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Excellence Canada has developed this Hospital Harm Improvement Resource – a compilation of resources to support patient safety and improvement efforts.","fe2aa94c-215a-4302-89a5-1a8ebb48552a",[284],{"_uid":285,"image":286,"title":291,"format":292,"component":295,"description":296,"key_learning":304,"prerequisite":307},"efc60e6a-070a-4335-af48-979eea4f84ce",{"id":287,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":288,"copyright":16,"fieldtype":289,"meta_data":290,"is_external_url":277},121293751894639,"https://a-ca.storyblok.com/f/850807391887861/2216x1568/ea857fcb8e/shapes.webp","asset",{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Sepsis",{"type":12,"content":293},[294],{"type":15},"hero-resource",{"type":12,"content":297},[298],{"type":15,"attrs":299,"content":300},{"textAlign":53},[301],{"text":302,"type":303},"Sepsis is defined as: \"life-threatening organ dysfunction caused by dysregulated host response to infection\" (Singer et al., 2016). It affects neonatal, pediatric, and adult patients worldwide. Differentiated from an uncomplicated infection by virtue of the dysregulated host response and acute organ dysfunction, sepsis can present as or progress to septic shock, recently redefined as: \"a subset of sepsis in which particularly profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone.\" (Singer et al., 2016). Maternal sepsis is a life-threatening condition defined as an organ dysfunction caused by an infection during pregnancy, delivery, puerperium, or after an abortion (Escobar et al., 2020).","text",{"type":12,"content":305},[306],{"type":15},{"type":12,"content":308},[309],{"type":15},[76,8],[312,327,523,905,952,1562,1626,1775],{"_uid":313,"link":314,"image":315,"title":317,"component":318,"media_type":319,"description":320},"a40f3c31-2be0-450d-8ec3-bc72ad634bf2",[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":289,"meta_data":316},{},"Goal","info-block-program","none",{"type":12,"content":321},[322],{"type":15,"attrs":323,"content":324},{"textAlign":53},[325],{"text":326,"type":303},"To decrease the morbidity and mortality from sepsis and to prevent nosocomial sepsis in the hospitalized pediatric and adult population.",{"_uid":328,"content":329,"component":522},"1010ae87-305e-4413-a52a-63495dbe7cf3",[330],{"_uid":331,"content":332,"component":521},"a217acfe-5514-41a9-b405-799b24d56e71",{"type":12,"content":333},[334,341,364,369,374,379,384,389,395,476,481,486,492,507,512],{"type":335,"attrs":336,"content":338},"heading",{"level":337,"textAlign":53},2,[339],{"text":340,"type":303},"Overview",{"type":15,"attrs":342,"content":343},{"textAlign":53},[344,346,362],{"text":345,"type":303},"Healthcare Excellence Canada has developed this ",{"text":347,"type":303,"marks":348},"Hospital Harm Improvement Resource",[349],{"type":350,"attrs":351},"link",{"href":352,"uuid":353,"anchor":53,"custom":354,"target":355,"linktype":356,"story":357},"/resources/hospital-harm-improvement-resource","2fa59e87-8ca2-4dcf-96b5-e7ee0bf5217f",{},"_self","story",{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360,"_stopResolving":361},119563150823813,"hospital-harm-improvement-resource","resources/hospital-harm-improvement-resource",true,{"text":363,"type":303}," – a compilation of resources to support patient safety and improvement efforts.",{"type":15,"attrs":365,"content":366},{"textAlign":53},[367],{"text":368,"type":303},"Healthcare-associated infections (HAIs) can lead to sepsis and its deleterious outcomes (Riley & Wheeler, 2012). Failure to comply with evidence-based infection preventive practices for HAIs increases the incidence of hospital-acquired sepsis.",{"type":15,"attrs":370,"content":371},{"textAlign":53},[372],{"text":373,"type":303},"HAIs account for a large proportion of patient safety incidents in Canada. Every year, it is estimated that 220,000 Canadian patients (approximately one in nine) will develop an infection during their stay in hospital. Complicating the problem is the fact that many HAIs are caused by antimicrobial-resistant organisms (AROs), which make them difficult to treat. Although progress has been made to prevent and control ARO-related HAIs, much work remains to be done. Globally and in Canada, the steps taken to mitigate antimicrobial resistance (AMR) are relatively limited (MacLaurin et al., 2020). The Public Health Agency of Canada (PHAC) estimates that approximately two per cent of patients admitted to large, academic Canadian hospitals will have acquired an infection with an ARO during the course of their hospital stay (Mitchell et al., 2019) and that at any given time, three to 10 per cent of patients who are hospitalized in Canada will either be infected or be a carrier of an ARO (Martin et al., 2019).",{"type":15,"attrs":375,"content":376},{"textAlign":53},[377],{"text":378,"type":303},"Canada continues to lag behind other OECD countries on sepsis following abdominal surgery (CIHI, 2019b). In 2019, the Canadian in-hospital sepsis rate was 3.9 per 1,000 patients (CIHI, 2019a).  Sepsis affects approximately 1.7 million adults in the United States each year and potentially contributes to more than 250,000 deaths. Various studies estimate that sepsis is present in 30 to 50 per cent of hospitalizations that culminate in death. The high burden of sepsis and the perception that most sepsis-associated deaths are preventable with better care has catalyzed numerous sepsis performance improvement initiatives in hospitals around the world (Rhee et al., 2019).  ",{"type":15,"attrs":380,"content":381},{"textAlign":53},[382],{"text":383,"type":303},"It has been reported in a recent study that hospital-onset sepsis preferentially afflicted ill patients but even after risk-adjustment, they were twice as likely to die as community-onset sepsis patients; in patients admitted without sepsis, hospital-onset sepsis tripled the risk of death. Hospital-onset sepsis is an important target for surveillance, prevention, and quality improvement initiatives (Rhee et al., 2019).",{"type":15,"attrs":385,"content":386},{"textAlign":53},[387],{"text":388,"type":303},"Recommendations for guiding care for adults with critical or severe Coronavirus associated sepsis have been developed by the Surviving Sepsis Campaign Coronavirus Disease 2019 panel and will be updated as necessary (Alhazzani et al., 2020). ",{"type":335,"attrs":390,"content":392},{"level":391,"textAlign":53},3,[393],{"text":394,"type":303},"Risk Factors",{"type":396,"content":397},"bullet_list",[398,406,413,420,427,434,441,448,455,462,469],{"type":399,"content":400},"list_item",[401],{"type":15,"attrs":402,"content":403},{"textAlign":53},[404],{"text":405,"type":303},"Examples