Transcripts are auto-generated and may contain errors
Pat Posa: [00:00:00] We know that 87% of sepsis starts in the community, and so it’s so important to get to a healthcare facility. When you are feeling like that, you can’t just sleep it off, oh, I’ll go to bed and I’ll feel better.
Nicole Kupchik: This is the sepsis spectrum, a podcast about antimicrobial resistance, sepsis, and how to expect the unexpected in your practice.
Okay. If it’s safe to do so, close your eyes. Take a breath
now. Open your eyes. You’re lying in a hospital bed and over on your chart it reads and infection. That’s not entirely alarming. Until your blood pressure crashes, your organs start to fail. Nurses zip into action, monitor screen, [00:01:00] and then you hear it. The word that changes everything. Sepsis and thankfully you survived.
Although, as we all know, survival is only the beginning. The bacteria that nearly killed you, it might be stronger now. More cunning resistant to what saved you last time. So as you leave the hospital disoriented and exhausted, little do you realize you’re actually stepping into a maze of follow ups, confusion, and risk.
And when you dive in. To that tight web that connects infection, antimicrobial resistance, and sepsis, it becomes abundantly clear why every link in that chain matters more than ever. Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs, and often causes death.
In other words, it’s your body’s overactive and toxic [00:02:00] response to an infection. Sepsis is a medical emergency. That requires rapid diagnosis and treatment.
Hi everyone, and welcome to the sepsis spectrum. I’m Nicole kic, critical care nurse and clinical nurse specialist and your guide through the we world of sepsis and antimicrobial resistance, or as we like to call this season, microbial Mysteries. I. On today’s episode, we’re gonna chat about how infection antimicrobial resistance, A-K-A-A-M-R, and sepsis are all tangled together, and how they’re putting serious pressure on public health communities and the social factors that affect people’s wellbeing.
- We’re gonna dig into why stopping infections before they start is one of the smartest ways to prevent sepsis no matter where care is happening. We’re also going to reflect on how big global health moments like the COVID-19 pandemic have changed the game when it comes to a MR and [00:03:00] sepsis outcomes.
We’re going to explore real world challenges that healthcare pros face when trying to tackle sepsis. Hospital acquired infections and growing resistance to treatment. And finally, we’re gonna revisit why education tools like podcasts matter. Because spreading awareness and education can close knowledge gaps and spark real change in how we handle sepsis a MR and health equity.
Today I have the honor to host not one, but two powerhouse voices in infection prevention, sepsis, and quality improvement. Pat Za is an icon in the world of quality improvement with decades of experience leading sepsis strategy at both the bedside and systems level. She also shares her personal story about how her grandson, her husband and mother-in-law, all survived sepsis.
Additionally, we’re joined by Dr. Cindy Ho, a national leader in infection prevention, combining research and real world [00:04:00] leadership to push for safer, more equitable care. Together, they bring unmatched clarity, expertise, and urgency to the conversation around reducing hospital harm. As we all know, preventing sepsis isn’t just about protocols.
It’s about people. So join me as we hear from two of the very best.
All right. Welcome to the show, Dr. Ho and Pat Za. How are you both? Great. Great. I’m so excited to chat with you both, but all of us have done a lot of work in sepsis. I’m gonna kind of kick it off with Pat. So Pat, you have a really interesting background. So you’ve done a lot of work with sepsis, quality improvement education publications, but you also have a personal experience with sepsis and that you’re, you’ve had two family members experience sepsis.
Tell us all about it. Three, actually.
Pat Posa: Actually three. Three, three. Yeah. So, [00:05:00] uh. Mother-in-law, um, she experienced, uh, a community acquired pneumonia that went into sepsis, um, actually went into septic shock. Um, and she was 86 years old. It was the first time she was ever in the hospital. Um, and she went to the hospitals that I worked at and, uh, had started the sepsis program and, um, things.
Went pretty, went pretty well. She got, uh, early goal directed therapy. Um, she got all of the bundles, the three and six hour bundle, and at that time, I think it was during the six and 24 hour bundle. Um, but uh, went to the ICU and it was funny. I had to. Warned the ICU, that this was not a sim, right? That it was my mother-in-law coming.
