“Ensuring greater awareness on the part of both the public and health care workers is a crucial step in reducing the global burden of sepsis. Approximately 70% of sepsis cases are community-acquired, and since treatment with appropriate antibiotics must begin early to be effective, educating people about seeking treatment without delay is key to preventing unnecessary deaths and disability… [S]epsis can affect anyone at any time, which means that national public awareness programs are needed,” members of the GSA executive board wrote in a commentary
published on June 28, 2017 in the New England Journal of Medicine
In the United States, New York became the first state to require hospitals to adopt evidence-based protocols for the diagnosis and management of sepsis, when its legislature approved “Rory’s Regulations” in 2013. Named for Rory Staunton, a 12-year-old boy who died from sepsis in an Empire State emergency department, the regulations have led to a 16% reduction in sepsis-related mortality over the 2 years they have been in effect, according to the Healthcare Association of New York State
However, not everyone is happy with these regulations. In another NEJM commentary
, published on June 15, 2017, health policy and critical care experts from the University of Pittsburgh warned that the regulations may have “unintended consequences”—including longer hospital stays and… wait for it… higher costs. Also at issue is the earlier initiation of antibiotic therapy that may result from hospitals’ desire to ensure compliance with Rory’s Regulations. This, of course, could compound the problem of overuse of these drugs, which would contradict WHO’s recommendations.
Indeed, it’s important to note that, in effect, the authors’ problems with Rory’s Regulations were not the spirit of them, but rather who authored them. They would vastly prefer clinicians take the lead in efforts to reduce sepsis, writing, “Clinical practice guidelines may make strong recommendations based on rigorous scientific evidence, but they are also inherently flexible, allowing physicians to exercise considerable professional judgment. Legislation and regulation, however, are inherently inflexible, forcing clinicians to adopt certain care practices independent of clinical judgment.”
Which is, arguably, a not-so-veiled jab at government officials sticking their noses in healthcare.
Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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