of risk factors are:",{"type":399,"content":407},[408],{"type":15,"attrs":409,"content":410},{"textAlign":53},[411],{"text":412,"type":303},"Age (higher risk in neonates and elderly persons than in other age groups).",{"type":399,"content":414},[415],{"type":15,"attrs":416,"content":417},{"textAlign":53},[418],{"text":419,"type":303},"Chronic diseases with/without severe organ dysfunction.",{"type":399,"content":421},[422],{"type":15,"attrs":423,"content":424},{"textAlign":53},[425],{"text":426,"type":303},"Immunodeficiency.",{"type":399,"content":428},[429],{"type":15,"attrs":430,"content":431},{"textAlign":53},[432],{"text":433,"type":303},"Immunosuppressive agents.",{"type":399,"content":435},[436],{"type":15,"attrs":437,"content":438},{"textAlign":53},[439],{"text":440,"type":303},"Inappropriate use of antibiotics.",{"type":399,"content":442},[443],{"type":15,"attrs":444,"content":445},{"textAlign":53},[446],{"text":447,"type":303},"The presence of implanted medical devices (intravascular or other).",{"type":399,"content":449},[450],{"type":15,"attrs":451,"content":452},{"textAlign":53},[453],{"text":454,"type":303},"Pregnancy.",{"type":399,"content":456},[457],{"type":15,"attrs":458,"content":459},{"textAlign":53},[460],{"text":461,"type":303},"Prematurity.",{"type":399,"content":463},[464],{"type":15,"attrs":465,"content":466},{"textAlign":53},[467],{"text":468,"type":303},"Infection is more likely to occur when the normal anatomy is altered by a process – benign or malignant - that either obstructs a normal passage (e.g., calculous cholecystitis, prostatitis) or breaks and enters a previously sterile system (e.g., skin breakdown by trauma, dermatological conditions).",{"type":399,"content":470},[471],{"type":15,"attrs":472,"content":473},{"textAlign":53},[474],{"text":475,"type":303},"Patients unable to communicate their symptoms often present later in their illness (i.e., often with sepsis) (CPSI et al., 2015).",{"type":335,"attrs":477,"content":478},{"level":337,"textAlign":53},[479],{"text":480,"type":303},"Importance to Patients and Families",{"type":335,"attrs":482,"content":483},{"level":391,"textAlign":53},[484],{"text":485,"type":303},"Patient Stories",{"type":335,"attrs":487,"content":489},{"level":488,"textAlign":53},4,[490],{"text":491,"type":303},"Julie's Story",{"type":15,"attrs":493,"content":494},{"textAlign":53},[495,497,505],{"text":496,"type":303},"This short documentary accompanies \"",{"text":491,"type":303,"marks":498},[499],{"type":350,"attrs":500},{"href":501,"uuid":53,"anchor":53,"custom":502,"target":503,"linktype":504},"https://www.patientstories.org.uk/recent-posts/julies-story-now-available/","[object Object]","_blank","url",{"text":506,"type":303},"\". In 2008, Julie Carman was involved in a road traffic accident whilst on a cycling holiday. She suffered injuries to her face, jaw and legs but made a good initial recovery and expected to be back at work within three months. Three years later she was still having treatment having experienced two further emergency admissions to hospital due to acute cellulitis and sepsis. In this short film, Julie explains how a series of \"everyday\" communication failures conspired to create delays in her receiving effective treatment (Patient Stories, 2013).",{"type":335,"attrs":508,"content":509},{"level":488,"textAlign":53},[510],{"text":511,"type":303},"Additional Sepsis Survival Stories",{"type":15,"attrs":513,"content":514},{"textAlign":53},[515],{"text":516,"type":303,"marks":517},"https://bcpsqc.ca/improve-care/sepsis/sepsis-survival-stories/",[518],{"type":350,"attrs":519},{"href":520,"uuid":53,"anchor":53,"custom":502,"target":503,"linktype":504},"https://healthqualitybc.ca/improve-care/sepsis/sepsis-survival-stories/","simple-richtext","wysiwyg-program",{"_uid":524,"items":525,"title":851,"component":852,"description":853},"56ab3959-1b16-41e9-818d-10a351c10b24",[526],{"_uid":527,"title":528,"ctaLeft":529,"ctaRight":530,"component":531,"columnLeft":532,"columnRight":558},"610b88a1-8386-4bd1-868e-1ec5ba02ae49","Expand to see a full list of resources",[],[],"accordion-item-columns",{"type":12,"content":533},[534],{"type":15,"attrs":535,"content":536},{"textAlign":53},[537,544,553],{"text":538,"type":303,"marks":539},"To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the ",[540],{"type":541,"attrs":542},"textStyle",{"color":543},"#000000",{"text":545,"type":303,"marks":546},"Hospital Harm Improvement Resource Introduction",[547,551],{"type":350,"attrs":548},{"href":352,"uuid":353,"anchor":53,"custom":549,"target":355,"linktype":356,"story":550},{},{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360,"_stopResolving":361},{"type":552},"underline",{"text":554,"type":303,"marks":555},".",[556],{"type":541,"attrs":557},{"color":543},{"type":12,"content":559},[560,574,579,802,810],{"type":15,"attrs":561,"content":562},{"textAlign":53},[563,565,572],{"text":564,"type":303},"To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the ",{"text":566,"type":303,"marks":567},"Hospital Harm Improvement Resources Introduction",[568],{"type":350,"attrs":569},{"href":352,"uuid":353,"anchor":53,"custom":570,"target":355,"linktype":356,"story":571},{},{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360,"_stopResolving":361},{"text":573,"type":303},". ",{"type":15,"attrs":575,"content":576},{"textAlign":53},[577],{"text":578,"type":303},"If your review reveals that your cases of Sepsis are linked to specific processes or procedures, you may find these resources helpful:",{"type":396,"content":580},[581,594,607,620,627,634,641,659,672,685,698,711,724,737,750,763,776,789],{"type":399,"content":582},[583],{"type":15,"attrs":584,"content":585},{"textAlign":53},[586,588],{"text":587,"type":303},"BC Patient Safety and Quality Council ",{"text":589,"type":303,"marks":590},"https://bcpsqc.ca/",[591],{"type":350,"attrs":592},{"href":589,"uuid":53,"anchor":53,"custom":593,"target":503,"linktype":504},{},{"type":399,"content":595},[596],{"type":15,"attrs":597,"content":598},{"textAlign":53},[599,601],{"text":600,"type":303},"BC Patient Safety & Quality Council. BC Sepsis Network. BC Patient Safety & Quality Council. ",{"text":602,"type":303,"marks":603},"https://bcpsqc.ca/improve-care/bc-sepsis-network/",[604],{"type":350,"attrs":605},{"href":602,"uuid":53,"anchor":53,"custom":606,"target":503,"linktype":504},{},{"type":399,"content":608},[609],{"type":15,"attrs":610,"content":611},{"textAlign":53},[612,614],{"text":613,"type":303},"Canadian Patient Safety Institute (CPSI) ",{"text":615,"type":303,"marks":616},"https://www.patientsafetyinstitute.ca/en/toolsResources/Hospital-Harm-Measure/Improvement-Resources/Pages/default.aspx",[617],{"type":350,"attrs":618},{"href":615,"uuid":53,"anchor":53,"custom":619,"target":503,"linktype":504},{},{"type":399,"content":621},[622],{"type":15,"attrs":623,"content":624},{"textAlign":53},[625],{"text":626,"type":303},"Hospital Harm Improvement Resource – Infections due to C.diff, MRSA, VRE",{"type":399,"content":628},[629],{"type":15,"attrs":630,"content":631},{"textAlign":53},[632],{"text":633,"type":303},"Hospital Harm Improvement Resource – Pneumonia",{"type":399,"content":635},[636],{"type":15,"attrs":637,"content":638},{"textAlign":53},[639],{"text":640,"type":303},"Hospital Harm Improvement Resource – Post-Procedure Infections",{"type":399,"content":642},[643],{"type":15,"attrs":644,"content":645},{"textAlign":53},[646],{"text":647,"type":303,"marks":648},"Hospital Harm Improvement Resource – UTI",[649],{"type":350,"attrs":650},{"href":651,"uuid":652,"anchor":53,"custom":653,"target":355,"linktype":356,"story":654},"/resources/uti","84f2d6ed-e605-4661-a35e-a72925e2fd41",{},{"name":655,"id":656,"uuid":652,"slug":657,"url":658,"full_slug":658,"_stopResolving":361},"UTI",120912827454023,"uti","resources/uti",{"type":399,"content":660},[661],{"type":15,"attrs":662,"content":663},{"textAlign":53},[664,666],{"text":665,"type":303},"Centers for Disease Control and Prevention ",{"text":667,"type":303,"marks":668},"www.cdc.gov",[669],{"type":350,"attrs":670},{"href":667,"uuid":53,"anchor":53,"custom":671,"target":503,"linktype":504},{},{"type":399,"content":673},[674],{"type":15,"attrs":675,"content":676},{"textAlign":53},[677,679],{"text":678,"type":303},"Centers for Disease Control and Prevention. Sepsis: Clinical Information. Clinical Resources. Published December 7, 2020. Accessed March 2021. ",{"text":680,"type":303,"marks":681},"https://www.cdc.gov/sepsis/clinicaltools/index.html",[682],{"type":350,"attrs":683},{"href":680,"uuid":53,"anchor":53,"custom":684,"target":503,"linktype":504},{},{"type":399,"content":686},[687],{"type":15,"attrs":688,"content":689},{"textAlign":53},[690,692],{"text":691,"type":303},"Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for prevention of catheter-associated urinary tract infections 2009. Infection Control Hospital Epidemiology. 2010;31(4):319-326. ",{"text":693,"type":303,"marks":694},"http://www.cdc.gov/hicpac/pdf/cauti/cautiguideline2009final.pdf",[695],{"type":350,"attrs":696},{"href":693,"uuid":53,"anchor":53,"custom":697,"target":503,"linktype":504},{},{"type":399,"content":699},[700],{"type":15,"attrs":701,"content":702},{"textAlign":53},[703,705],{"text":704,"type":303},"Novosad SA, Sapiano MRP, Grigg C, et al. Vital Signs: Epidemiology of Sepsis: Prevalence of Health Care Factors and Opportunities for Prevention. Morbidity and Mortality Weekly Report. 2016;65(33):864-869. ",{"text":706,"type":303,"marks":707},"http://dx.doi.org/10.15585/mmwr.mm6533e1",[708],{"type":350,"attrs":709},{"href":706,"uuid":53,"anchor":53,"custom":710,"target":503,"linktype":504},{},{"type":399,"content":712},[713],{"type":15,"attrs":714,"content":715},{"textAlign":53},[716,718],{"text":717,"type":303},"Tumpey A. Empowering Nurses for Early Sepsis Recognition; 2016. Accessed March 2021. ",{"text":719,"type":303,"marks":720},"https://www.youtube.com/watch?v=s687VMj6iwo",[721],{"type":350,"attrs":722},{"href":719,"uuid":53,"anchor":53,"custom":723,"target":503,"linktype":504},{},{"type":399,"content":725},[726],{"type":15,"attrs":727,"content":728},{"textAlign":53},[729,731],{"text":730,"type":303},"Tumpey A. Sepsis Standard Work: Improving Compliance with Early Recognition and Management of Perinatal Sepsis; 2017. ",{"text":732,"type":303,"marks":733},"https://www.youtube.com/watch?v=BUuFfwsj1W4",[734],{"type":350,"attrs":735},{"href":732,"uuid":53,"anchor":53,"custom":736,"target":503,"linktype":504},{},{"type":399,"content":738},[739],{"type":15,"attrs":740,"content":741},{"textAlign":53},[742,744],{"text":743,"type":303},"Tumpey A. Advances in Sepsis: Protecting Patients Throughout the Lifespan; 2016. Accessed March 23, 2021. ",{"text":745,"type":303,"marks":746},"https://www.youtube.com/watch?v=EASYi4-_bv4",[747],{"type":350,"attrs":748},{"href":745,"uuid":53,"anchor":53,"custom":749,"target":503,"linktype":504},{},{"type":399,"content":751},[752],{"type":15,"attrs":753,"content":754},{"textAlign":53},[755,757],{"text":756,"type":303},"Global Sepsis Alliance ",{"text":758,"type":303,"marks":759},"www.global-sepsis-alliance.org",[760],{"type":350,"attrs":761},{"href":758,"uuid":53,"anchor":53,"custom":762,"target":503,"linktype":504},{},{"type":399,"content":764},[765],{"type":15,"attrs":766,"content":767},{"textAlign":53},[768,770],{"text":769,"type":303},"Infection Prevention and Control Canada ",{"text":771,"type":303,"marks":772},"www.ipac-canada.org",[773],{"type":350,"attrs":774},{"href":771,"uuid":53,"anchor":53,"custom":775,"target":503,"linktype":504},{},{"type":399,"content":777},[778],{"type":15,"attrs":779,"content":780},{"textAlign":53},[781,783],{"text":782,"type":303},"Society of Critical Care Medicine ",{"text":784,"type":303,"marks":785},"https://www.sccm.org",[786],{"type":350,"attrs":787},{"href":784,"uuid":53,"anchor":53,"custom":788,"target":503,"linktype":504},{},{"type":399,"content":790},[791],{"type":15,"attrs":792,"content":793},{"textAlign":53},[794,796],{"text":795,"type":303},"Surviving Sepsis Campaign ",{"text":797,"type":303,"marks":798},"https://www.sccm.org/SurvivingSepsisCampaign/Home",[799],{"type":350,"attrs":800},{"href":797,"uuid":53,"anchor":53,"custom":801,"target":503,"linktype":504},{},{"type":15,"attrs":803,"content":804},{"textAlign":53},[805],{"text":806,"type":303,"marks":807},"Guidelines and Bundles",[808],{"type":809},"bold",{"type":396,"content":811},[812,825,838],{"type":399,"content":813},[814],{"type":15,"attrs":815,"content":816},{"textAlign":53},[817,819],{"text":818,"type":303},"Covid-19 Guideline ",{"text":820,"type":303,"marks":821},"https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/COVID-19",[822],{"type":350,"attrs":823},{"href":820,"uuid":53,"anchor":53,"custom":824,"target":503,"linktype":504},{},{"type":399,"content":826},[827],{"type":15,"attrs":828,"content":829},{"textAlign":53},[830,832],{"text":831,"type":303},"Adult Patients ",{"text":833,"type":303,"marks":834},"https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/Adult-Patients",[835],{"type":350,"attrs":836},{"href":833,"uuid":53,"anchor":53,"custom":837,"target":503,"linktype":504},{},{"type":399,"content":839},[840],{"type":15,"attrs":841,"content":842},{"textAlign":53},[843,845],{"text":844,"type":303},"Pediatric