Uh, this is for real this time for real. This is for real. ’cause uh, we would do simulations, but she did really well. Um, you know, she never needed intubated. She was lined up though, and she was on pressers. But, [00:06:00] um, she did great because we recognized it and um, and did all the appropriate interventions.
Helps to have a advocate, you know? Um, and then my, my husband had sepsis twice. Um, septic shock once, and then severe sepsis. Uh, we went to the. Doctor’s office ’cause he had woke up with rigors and he ended up passing out in the doctor’s office and he got an ambulance ride to the hospital. He, he got the, um, fluids and antibiotics and um, and never needed pressors and uh, um.
He did well, but he suffered significantly, even though he wasn’t in the ICU, he suffered from post sepsis syndrome. He had brain fog. He had every, all the laundry list of things, the insomnia, the inability to pay attention, um, um, anxiety. Uh, so, and that took a, a while [00:07:00] to, um, to. Go away, especially a year later, he had the same thing and again, after a dental cleaning, even though we had changed antibiotics.
Um, and so, but he’s doing great now. Um, no additional problems. And then I had a grandson. The day he came home from the hospital, so it was, uh, 36 hours after he was born. He, uh, was not awake a lot, and so they gave him a bath to try and wake him up, and then he, um, stopped breathing. And so I was there so we didn’t have to do full resuscitation, just rescue breathing.
And he went to the hospital and then we got transported to the University of Michigan, uh, Mott Hospital. And, uh, he never needed to be intubated either. Um, but it was strep pneumonia. And he has, um, some long term, he did have some long term effects, [00:08:00] but. He’s doing great. He’s seven and, um, thriving. Thriving and, uh, still has respiratory issues.
Um, but, uh, he’s, um, playing flag football and, uh, just started playing softball, uh, or baseball. So, yeah, he’s a great little kid.
Nicole Kupchik: Well, and I, okay, so do all the work you’ve done. I mean, we, all three of us know that sepsis is the leading. Cause of mortality in hospitalized patients and just knowing that, you know, even in the pre-hospital setting, things are not always great.
What, pat, just from your experience, like what would be some advice that you would give to like, let’s say the public, anyone who’s listening, just of the, just signs that you’d say,
Pat Posa: don’t ignore malaise. Altered mental status, that confusion is a significant sign fever. But, you know, fortunate, you’ll be fortunate if you have a fever.
’cause if you don’t, you’re less likely to, to go in. But, so it’s that [00:09:00] fever. You feel like your heart’s racing. You just don’t feel like you have any, any energy. You feel the worst that you have in, in forever. Um. You need to see someone. And, uh, and it, it’s really, I mean, we know that 87% of sepsis starts in the community, right?
And so it’s so important to get to a healthcare facility, um, when you are feeling like that. And you know, you can’t just sleep it off, right? Oh, I’ll go to bed and Yeah. You know, I’ll feel better.
Nicole Kupchik: Yeah, and I think, you know, one of the things I always kind of joke around with when I’m teaching, when I’m teaching nurses and physicians and other healthcare providers, I always teach about that.
Cute. You’re getting a report from the emergency department, a cute little lady who’s got a urinary tract infection and who’s pleasantly I.
[music]: Confused. Confused. Yeah. Right.
Nicole Kupchik: But you know, just truly like thinking about paying attention to that. Or even asking patients if they feel like they’re out of [00:10:00] it or somebody who’s close to them because it’s so common.
And in the elderly we would just dismiss it as dementia or, you know, other things going on when really it’s not, it’s a
Pat Posa: change. Yeah. And that’s so important because in, you know, in, in the state of Michigan we have a statewide collaborative, um, and helping, uh, hospitals, um, do more appropriate care for sepsis patients.
And the key factor or key symptom people come with, uh, for sepsis, um, is altered mental status. I mean, that’s the, that’s the trigger related to organ dysfunction. Um, you know, there’s tachycardia and fever, but, um, it’s altered mental status. So, and you’re right, Nicole asking, as healthcare professionals, we, the person might not know, they’re confused asking their, uh, family member, ha have they sounded off?
Um, and, uh, that [00:11:00] that’s a really important indicator.
