PALTC Clinicians as First Responders Promotes Early Recognition, Better Outcomes for Sepsis
An article in the March issue of JAMDA details how post-acute and long-term care (PALTC) clinicians, working as first responders, can promote early recognition of sepsis and help prevent hospitalizations and readmissions related to this condition.
In “Post-acute and Long-term Care Settings as First Responders for the Surviving Sepsis Campaign,” the authors suggested that PALTC professionals are poised to serve as a first response for those individuals with suspected sepsis. Not only can this help reduce Emergency Department (ED) visits and hospitalizations, they said; it also may help residents survive sepsis. These efforts are in line with the Society of Critical Care’s Surviving Sepsis Campaign, which was introduced in 2016 to encourage early recognition and management of this potentially deadly condition.
Older adults, particularly frail nursing home residents, are at a higher risk of sepsis, a serious infection caused by harmful microorganisms in the blood or other tissues. Sepsis can lead to organ malfunction and/or damage, shock, and even death. Frail older patients who develop sepsis have higher rates of intensive care admissions, longer hospital lengths of stay, and greater chance of in-hospital mortality.
As first responders, the authors observed, “PALTC staff can and should initiate efforts to support a resident with concerns for early sepsis. These activities should occur simultaneously with assessing the need for transfer for acute care and, provided that hospitalization is part of the resident’s goals of care, making those arrangements when indicated.” The authors indicated that sepsis screening tools and protocols may help PALTC staff actually assess residents for sepsis and communicate their findings to on-call practitioners in real time. These protocols, they said, should take into account staff skills. The authors further noted that the first responders team also will need to document any clinical findings that prompted the concern about sepsis, the interventions used, and the resident’s clinical response to those interventions.
Ultimately, the authors said, “The recognition of PALTC staff as first responders in potential sepsis identification positions them to become champions for their residents. They can be empowered with the potential to reduce mortality.”
This study was conducted by researchers at the Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center in Ohio; and the Lahey Hospital and Medical Center in Burlington, MA.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About the Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PA/LTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.