Patients ",{"text":846,"type":303,"marks":847},"https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/Pediatric-Patients",[848],{"type":350,"attrs":849},{"href":846,"uuid":53,"anchor":53,"custom":850,"target":503,"linktype":504},{},"Clinical and System Reviews, Incident Analyses","accordion-2-columns",{"type":12,"content":854},[855,866,872],{"type":15,"attrs":856,"content":857},{"textAlign":53},[858,860,864],{"text":859,"type":303},"Given the broad range of potential causes of ",{"text":270,"type":303,"marks":861},[862],{"type":863},"italic",{"text":865,"type":303},", in addition to recommendations listed above, we recommend conducting clinical and system reviews to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":867,"content":869},{"textAlign":868},"left",[870],{"text":871,"type":303},"Occurrences of harm are often complex with many contributing factors. Organizations need to:",{"type":873,"attrs":874,"content":876},"ordered_list",{"order":875},1,[877,884,891,898],{"type":399,"content":878},[879],{"type":15,"attrs":880,"content":881},{"textAlign":53},[882],{"text":883,"type":303},"Measure and monitor the types and frequency of these occurrences.",{"type":399,"content":885},[886],{"type":15,"attrs":887,"content":888},{"textAlign":53},[889],{"text":890,"type":303},"Use appropriate analytical methods to understand the contributing factors.",{"type":399,"content":892},[893],{"type":15,"attrs":894,"content":895},{"textAlign":53},[896],{"text":897,"type":303},"Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.",{"type":399,"content":899},[900],{"type":15,"attrs":901,"content":902},{"textAlign":53},[903],{"text":904,"type":303},"Have mechanisms in place to mitigate consequences of harm when it occurs.",{"_uid":906,"items":907,"title":943,"component":944,"description":945},"be3b7a82-b7ec-4b53-a512-e4112073c052",[908,919,927,935],{"_uid":909,"image":910,"title":914,"component":915,"description":916},"458f36cf-6776-4902-a081-12df8c65ad9f",{"id":911,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":912,"copyright":16,"fieldtype":289,"meta_data":913,"is_external_url":277},119537678778928,"https://a-ca.storyblok.com/f/850807391887861/600x600/c301964117/checkmark-icon.png",{},"You may use different measures or modify the measures described below to make them more appropriate and/or useful to your particular setting. However, be aware that modifying measures may limit the comparability of your results to others.","small-text-image-item",{"type":12,"content":917},[918],{"type":15},{"_uid":920,"image":921,"title":923,"component":915,"description":924},"498e534c-913a-4ac0-90da-3396951645da",{"id":911,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":912,"copyright":16,"fieldtype":289,"meta_data":922,"is_external_url":277},{},"Evaluate your choice of measures in terms of the usefulness of the final results and the resources required to obtain them; try to maximize the former while minimizing the latter.",{"type":12,"content":925},[926],{"type":15},{"_uid":928,"image":929,"title":931,"component":915,"description":932},"5c88ef3c-3fd2-442e-b9cf-478a0643de91",{"id":911,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":912,"copyright":16,"fieldtype":289,"meta_data":930,"is_external_url":277},{},"Whenever possible, use measures you are already collecting for other programs.",{"type":12,"content":933},[934],{"type":15},{"_uid":936,"image":937,"title":939,"component":915,"description":940},"6c6d04c8-d218-424c-945d-1f645847d838",{"id":911,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":912,"copyright":16,"fieldtype":289,"meta_data":938,"is_external_url":277},{},"Try to include both process and outcome measures in your measurement scheme.",{"type":12,"content":941},[942],{"type":15},"Measures","small-text-image",{"type":12,"content":946},[947],{"type":15,"attrs":948,"content":949},{"textAlign":53},[950],{"text":951,"type":303},"Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is actually being carried out (process measures), and whether any unintended consequences ensue (balancing measures). In selecting your measures, consider the following:",{"_uid":953,"items":954,"title":1538,"component":852,"description":1539},"ed575e2d-c13a-4a32-9df1-afe3f84c8465",[955,1111,1272,1421],{"_uid":956,"title":957,"ctaLeft":958,"ctaRight":959,"component":531,"columnLeft":960,"columnRight":1021},"31df90e3-3c2a-448e-8c03-8cbb7c9f6e6f","Selection Criteria",[],[],{"type":12,"content":961},[962,969,1000,1016],{"type":15,"attrs":963,"content":964},{"textAlign":53},[965],{"text":966,"type":303,"marks":967},"Exclusions",[968],{"type":809},{"type":873,"attrs":970,"content":971},{"order":875},[972,979,986,993],{"type":399,"content":973},[974],{"type":15,"attrs":975,"content":976},{"textAlign":53},[977],{"text":978,"type":303},"Abstracts with age on admission less than 1 year.",{"type":399,"content":980},[981],{"type":15,"attrs":982,"content":983},{"textAlign":53},[984],{"text":985,"type":303},"Abstracts with a length of stay less than 2 days",{"type":399,"content":987},[988],{"type":15,"attrs":989,"content":990},{"textAlign":53},[991],{"text":992,"type":303},"Abstracts with a most responsible diagnosis of palliative care (ICD-10-CA: Z51:5)",{"type":399,"content":994},[995],{"type":15,"attrs":996,"content":997},{"textAlign":53},[998],{"text":999,"type":303},"Abstracts where sepsis is also identified as a pre-admit condition are excluded from the numerator:",{"type":396,"content":1001},[1002,1009],{"type":399,"content":1003},[1004],{"type":15,"attrs":1005,"content":1006},{"textAlign":53},[1007],{"text":1008,"type":303},"Abstracts with sepsis codes (ICD-10-CA: A40.–, A41.–, B37.7, R65.1, R57.2) or the associated post-procedural complication codes (ICD-10-CA: T80.2, T81.1, T81.4, T82.6, T82.7–, T83.5, T83.6, T84.5–, T84.6–, T84.7, T85.7, T88.0) identified as pre-admit [type (M), (1), (W), (X) or (Y)]",{"type":399,"content":1010},[1011],{"type":15,"attrs":1012,"content":1013},{"textAlign":53},[1014],{"text":1015,"type":303},"Abstract with sepsis in obstetric patients where the puerperal sepsis code or the associated obstetric infection code is identified as pre-admit [ICD-10-CA: O85.004, O85.009, O98.501, O98.503, O98.504, O98.509, O98.801, O98.803, O98.804, O98.809 — any diagnosis type or O03.0, O03.5, O04.0, O04.5, O05.0, O05.5, O07.3, O08.0 as type (M), (1), (W), (X) or (Y)]",{"type":15,"attrs":1017,"content":1018},{"textAlign":53},[1019],{"text":1020,"type":303},"As an exception, sepsis is not considered as a pre-admit condition when the above codes identified as type (M), (W), (X) or (Y) also appear as type (2) or within a post-admit sepsis coding scenario (sepsis code as type (2); sepsis code as type (3) or an associated infection code as type (2) in sepsis as post-procedural or obstetric complications",{"type":12,"content":1022},[1023,1032,1047,1055,1063,1070,1078,1085,1093,1102],{"type":15,"attrs":1024,"content":1025},{"textAlign":53},[1026,1030],{"text":1027,"type":303,"marks":1028},"Code",[1029],{"type":809},{"text":1031,"type":303},": Condition",{"type":15,"attrs":1033,"content":1034},{"textAlign":53},[1035,1042],{"text":1036,"type":303,"marks":1037},"A40.