Nicole Kupchik: Now let’s kind of, let’s go to the professional side of what you’ve done. ’cause you’ve done a lot of work, especially in the state of Michigan. You’ve done work with sepsis alliance. Tell us about what you’ve done and any, ’cause you just, you recently retired, not to fully, you’re still doing a lot of work, but tell us about, okay, now you’re at a reflection point in your career.
Like, what’s the work you’ve done and what are you reflecting on?
Pat Posa: I’ve always been passionate about sepsis. I started my practice in the late seventies and I was in a medical ICU, um, in a downtown Detroit hospital. And the patients that came to us were so sick. Um, by the time they got to us, um, they had three or four organs down and they just didn’t survive.
And our unit’s nickname was almost heaven. So that kind of, I, I’ve always had a, a passion for sepsis and I, uh, through my career, watched the research to see what can we do [00:12:00] about this? And at my hospital we put together a sepsis program with, uh, we started in the ED and the ICU, um, and we started with early identification, so screening.
And at that time it was paper screening. ’cause we didn’t have the electronic EMRs, so we did, um. Screening and uh, um, and we followed the early goal directed therapy, which is what came out in the surviving sepsis, um, initial guidelines. And, uh, um, we. Collected data, um, gave that data and feedback back to, to the staff on how they were doing.
A year later, we rolled it out, um, uh, the screening and the, the care for the sepsis patient, um, out to house wide to the rest of the hospital. And I remember teaching some of the nurses and after the class, one of the nurse, one of a nurse came up to me and said, thank you, because. I [00:13:00] have always wondered what was happening.
And you know, I had a patient last night that had these things, these signs and symptoms, and I knew something was wrong, but now I can put a name to it and, and I know what to do about it. Um, so that, um, so the work that we did at St. Joe’s, then, you know, we. Tried to assist the rest of the, um, the, the state in doing it.
And then, um, I worked along with my, um. Sister, um, Kathleen Bowman, and we kind of developed a framework for implementing a sepsis program. Um, and then we consulted around the country helping others, uh, put in sepsis programs. The most recent, um, is that I. Moved over to and took a position in charge of quality and safety for the adult hospitals at the University of Michigan and, uh, helped build a sepsis [00:14:00] program there.
Um, and then, uh, I’m also in my semi-retirement now. I left that position, but I’m working with, um, the. Uh, CQI sponsored by Blue Cross Blue Shield in the state of Michigan called the Hospital Medicine Safety Consortium, and I’m on their sepsis group. We have Rich Data Source, uh, because they’re Blue Cross Funds.
Uh. Um, abstractors at each hospital. And so they’re collecting. And so we have now, we have like 50,000 patients and so we can really examine care and help in improve care. And we partnered with the CD, C and, and, uh, um, helped write the CDCs sepsis core elements for hospitals. And so just. You’ve been busy.
Lots of fun. I’ve been busy. Yeah, you’ve been busy. It, it’s my, you know, it’s my life work, my heart and soul. Um, [00:15:00] and, and then I’ve been involved with Sepsis Alliance for a number of years, um, at, on their advisory board and doing education, et cetera. And then just recently, in the last six months, I’m now on their board of directors.
Nicole Kupchik: Are you a nurse infection, preventionist, or healthcare professional who wants to stay ahead of the curve? Visit sepsis podcast.org to learn how you can receive free nursing CE credits by listening to or watching the sepsis spectrum. It’s our way of supporting you and together better understanding the ever evolving world of sepsis care and a MR.
And now back to the show.
One of the things just in listening to you talk is this, I, it’s really exciting to know that so much effort is happening on a national level to keep [00:16:00] driving us forward and pushing us forward. And I mean, sepsis is such a common problem that have either of you watched that the new show, the pit. On HBO O Max.
Yeah. Yeah. I mean, even the pit is, has it had a big episode on where sepsis was a huge focus and you know, and the sky went from being okay to like dead quickly. Yeah. You know, and I just, I, because I think that’s one of the challenges, right? Is that the public understands signs of stroke. They understand signs of a heart attack, but does the public understand truly what, like what, what is
Pat Posa: sepsis even.
And they don’t. Right. And, and now it’s, it’s gotten better. And, uh, Dr. Ho, you can chime in. Sepsis Alliance, um, which is a voluntary organization, a nonprofit organization whose whole mission is to. Decreased suffering from sepsis. Right. And in increase education and knowledge. They do a sur, they’ve been doing a survey and I can’t [00:17:00] remember how many years, but they’ve seen it go from only 22% even recognize the word, uh, sepsis to now there’s recognition up in the high sixties.
