|
| 40 | + | specific treatment goals; 19 |
|---|
| 43 | | - | LC001058/SUB A/2 - Page 2 of 3 |
|---|
| 44 | | - | to: 1 |
|---|
| 45 | | - | (1) An evidence-based screening tool that can be used at initial evaluation of adult and 2 |
|---|
| 46 | | - | pediatric patients in these settings; 3 |
|---|
| 47 | | - | (2) An evidence-based treatment protocol for adult and pediatric patients that includes 4 |
|---|
| 48 | | - | time-specific treatment goals; 5 |
|---|
| 49 | | - | (3) Nurse-driven testing protocols to enable nurses to initiate care for patients with 6 |
|---|
| 50 | | - | suspected sepsis; 7 |
|---|
| 51 | | - | (4) Incorporation of sepsis screening and treatment tools into the electronic health record 8 |
|---|
| 52 | | - | where possible; 9 |
|---|
| 53 | | - | (5) Mechanisms to prompt escalation of care within these settings, and, when appropriate, 10 |
|---|
| 54 | | - | to stabilize and transfer to a facility able to provide a higher level of care; 11 |
|---|
| 55 | | - | (6) Strategies for appropriate hand-offs and communication regarding the care of patients 12 |
|---|
| 56 | | - | with sepsis and for the reassessments of patients at regular intervals; 13 |
|---|
| 57 | | - | (7) Hospital specific antibiotic guidelines for use in treating patients with sepsis and a 14 |
|---|
| 58 | | - | mechanism for reevaluating a patient’s antibiotic treatment based on culture results that provides 15 |
|---|
| 59 | | - | reassessment and de-escalation of antibiotic treatment when appropriate; and 16 |
|---|
| 60 | | - | (8) Staff education on sepsis policies and procedures during the onboarding process and at 17 |
|---|
| 61 | | - | least annually and when new practice guidelines are published or existing standards are updated to 18 |
|---|
| 62 | | - | ensure that care reflects current standards of practice. 19 |
|---|
| 63 | | - | (c) In order to enhance patient safety and protection, each hospital licensed in the state shall 20 |
|---|
| 64 | | - | establish a multi-disciplinary committee to implement policies, procedures and staff education in 21 |
|---|
| 65 | | - | accordance with the best practices issued by the department of health. 22 |
|---|
| 66 | | - | (1) The multi-disciplinary committee at each hospital shall be responsible for the 23 |
|---|
| 67 | | - | collection, use, and reporting of quality measures related to the recognition and treatment of severe 24 |
|---|
| 68 | | - | sepsis for purposes of internal quality improvement and hospital reporting. Such measures shall 25 |
|---|
| 69 | | - | include, but not be limited to, data sufficient to evaluate each hospital’s adherence rate to its own 26 |
|---|
| 70 | | - | sepsis protocols, including adherence to timeframes and implementation of all protocol components 27 |
|---|
| 71 | | - | for adults and children. 28 |
|---|
| 72 | | - | (d) Contingent upon the availability of funding, the department of health shall offer 29 |
|---|
| 73 | | - | continuing education credits and other educational opportunities such as provider briefings for 30 |
|---|
| 74 | | - | pediatricians and EMS agencies on the early recognition and treatment of patients with sepsis. 31 |
|---|
| 75 | | - | SECTION 2. This act shall take effect upon passage. 32 |
|---|
| 43 | + | LC001058 - Page 2 of 4 |
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| 44 | + | (3) Nurse-driven testing protocols to enable nurses to initiate care for patients with 1 |
|---|
| 45 | + | suspected sepsis; 2 |
|---|
| 46 | + | (4) Incorporation of sepsis screening and treatment tools into the electronic health record 3 |
|---|
| 47 | + | where possible; 4 |
|---|
| 48 | + | (5) Mechanisms to prompt escalation of care within the facility, and, when appropriate, to 5 |
|---|
| 49 | + | stabilize and transfer to a facility able to provide a higher level of care; 6 |
|---|
| 50 | + | (6) Strategies for appropriate hand-offs and communication regarding the care of patients 7 |
|---|
| 51 | + | with sepsis and for the reassessments of patients at regular intervals; 8 |
|---|
| 52 | + | (7) Hospital specific antibiotic guidelines for use in treating patients with sepsis and a 9 |
|---|
| 53 | + | mechanism for reevaluating a patient’s antibiotic treatment based on culture results that provides 10 |
|---|
| 54 | + | reassessment and de-escalation of antibiotic treatment when appropriate; and 11 |
|---|
| 55 | + | (8) Staff education on sepsis policies and procedures during the onboarding process and at 12 |
|---|
| 56 | + | least annually and when new practice guidelines are published or existing standards are updated to 13 |
|---|
| 57 | + | ensure that care reflects current standards of practice. 14 |
|---|
| 58 | + | (c) In order to enhance patient safety and protection, each hospital and freestanding 15 |
|---|
| 59 | + | emergency-care facility licensed in the state shall implement policies and procedures in accordance 16 |
|---|
| 60 | + | with the best practices issued by the department of health. 17 |
|---|
| 61 | + | (d) Collection and reporting of sepsis measures. Each hospital and freestanding emergency-18 |
|---|
| 62 | + | care facility licensed in the state shall be responsible for the collection of data and the reporting of 19 |
|---|
| 63 | + | that data to the department annually, or more frequently at the request of the department, and shall 20 |
|---|
| 64 | + | be subject to audit at the discretion of the department. Regarding the collection of the data: 21 |
|---|
| 65 | + | (1) The medical staff shall be responsible for the collection, use, and reporting of quality 22 |
|---|
| 66 | + | measures related to the recognition and treatment of severe sepsis for purposes of internal quality 23 |
|---|
| 67 | + | improvement and hospital reporting to the department. Such measures shall include, but not be 24 |
|---|
| 68 | + | limited to, data sufficient to evaluate each hospital’s adherence rate to its own sepsis protocols, 25 |
|---|
| 69 | + | including adherence to timeframes and implementation of all protocol components for adults and 26 |
|---|
| 70 | + | children. 27 |
|---|
| 71 | + | (2) Hospitals shall submit data specified by the department to permit the department to 28 |
|---|
| 72 | + | develop risk-adjusted sepsis mortality rates in consultation with appropriate national, hospital and 29 |
|---|
| 73 | + | expert stakeholders. 30 |
|---|
| 74 | + | (e) Beginning on July 1, 2024, the department shall not issue or renew a license unless the 31 |
|---|
| 75 | + | applicant is in compliance with this section. 32 |
|---|
| 76 | + | |
|---|
| 77 | + | |
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| 78 | + | LC001058 - Page 3 of 4 |
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| 79 | + | SECTION 2. This act shall take effect upon passage. 1 |
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