–, A41.–, B37.7, R57.2, R65.1",[1038,1041],{"type":541,"attrs":1039},{"color":1040},"#575757",{"type":809},{"text":1043,"type":303,"marks":1044},": Identified as diagnosis type (2)",[1045],{"type":541,"attrs":1046},{"color":1040},{"type":15,"attrs":1048,"content":1049},{"textAlign":53},[1050],{"text":1051,"type":303,"marks":1052},"OR",[1053],{"type":541,"attrs":1054},{"color":1040},{"type":15,"attrs":1056,"content":1057},{"textAlign":53},[1058],{"text":1059,"type":303,"marks":1060},"Identified as diagnosis type (3) AND T80.2, T81.4, T82.6,   T82.7–, T83.5, T83.6, T84.5–, T84.6–, T84.7, T85.7 or T88.0 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster",[1061],{"type":541,"attrs":1062},{"color":1040},{"type":15,"attrs":1064,"content":1065},{"textAlign":53},[1066],{"text":1051,"type":303,"marks":1067},[1068],{"type":541,"attrs":1069},{"color":1040},{"type":15,"attrs":1071,"content":1072},{"textAlign":53},[1073],{"text":1074,"type":303,"marks":1075},"Identified as diagnosis type (3) AND O03.0, O03.5, O04.0, O04.5, O05.0, O05.5, O07.3 or O08.0– as diagnosis type (2) on the same abstract",[1076],{"type":541,"attrs":1077},{"color":1040},{"type":15,"attrs":1079,"content":1080},{"textAlign":53},[1081],{"text":1051,"type":303,"marks":1082},[1083],{"type":541,"attrs":1084},{"color":1040},{"type":15,"attrs":1086,"content":1087},{"textAlign":53},[1088],{"text":1089,"type":303,"marks":1090},"Identified as diagnosis type (3) AND O98.502 or O98.802 as diagnosis type (M), (1), (2), (W), (X) or (Y) on the same abstract",[1091],{"type":541,"attrs":1092},{"color":1040},{"type":15,"attrs":1094,"content":1095},{"textAlign":53},[1096,1100],{"text":1097,"type":303,"marks":1098},"O85.002",[1099],{"type":809},{"text":1101,"type":303},": Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)",{"type":15,"attrs":1103,"content":1104},{"textAlign":53},[1105,1109],{"text":1106,"type":303,"marks":1107},"R57.2",[1108],{"type":809},{"text":1110,"type":303},": Identified as diagnosis type (3) AND T81.1 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster",{"_uid":1112,"title":1113,"ctaLeft":1114,"ctaRight":1115,"component":531,"columnLeft":1116,"columnRight":1120},"b9b8c1e0-53ae-4f62-8dc7-54e61e464643","Codes & Code Descriptions",[],[],{"type":12,"content":1117},[1118],{"type":15,"attrs":1119},{"textAlign":53},{"type":12,"content":1121},[1122,1130,1139,1148,1157,1166,1175,1184,1193,1202,1211,1220,1229,1237,1246,1255,1263],{"type":15,"attrs":1123,"content":1124},{"textAlign":53},[1125,1128],{"text":1027,"type":303,"marks":1126},[1127],{"type":809},{"text":1129,"type":303},": Code Description",{"type":15,"attrs":1131,"content":1132},{"textAlign":53},[1133,1137],{"text":1134,"type":303,"marks":1135},"A40",[1136],{"type":809},{"text":1138,"type":303},": Streptococcal sepsis",{"type":15,"attrs":1140,"content":1141},{"textAlign":53},[1142,1146],{"text":1143,"type":303,"marks":1144},"A41",[1145],{"type":809},{"text":1147,"type":303},".–: Other sepsis",{"type":15,"attrs":1149,"content":1150},{"textAlign":53},[1151,1155],{"text":1152,"type":303,"marks":1153},"B37.7",[1154],{"type":809},{"text":1156,"type":303},": Candidal sepsis",{"type":15,"attrs":1158,"content":1159},{"textAlign":53},[1160,1164],{"text":1161,"type":303,"marks":1162},"O03.0",[1163],{"type":809},{"text":1165,"type":303},": Spontaneous abortion, incomplete, complicated by genital tract and pelvic infection",{"type":15,"attrs":1167,"content":1168},{"textAlign":53},[1169,1173],{"text":1170,"type":303,"marks":1171},"O03.5",[1172],{"type":809},{"text":1174,"type":303},": Spontaneous abortion, complete or unspecified, complicated by genital tract and pelvic infection",{"type":15,"attrs":1176,"content":1177},{"textAlign":53},[1178,1182],{"text":1179,"type":303,"marks":1180},"O04.0",[1181],{"type":809},{"text":1183,"type":303},": Medical abortion, incomplete, complicated by genital tract and pelvic infection",{"type":15,"attrs":1185,"content":1186},{"textAlign":53},[1187,1191],{"text":1188,"type":303,"marks":1189},"O04.5",[1190],{"type":809},{"text":1192,"type":303},": Medical abortion, complete or unspecified, complicated by genital tract and pelvic infection",{"type":15,"attrs":1194,"content":1195},{"textAlign":53},[1196,1200],{"text":1197,"type":303,"marks":1198},"O05.0",[1199],{"type":809},{"text":1201,"type":303},": Other abortion, incomplete, complicated by genital tract and pelvic infection",{"type":15,"attrs":1203,"content":1204},{"textAlign":53},[1205,1209],{"text":1206,"type":303,"marks":1207},"O05.5",[1208],{"type":809},{"text":1210,"type":303},": Other abortion, complete or unspecified, complicated by genital tract and pelvic infection",{"type":15,"attrs":1212,"content":1213},{"textAlign":53},[1214,1218],{"text":1215,"type":303,"marks":1216},"O07.3",[1217],{"type":809},{"text":1219,"type":303},": Failed attempted abortion, complicated",{"type":15,"attrs":1221,"content":1222},{"textAlign":53},[1223,1227],{"text":1224,"type":303,"marks":1225},"O08.0–",[1226],{"type":809},{"text":1228,"type":303},": Complications following abortion and ectopic and molar pregnancy; genital tract and pelvic infection",{"type":15,"attrs":1230,"content":1231},{"textAlign":53},[1232,1235],{"text":1097,"type":303,"marks":1233},[1234],{"type":809},{"text":1236,"type":303},": Puerperal sepsis, delivered with mention of postpartum complication",{"type":15,"attrs":1238,"content":1239},{"textAlign":53},[1240,1244],{"text":1241,"type":303,"marks":1242},"O98.502",[1243],{"type":809},{"text":1245,"type":303},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; delivered with mention of postpartum complication",{"type":15,"attrs":1247,"content":1248},{"textAlign":53},[1249,1253],{"text":1250,"type":303,"marks":1251},"O98.802",[1252],{"type":809},{"text":1254,"type":303},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; delivered with mention of postpartum complication",{"type":15,"attrs":1256,"content":1257},{"textAlign":53},[1258,1261],{"text":1106,"type":303,"marks":1259},[1260],{"type":809},{"text":1262,"type":303},": Septic