Right.
Cindy Hou: It’s a higher percentage. I can’t recall the number offhand, but, um, you know, there’s a lot of gaps in knowledge, uh, out there in the public, and that’s why Sepsis Alliance and other entities exist for sure. You know, and all the stuff. Pat and are doing, I just kinda wanna say a quick amen because I mean, it was like a lot, like a lot for sepsis.
So thanks for everything you’re doing. Yeah. So, Dr. Ho, tell us
Nicole Kupchik: what you’re up to. You, you’ve been busy as well. Uh,
Cindy Hou: I do a little bit of this or that. Um, well, I’ll explain that. For Sepsis Alliance, I’m also on the board of directors, along with Pat and others, and I serve as the Chief Medical Officer. I also work on equity, diversity inclusion for sepsis alliance.
And then in my doctor had, I’m an infectious disease doctor for Jefferson Health. Uh, Jefferson is a [00:18:00] system of round 32 hospitals and I stay in my local area, New Jersey. Um, so, and in that capacity, what I do are things related to sepsis. I would say at one point we actually had around three different sepsis committees internally going around at the same time.
And, uh, I also focus on my. Uh, hat as an infection control officer, which deals a lot with preventing an infection from occurring in the first place. Uh, there’s also antibiotic stewardship, which has to do with antibiotics and tailoring them to the individual. And then there’s somewhat more random things that don’t really seem like they’re related to sepsis, but actually they could be.
And in the past couple years I’ve been, uh, working on quality improvement, patient safety, equity, and of all things language access. So I’ve been a little bit busy, but, um, um, I actually could probably do a little bit more, to be honest with you. So looking for stuff [00:19:00] to do out there. Well, okay,
Nicole Kupchik: let’s, lemme ask you this.
So it’s been five years since the pandemic. Mm-hmm. Do you think the pandemic helped us move in a good direction on just calling sepsis what it is and maybe do you think it’s helped hospitals become better, or do you think we took some steps back? I would just love your perspective on that.
Cindy Hou: Yeah. Um, well, as an infectious disease doctor, and especially in my role as infection control officer, I’m sort of the sacrificial lamb.
So it turns out that I actually saw the very first COVID patient in kind of our region, really. Um, and there were, there were so many other, um. Factors. Factors because this patient, patient spoke a language other than English and we had to use interpreters. And then there were, um, we wanted to sort of reunite the family as there was some separation from the family that the person was a part of.
And during those COVID times, [00:20:00] the infectious disease, what we call census, that’s the kind of the list of patients that you see really, really just was gigantic. And uh, we had to triage and go and see all these incredibly sick patients that, um. That really had a severe sepsis from COVID because the organ dysfunction, which Pat described of encephalopathy or uh, altered mental status was certainly occurring.
But so was the cascade to being so hypoxemic or having low oxygen that people would be on the ventilator, which was kind of a poor prognostic sign initially, and also other kind of, uh, higher amounts of oxygen that were not necessarily related to the ventilator. And so during those times, of course, you have to be, uh, very, uh, studious and, uh, careful to prevent secondary infection.
And I have to say that from an infection prevention standpoint, it was really nice because you saw very [00:21:00] diligence to, uh, use of, uh, hand hygiene and personal protective equipment. And then, um, and then, you know, uh, so, and, and the people that were also sick from other infections, they either stayed away and the, uh, outpatient offices did a really good job and or by the time they came in from other non COVID infections were pretty sick, uh, with severe sepsis, septic shock from bacterial reasons.
And I, I think it really kind of mobilized, uh, certain entities, certainly infectious disease, critical care realms, but I think there was a part that didn’t, um, that we had some gaps in. So, for instance, the next gen of medical students, sometimes the house staff may not have been exposed initially, initially just to prevent them from getting infected.
Um, and so there’s, there’s a lot of difference when you don’t have that, uh. And as far as what’s transpired, because [00:22:00] from a public health standpoint, there is so much focus on, on items like COVID than other things sometimes lapsed. And so, you know, I think that, um, we certainly need, uh, uh, a more call to arms and, uh.
