| Chapter 335 |
| 2023 -- H 5869 SUBSTITUTE A Enacted 06/24/2023 |
| 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 |
| It is enacted by the General Assembly as follows: |
| SECTION 1. Chapter 23-17 of the General Laws entitled "Licensing of Healthcare |
| Facilities" is hereby amended by adding thereto the following section: |
| 23-17-66. Protocols for the early recognition and treatment of patients with |
| sepsis/severe sepsis/septic shock. |
| (a) For purposes of this section, the following words and terms shall have the following |
| meanings: |
| (1) "Sepsis" means a known or suspected infection with at least two (2) or more system |
| inflammatory response syndrome (SIRS) criteria as developed by American College of Chest |
| Physicians/Society of Critical Care Medicine (1991). |
| (2) "Severe sepsis" means a known or suspected infection with at least two (2) or more |
| SIRS criteria and sepsis-related tissue hypoperfusion or organ dysfunction. |
| (3) "Septic shock" means sepsis-induced hypotension persisting despite adequate |
| intravenous (IV) fluid resuscitation and/or evidence of tissue hypoperfusion. |
| (b) On or before February 1, 2024, to the extent allowable by available state and federal |
| funding, the director of the department of health shall in coordination with the department of |
| health's Antimicrobial Stewardship and Environmental Cleaning task force, make available to |
| hospitals, urgent care facilities, freestanding emergency rooms, pediatric practices, and EMS |
| agencies, information on best practices for the treatment of patients with sepsis and septic shock. |
| The best practices shall be based on generally accepted standards of care, including, but not limited |
| to: |
| (1) An evidence-based screening tool that can be used at initial evaluation of adult and |
| pediatric patients in these settings; |
| (2) An evidence-based treatment protocol for adult and pediatric patients that includes |
| time-specific treatment goals; |
| (3) Nurse-driven testing protocols to enable nurses to initiate care for patients with |
| suspected sepsis; |
| (4) Incorporation of sepsis screening and treatment tools into the electronic health record |
| where possible; |
| (5) Mechanisms to prompt escalation of care within these settings, and, when appropriate, |
| to stabilize and transfer to a facility able to provide a higher level of care; |
| (6) Strategies for appropriate hand-offs and communication regarding the care of patients |
| with sepsis and for the reassessments of patients at regular intervals; |
| (7) Hospital-specific antibiotic guidelines for use in treating patients with sepsis and a |
| mechanism for reevaluating a patient’s antibiotic treatment based on culture results that provides |
| reassessment and de-escalation of antibiotic treatment when appropriate; and |
| (8) Staff education on sepsis policies and procedures during the onboarding process and at |
| least annually and when new practice guidelines are published or existing standards are updated to |
| ensure that care reflects current standards of practice. |
| (c) In order to enhance patient safety and protection, each hospital licensed in the state shall |
| establish a multi-disciplinary committee to implement policies, procedures, and staff education in |
| accordance with the best practices issued by the department of health. |
| (1) The multi-disciplinary committee at each hospital shall be responsible for the |
| collection, use, and reporting of quality measures related to the recognition and treatment of severe |
| sepsis for purposes of internal quality improvement and hospital reporting. Such measures shall |
| include, but not be limited to, data sufficient to evaluate each hospital’s adherence rate to its own |
| sepsis protocols, including adherence to timeframes and implementation of all protocol components |
| for adults and children. |
| (d) Contingent upon the availability of funding, the department of health shall offer |
| continuing education credits and other educational opportunities such as provider briefings for |
| pediatricians and EMS agencies on the early recognition and treatment of patients with sepsis. |
| SECTION 2. This act shall take effect upon passage. |
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| LC002395/SUB A/2 |
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