shock",{"type":15,"attrs":1264,"content":1265},{"textAlign":53},[1266,1270],{"text":1267,"type":303,"marks":1268},"R65.1",[1269],{"type":809},{"text":1271,"type":303},": Systemic inflammatory response syndrome of infectious origin with acute organ failure",{"_uid":1273,"title":1274,"ctaLeft":1275,"ctaRight":1276,"component":531,"columnLeft":1277,"columnRight":1281},"298700c3-a866-4c7b-9c20-e87c98c04dea","Additional codes & Inclusions",[],[],{"type":12,"content":1278},[1279],{"type":15,"attrs":1280},{"textAlign":53},{"type":12,"content":1282},[1283,1290,1304,1313,1322,1331,1340,1349,1358,1367,1376,1385,1394,1403],{"type":15,"attrs":1284,"content":1285},{"textAlign":53},[1286,1289],{"text":1027,"type":303,"marks":1287},[1288],{"type":809},{"text":1129,"type":303},{"type":15,"attrs":1291,"content":1292},{"textAlign":53},[1293,1299],{"text":1294,"type":303,"marks":1295},"T80.2",[1296,1298],{"type":541,"attrs":1297},{"color":1040},{"type":809},{"text":1300,"type":303,"marks":1301},": Infections following infusion, transfusion, and therapeutic injection",[1302],{"type":541,"attrs":1303},{"color":1040},{"type":15,"attrs":1305,"content":1306},{"textAlign":53},[1307,1311],{"text":1308,"type":303,"marks":1309},"T81.4",[1310],{"type":809},{"text":1312,"type":303},": Infection following a procedure, not elsewhere classified",{"type":15,"attrs":1314,"content":1315},{"textAlign":53},[1316,1320],{"text":1317,"type":303,"marks":1318},"T81.1",[1319],{"type":809},{"text":1321,"type":303},": Shock during or resulting from a procedure, not elsewhere classified",{"type":15,"attrs":1323,"content":1324},{"textAlign":53},[1325,1329],{"text":1326,"type":303,"marks":1327},"T82.6",[1328],{"type":809},{"text":1330,"type":303},": Infection and inflammatory reaction due to cardiac valve prosthesis",{"type":15,"attrs":1332,"content":1333},{"textAlign":53},[1334,1338],{"text":1335,"type":303,"marks":1336},"T82.7",[1337],{"type":809},{"text":1339,"type":303},": Infection and inflammatory reaction due to other cardiac and vascular devices, implants, and grafts",{"type":15,"attrs":1341,"content":1342},{"textAlign":53},[1343,1347],{"text":1344,"type":303,"marks":1345},"T83.5",[1346],{"type":809},{"text":1348,"type":303},": Infection and inflammatory reaction due to prosthetic device, implant, and graft in urinary system",{"type":15,"attrs":1350,"content":1351},{"textAlign":53},[1352,1356],{"text":1353,"type":303,"marks":1354},"T83.6",[1355],{"type":809},{"text":1357,"type":303},": Infection and inflammatory reaction due to prosthetic device, implant, and graft in genital tract",{"type":15,"attrs":1359,"content":1360},{"textAlign":53},[1361,1365],{"text":1362,"type":303,"marks":1363},"T84.5–",[1364],{"type":809},{"text":1366,"type":303},": Infection and inflammatory reaction due to internal joint prosthesis",{"type":15,"attrs":1368,"content":1369},{"textAlign":53},[1370,1374],{"text":1371,"type":303,"marks":1372},"T84.6–",[1373],{"type":809},{"text":1375,"type":303},": Infection and inflammatory reaction due to internal fixation device (any site)",{"type":15,"attrs":1377,"content":1378},{"textAlign":53},[1379,1383],{"text":1380,"type":303,"marks":1381},"T84.7",[1382],{"type":809},{"text":1384,"type":303},": Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants, and grafts",{"type":15,"attrs":1386,"content":1387},{"textAlign":53},[1388,1392],{"text":1389,"type":303,"marks":1390},"T85.7",[1391],{"type":809},{"text":1393,"type":303},": Infection and inflammatory reaction due to other internal prosthetic devices, implants, and grafts",{"type":15,"attrs":1395,"content":1396},{"textAlign":53},[1397,1401],{"text":1398,"type":303,"marks":1399},"T88.0",[1400],{"type":809},{"text":1402,"type":303},": Infection following immunization",{"type":15,"attrs":1404,"content":1405},{"textAlign":53},[1406,1410,1412,1419],{"text":1407,"type":303,"marks":1408},"Y60–Y84",[1409],{"type":809},{"text":1411,"type":303},": Complications of medical and surgical care (refer to Appendix A of the ",{"text":1413,"type":303,"marks":1414},"Hospital Harm Indicator General Methodology Notes",[1415],{"type":350,"attrs":1416},{"href":1417,"uuid":53,"anchor":53,"custom":1418,"target":503,"linktype":504},"https://www.cihi.ca/display/HSPIL/Hospital+Harm?preview=%5c10453027%5c15564910%5cHospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf",{},{"text":1420,"type":303},")",{"_uid":1422,"title":1423,"ctaLeft":1424,"ctaRight":1425,"component":531,"columnLeft":1426,"columnRight":1430},"c821949f-5ba5-41b7-a677-56ff361a10be","Additional codes & Exclusions",[],[],{"type":12,"content":1427},[1428],{"type":15,"attrs":1429},{"textAlign":53},{"type":12,"content":1431},[1432,1439,1448,1457,1466,1475,1484,1493,1502,1511,1520,1529],{"type":15,"attrs":1433,"content":1434},{"textAlign":53},[1435,1438],{"text":1027,"type":303,"marks":1436},[1437],{"type":809},{"text":1129,"type":303},{"type":15,"attrs":1440,"content":1441},{"textAlign":53},[1442,1446],{"text":1443,"type":303,"marks":1444},"O85.004",[1445],{"type":809},{"text":1447,"type":303},": Puerperal sepsis, postpartum condition, or complication",{"type":15,"attrs":1449,"content":1450},{"textAlign":53},[1451,1455],{"text":1452,"type":303,"marks":1453},"O85.009",[1454],{"type":809},{"text":1456,"type":303},": Puerperal sepsis, unspecified as to episode of care, or not applicable",{"type":15,"attrs":1458,"content":1459},{"textAlign":53},[1460,1464],{"text":1461,"type":303,"marks":1462},"O98.501",[1463],{"type":809},{"text":1465,"type":303},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; delivered with or without mention of antepartum condition",{"type":15,"attrs":1467,"content":1468},{"textAlign":53},[1469,1473],{"text":1470,"type":303,"marks":1471},"O98.503",[1472],{"type":809},{"text":1474,"type":303},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication",{"type":15,"attrs":1476,"content":1477},{"textAlign":53},[1478,1482],{"text":1479,"type":303,"marks":1480},"O98.504",[1481],{"type":809},{"text":1483,"type":303},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication",{"type":15,"attrs":1485,"content":1486},{"textAlign":53},[1487,1491],{"text":1488,"type":303,"marks":1489},"O98.509",[1490],{"type":809},{"text":1492,"type":303},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care, or not applicable",{"type":15,"attrs":1494,"content":1495},{"textAlign":53},[1496,1500],{"text":1497,"type":303,"marks":1498},"O98.801",[1499],{"type":809},{"text":1501,"type":303},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; delivered with or without mention of antepartum