And, uh, so the answer to your question ultimately is that I think we have some lessons learned of what we could do better, like preparing for the next pandemic, um, trying to prevent infections from occurring in the first place so you don’t get sepsis with things like the COVID vaccine and so forth. But, um, there’s a lot more to be learned that, uh, you know, it is, is, is, is to be determined as they say.
Nicole Kupchik: Yeah, it was, I think it was definitely a good audit tool of how prepared hospitals were at the time. I, I don’t know. How convinced do you both feel that hospitals across the country have really done a good, a good reflection and [00:23:00] said, okay, here’s what we’re gonna do different next time.
Cindy Hou: I. At least for Jefferson, I, uh, you know, we’re on all sorts of committees, but I’ll just tell you that Jefferson, I actually am on a pandemic preparedness committee, so we’re prepared.
Nice.
Nicole Kupchik: That’s so good. That’s amazing though. That’s how it needs to be, right?
Cindy Hou: Yeah. And, and so you get together teams of people who are infectious disease infection prevention officers, and you just consider, what did we learn then and how could we prepare kind of contingency planning. Of course not every place is like that, so I will defer to Pat for additional insights from her end.
Pat Posa: Well, and, and I, I don’t think every hospital is doing that. I, I know that, um, I was at University of Michigan during the pandemic and, and I know they have something similar going on where they are continuing to, to, uh, prepare just like joint commission readiness. They are, are, um, looking at being ready for a pandemic.
Um, I, I think there were, were some. Positives from, [00:24:00] from COVID. If you can say there are any positives. I think we’ve figured out we can make decisions faster and we can make changes, um, that are necessary faster. Um, the, we strengthened our communication between frontline and, um, and leadership during that time.
So I think those were, um, lessons learned. I think we took. Many steps back in some of our ICU practices that we need to still get back from. You know, our patients were heavily sedated because we, you know, would take a long time to get into the room and we had gone away from sedating them because we know of the consequences, uh, of that heavy sedation and lack of mobilization.
I think that, um, we. The public heard the term long COVID, um, which is really no different than or physiologically, and the reasons might be a little bit different, but. People [00:25:00] had with sepsis had been experiencing post sepsis syndrome. So I think that that was a positive in that people then realized that you can have some long-term effects from, uh, from sepsis.
Um, and those patients that had the severe, um, COVID with sepsis, uh, um, had long-term effects. I
Nicole Kupchik: think that’s honestly one of the positive things that came from the pandemic is the post hospital care. A lot of cities across the country have, uh, and now there’s a new ICD 10 code for post sepsis care as well.
Yeah. Yep. Yeah. So any other thoughts on that, Dr. Ho?
Cindy Hou: Yeah, I mean, um, I kind of feel that the, the. The sort of support for long COVID is perhaps much greater in respects than post sepsis because if you ask providers, they might [00:26:00] not familiar with the term, may not know what to look for. And, and, um, and so for instance, uh.
This is actually a true story, but, uh, there was a patient who had, um, looked up physicians in, in her area for her husband, and then she kind of googled sepsis alliances. Was happy to find that I was in the relative general area and kind of crossed state lines to, to see me and, um, kind of have not had, was basically a little bit ignored before from other physicians that they had gone to see.
Um. And so I, I think they really felt a lot of comfort from what I had to tell them about the entity. Um, so it, it’s, it’s in some ways under recognized, but great that, you know, if that fact weight of the IC 10 code, but just we need more people to recognize and to present to physicians and other providers who are comfortable with, with, uh, acknowledging this and how to manage it.
Nicole Kupchik: I [00:27:00] almost feel like it’s a specialty in and of itself, right? I mean, truly the rehabilitation part of it.
Pat Posa: I think that the. Your primary care doc, right? So when you get discharged from the hospital, you know, we know a, a best practice is to get them an appointment and that’s that ICD 10 code. Right? So it’s a, a special appointment.
It can be longer. Right? And they’ll get reimbursed for it. Specifically that post-hospitalization, uh, um, appointment. Um, I think we do need. We still have major gaps in our primary care providers understanding post sepsis syndrome, and, and they don’t have to be experts in it. Um, but they need to be able to recognize when their, uh.