condition",{"type":15,"attrs":1503,"content":1504},{"textAlign":53},[1505,1509],{"text":1506,"type":303,"marks":1507},"O98.803",[1508],{"type":809},{"text":1510,"type":303},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication",{"type":15,"attrs":1512,"content":1513},{"textAlign":53},[1514,1518],{"text":1515,"type":303,"marks":1516},"O98.804",[1517],{"type":809},{"text":1519,"type":303},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication",{"type":15,"attrs":1521,"content":1522},{"textAlign":53},[1523,1527],{"text":1524,"type":303,"marks":1525},"O98.809",[1526],{"type":809},{"text":1528,"type":303},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care, or not applicable",{"type":15,"attrs":1530,"content":1531},{"textAlign":53},[1532,1536],{"text":1533,"type":303,"marks":1534},"Z51.5",[1535],{"type":809},{"text":1537,"type":303},": Palliative care","Discharge Abstract Database",{"type":12,"content":1540},[1541,1552,1557],{"type":15,"attrs":1542,"content":1543},{"textAlign":53},[1544,1546],{"text":1545,"type":303},"Discharge Abstract Database (DAD) Codes included in this clinical category: ",{"text":1547,"type":303,"marks":1548},"B17: Sepsis",[1549,1551],{"type":541,"attrs":1550},{"color":1040},{"type":809},{"type":15,"attrs":1553,"content":1554},{"textAlign":53},[1555],{"text":1556,"type":303},"Concept: Sepsis identified during a hospital stay, excluding neonatal sepsis.",{"type":15,"attrs":1558,"content":1559},{"textAlign":53},[1560],{"text":1561,"type":303},"Notes: This clinical group includes an episode of sepsis that developed in hospital; however, the infection which led to sepsis might have been acquired in the community or hospital.",{"_uid":1563,"content":1564,"component":522},"6228c795-3291-4108-81fd-95c44b54c84a",[1565],{"_uid":1566,"content":1567,"component":521},"c08cb049-afe3-48fb-9071-3eaa4b8d0212",{"type":12,"content":1568},[1569,1574,1588,1600,1614],{"type":335,"attrs":1570,"content":1571},{"level":337,"textAlign":53},[1572],{"text":1573,"type":303},"Success Stories ",{"type":396,"content":1575},[1576],{"type":399,"content":1577},[1578],{"type":15,"attrs":1579,"content":1580},{"textAlign":53},[1581],{"text":1582,"type":303,"marks":1583},"Surviving Sepsis: A Human Factors Approach",[1584],{"type":350,"attrs":1585},{"href":1586,"uuid":53,"anchor":53,"custom":1587,"target":503,"linktype":504},"https://www.patientstories.org.uk/recent-posts/surviving-sepsis-a-human-factors-approach/",{},{"type":15,"attrs":1589,"content":1590},{"textAlign":53},[1591,1593,1598],{"text":1592,"type":303},"PatientStories.org and the Winchester and Eastleigh Healthcare NHS Trust in the UK have created ",{"text":1582,"type":303,"marks":1594},[1595],{"type":350,"attrs":1596},{"href":1586,"uuid":53,"anchor":53,"custom":1597,"target":503,"linktype":504},{},{"text":1599,"type":303},", a short film documenting their innovative human factors approach to identify and manage sepsis (Patient Stories, 2013).",{"type":396,"content":1601},[1602],{"type":399,"content":1603},[1604],{"type":15,"attrs":1605,"content":1606},{"textAlign":53},[1607],{"text":1608,"type":303,"marks":1609},"World Sepsis Declaration",[1610],{"type":350,"attrs":1611},{"href":1612,"uuid":53,"anchor":53,"custom":1613,"target":503,"linktype":504},"https://www.worldsepsisday.org/?MET=HOME&vLANGUAGE=EN",{},{"type":15,"attrs":1615,"content":1616},{"textAlign":53},[1617,1619,1624],{"text":1618,"type":303},"The ",{"text":1608,"type":303,"marks":1620},[1621],{"type":350,"attrs":1622},{"href":1612,"uuid":53,"anchor":53,"custom":1623,"target":503,"linktype":504},{},{"text":1625,"type":303}," is a call to action: To reduce sepsis incidence by 20 per cent by 2020. Internationally, over 4,200 organizations and individuals have signed this declaration to show their support. This includes organizations and individuals from across Canada. The pledge supports increasing awareness, implementing best practice, and tracking the positive impact of sepsis care and management.",{"_uid":1627,"items":1628,"title":1771,"component":852,"description":1772},"d27e0ee6-d543-4ffe-ba19-0beac7b5077d",[1629],{"_uid":1630,"title":1631,"ctaLeft":1632,"ctaRight":1633,"component":531,"columnLeft":1634,"columnRight":1638},"d1d27db9-bb85-49f3-bb9e-7342f7791eb1","Expand to see a full list of references",[],[],{"type":12,"content":1635},[1636],{"type":15,"attrs":1637},{"textAlign":53},{"type":12,"content":1639},[1640,1645,1657,1669,1680,1691,1703,1715,1720,1725,1730,1735,1745,1756,1761,1766],{"type":15,"attrs":1641,"content":1642},{"textAlign":53},[1643],{"text":1644,"type":303},"Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Medicine. 2020;46(5):854-887. doi:10.1007/s00134-020-06022-5",{"type":15,"attrs":1646,"content":1647},{"textAlign":53},[1648,1650],{"text":1649,"type":303},"Canadian Institute for Health Information. In Depth Bar Graph Data Export: In-Hospital Sepsis. CIHI Your Health System. Published 2019a. Accessed March 2021.",{"text":1651,"type":303,"marks":1652}," https://yourhealthsystem.cihi.ca/hsp/indepth?lang=en#/indicator/016/2/C300/",[1653],{"type":350,"attrs":1654},{"href":1655,"uuid":53,"anchor":53,"custom":1656,"target":503,"linktype":504},"https://www.cihi.ca/en/your-health-system-yhs-and-health-indicators-e-publication-epub-are-transitioning-to-serve-you?lang=en#/indicator/016/2/C300/",{},{"type":15,"attrs":1658,"content":1659},{"textAlign":53},[1660,1662],{"text":1661,"type":303},"Canadian Institute for Health Information. OECD Interactive Tool: International Comparisons - Patient Safety. Canadian Institute for Health Information. Published 2019b. Accessed March 2021. ",{"text":1663,"type":303,"marks":1664},"https://www.cihi.ca/en/oecd-interactive-tool-international-comparisons-patient-safety",[1665],{"type":350,"attrs":1666},{"href":1667,"uuid":53,"anchor":53,"custom":1668,"target":503,"linktype":504},"https://www.cihi.ca/en/organisation-for-economic-co-operation-and-development-oecd-health-statistics",{},{"type":15,"attrs":1670,"content":1671},{"textAlign":53},[1672,1674],{"text":1673,"type":303},"Canadian Institute for Health Information. Appendix A. In: Hospital Harm Indicator: General Methodology Notes. Canadian Institute for Health Information; 2019c. ",{"text":1675,"type":303,"marks":1676},"https://www.cihi.ca/sites/default/files/document/hospital-harm-indicator-general-methodology-notes.pdf",[1677],{"type":350,"attrs":1678},{"href":1675,"uuid":53,"anchor":53,"custom":1679,"target":503,"linktype":504},{},{"type":15,"attrs":1681,"content":1682},{"textAlign":53},[1683,1685],{"text":1684,"type":303},"Canadian Patient Safety Institute. Hospital Harm Improvement Resource. Published 2018. ",{"text":347,"type":303,"marks":1686},[1687],{"type":350,"attrs":1688},{"href":352,"uuid":353,"anchor":53,"custom":1689,"target":355,"linktype":356,"story":1690},{},{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360,"_stopResolving":361},{"type":15,"attrs":1692,"content":1693},{"textAlign":53},[1694,1696],{"text":1695,"type":303},"Canadian Patient Safety Institute, Bernier P, Boiteau P, et al. Sepsis: Prevention, Early Identification and Response: Getting Started Kit. Canadian Patient Safety Institute; 2015. ",{"text":1697,"type":303,"marks":1698},"https://doi.org/10.7939/r3-qs6h-nd54",[1699],{"type":350,"attrs":1700},{"href":1701,"uuid":53,"anchor":53,"custom":1702,"target":503,"linktype":504},"https://ualberta.scholaris.ca/items/0fc3b1a6-a5cc-485e-a6c1-3bd12a7304fb",{},{"type":15,"attrs":1704,"content":1705},{"textAlign":53},[1706,1708],{"text":1707,"type":303},"Escobar MF, Echavarría MP, Zambrano MA, Ramos I, Kusanovic JP. Maternal sepsis. American Journal of Obstetrics & Gynecology MFM. 2020;2(3). doi:",{"text":1709,"type":303,"marks":1710},"10.1016/j.ajogmf.2020.100149",[1711],{"type":350,"attrs":1712},{"href":1713,"uuid":53,"anchor":53,"custom":1714,"target":503,"linktype":504},"https://linkinghub.elsevier.com/retrieve/pii/S2589933320300938",{},{"type":15,"attrs":1716,"content":1717},{"textAlign":53},[1718],{"text":1719,"type":303},"Institute for Healthcare Improvement (IHI). How-to Guide: Prevent surgical site infections. Cambridge, MA: IHI; 2012. http://www.ihi.org/resources/pages/tools/howtoguidepreventsurgicalsiteinfection.aspx",{"type":15,"attrs":1721,"content":1722},{"textAlign":53},[1723],{"text":1724,"type":303},"MacLaurin A, Amaratunga K, Couris C, et al. Measuring and Monitoring Healthcare-Associated Infections: A Canadian Collaboration to Better Understand the Magnitude of the Problem. Healthcare Quarterly. 2020;22(SP):116-128. doi:10.12927/hcq.2020.26040",{"type":15,"attrs":1726,"content":1727},{"textAlign":53},[1728],{"text":1729,"type":303},"Martin P, Abou Chakra CN, Williams V, et al. Prevalence of antibiotic-resistant organisms in Canadian Hospitals. Comparison of point-prevalence survey results from 2010, 2012, and 2016. Infection Control & Hospital Epidemiology. 2019;40(1):53-59. doi:10.1017/ice.2018.279",{"type":15,"attrs":1731,"content":1732},{"textAlign":53},[1733],{"text":1734,"type":303},"Mitchell R, Taylor G, Rudnick W, et al. Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys. CMAJ. 2019;191(36):E981. doi:10.1503/cmaj.190361",{"type":15,"attrs":1736,"content":1737},{"textAlign":53},[1738,1740],{"text":1739,"type":303},"Patient Stories. Julie's Story; 2013. Accessed March 23, 2021. ",{"text":501,"type":303,"marks":1741},[1742],{"type":350,"attrs":1743},{"href":501,"uuid":53,"anchor":53,"custom":1744,"target":503,"linktype":504},{},{"type":15,"attrs":1746,"content":1747},{"textAlign":53},[1748,1750],{"text":1749,"type":303},"Patient Stories. Surviving Sepsis; 2010. Accessed March 23, 2021.",{"text":1751,"type":303,"marks":1752}," https://www.patientstories.org.uk/recent-posts/surviving-sepsis-a-human-factors-approach/",[1753],{"type":350,"attrs":1754},{"href":1586,"uuid":53,"anchor":53,"custom":1755,"target":503,"linktype":504},{},{"type":15,"attrs":1757,"content":1758},{"textAlign":53},[1759],{"text":1760,"type":303},"Rhee C, Jones TM, Hamad Y, et al. Prevalence, Underlying Causes, and Preventability of Sepsis-Associated Mortality in US Acute Care Hospitals. JAMA Network Open. 2019;2(2):e187571-e187571. doi:10.1001/jamanetworkopen.2018.7571",{"type":15,"attrs":1762,"content":1763},{"textAlign":53},[1764],{"text":1765,"type":303},"Riley C, Wheeler DS. Prevention of sepsis in children: a new paradigm for public policy. Crit Care Res Pract. 2012;2012:437139-437139. doi:10.1155/2012/437139",{"type":15,"attrs":1767,"content":1768},{"textAlign":53},[1769],{"text":1770,"type":303},"Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287","References",{"type":12,"content":1773},[1774],{"type":15},{"id":16,"_uid":1776,"items":1777,"component":1805},"3232811b-05e5-479b-9e6c-665a88720966",[1778],{"_uid":1779,"link":1780,"image":1792,"title":1796,"component":1797,"description":1798},"23611e6c-ad93-4f48-a4de-8720b1179679",[1781],{"_uid":1782,"link":1783,"label":1790,"component":1791},"a8a2c546-f504-48a1-94c9-0a04e7154602",{"id":1784,"url":16,"linktype":356,"fieldtype":1785,"cached_url":1786,"story":1787},"e810da59-1dac-470d-a9fa-5791fc96027f","multilink","resources/topics/hospital-harm",{"name":1788,"id":1789,"uuid":1784,"slug":9,"url":1786,"full_slug":1786,"_stopResolving":361},"Hospital Harm",147250689243354,"See all resources","simple-link",{"id":1793,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1794,"copyright":16,"fieldtype":289,"meta_data":1795,"is_external_url":277},121293076058734,"https://a-ca.storyblok.com/f/850807391887861/2068x1484/1aea4e8fb2/senior-woman-holding-doctors-hand.webp",{},"Hospital Harm Resources","image-text-colored-item",{"type":12,"content":1799},[1800],{"type":15,"attrs":1801,"content":1802},{"textAlign":53},[1803],{"text":1804,"type":303},"Healthcare Excellence Canada has developed Hospital Harm Improvement Resources – a compilation of resources to support patient safety and improvement efforts.","image-text-colored",[129,150,136,122,143,115,157],[185,192,200],"hec-page-resource-single","sepsis","resources/sepsis",-18630,[],103604225865405,"b1b1354c-2415-4bdc-8e10-792767f9a80b","2025-12-08T23:10:07.863Z","default",[],[1819],{"path":1820,"name":1809,"lang":1821,"published":361},"ressources/la-septicemie","fr",1776087000,[],[1825,1826,1827],{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360},{"name":655,"id":656,"uuid":652,"slug":657,"url":658,"full_slug":658},{"name":1788,"id":1789,"uuid":1784,"slug":9,"url":1786,"full_slug":1786},[1829,1836,1842],{"id":1793,"alt":16,"content_length":1830,"content_type":1831,"copyright":16,"created_at":1832,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1833,"s3_filename":1834,"meta_data":1835},282950,"image/webp","2025-12-09T17:42:47.391Z","2025-12-09T17:42:48.158Z","f/850807391887861/2068x1484/1aea4e8fb2/senior-woman-holding-doctors-hand.webp",{},{"id":287,"alt":16,"content_length":1837,"content_type":1831,"copyright":16,"created_at":1838,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1839,"s3_filename":1840,"meta_data":1841},41946,"2025-12-09T17:45:32.386Z","2025-12-09T17:45:33.077Z","f/850807391887861/2216x1568/ea857fcb8e/shapes.webp",{"alt":16,"title":16,"source":16,"copyright":16},{"id":911,"alt":16,"content_length":1843,"content_type":1844,"copyright":16,"created_at":1845,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1846,"s3_filename":1847,"meta_data":1848},28051,"image/png","2025-12-04T18:40:03.538Z","2025-12-04T18:40:04.613Z","f/850807391887861/600x600/c301964117/checkmark-icon.png",{},1776087482657]