And assess for it right in their patients that are coming to them after having a sepsis episode and be able to explain to them that these are things you might experience. Are you [00:28:00] experiencing any of them? These are not unusual. And, um, and then linking them with appropriate services based on what symptoms they might be experiencing, even though we know the, the, um, the research and the data on how to.
Help resolve post sepsis syndrome as, as well as post ICU syndrome is very weak. We don’t have a lot of, besides the functional piece where we know the physical therapy, et cetera, you know, the cognitive stuff is still in its infancy and, and restoring the cognitive functions.
Cindy Hou: It would be so nice to have kind of these, um.
Post sepsis clinics, and not necessarily for the diagnosis of post sepsis syndrome, but after somebody survives about a sepsis, to be able to see someone who’s more knowledgeable, it’s about sepsis because there’s actually that vulnerable period where after they have survived about they could potentially have a new infection.
Mm-hmm. [00:29:00] Um, and just be very, very vulnerable from an immune system standpoint. Um, and, and so there are some. Cases where I’ve seen somebody who’s incredibly sick, really survived septic shock, and I tried to hold onto a little bit longer in an outpatient setting just to see how they’re doing and everything.
Pat Posa: One of the things that we, it’s in its infancy as well, is we know that, you know, when you have sepsis, you’re on antibiotics, right? And the on antibiotics changes your gut flora, um, and the healthy bacteria go away. And, and my husband experienced that significantly having two bouts, um, you know, within a year.
Um, and, uh, um. And he did go to a specialist. ’cause then he was catching everything that came by. And we have eight grandkids and you know, and they’re Petri dishes, right? And, um, and so he did, he went to a specialist to help restore his appropriate gut flora. And, [00:30:00] and we don’t, you know, that’s not something that.
People are doing or recommending, or there isn’t a best practice for that. People are not aware that they should do that. You know it. So it’s, um, there, there’s lots of gaps still.
Nicole Kupchik: Yeah. And Dr. Ho, what advice do you give to patients? ’cause you see a lot of these patients, and so what advice do you give as far as staying ahead of a, a new infection or preventing a new infection?
Because I feel like, I don’t feel like I’ve, you know, I’ve discharged many patients but who’ve had sepsis and I don’t feel like I’ve really done a good job of arming them with information they need.
Cindy Hou: Sure. Um, well, I, I would say that, uh, there’s a motto that Sepsis Alliance has, and it’s called infection prevention, is sepsis prevention, which sounds really catchy, maybe because I helped them with it, but, or maybe not.
But it’s that infection control hat that I have. Um, but the way I’ll put it is this way that a lot of it is about education. Um, and if I am seeing [00:31:00] somebody who has sepsis due to a particular infection in the hospital, I’ll sort of explain the nature of their current infection, the treatment, and at times I’ll work them backwards to see if they know what their initial symptoms are versus, uh, how they are now.
What I’m trying to do really is to enable the patient, their loved one, or, uh, advocate that, uh, you know, these are some early signs and symptoms before you get sepsis of the infection itself. Uh, I’ll take UI tract infections as an example. Uh, you can have pain when you pee. You can have urgency, you can have frequency.
If you ignore those, then it kind of cascades from the bladder all the way up to the kidney and it gets much more severe, can cause pyelonephritis and sepsis. It’s terrible because you can have fevers of 1 0 3, 1 0 4 headaches because of those high fevers. And so often I’m actually talking about [00:32:00] seemingly random things like, um.
You know, the next time you have those symptoms, what I want you to do is get checked and get diagnosed. And I generally say, I like you, but I don’t wanna see you in the hospital. Yeah. And, and uh, and so if you get the, uh, earlier diagnosis of the infection, there are times that uh, if somebody is treated earlier, it never progresses to sepsis.
And that’s kind of my. My mantra, like one of these days, it would be great to be obsolete. Like so often we react to what’s happening. Now somebody’s in shock, you know, their blood pressure is so low that they have an invasive IV called central line. They’re in intensive care unit. There’s all these devices.
There’s such a risk or infection, but imagine. If you could catch all these things before when it’s just at the symptom stage. And so to me, I am literally talking about things like, I want you to drink more water. I want you to look at things like the color of [00:33:00] your urine, because if it’s dark, drink more water, or if it’s concentrated, if you can recognize symptoms that your loved one is off, they get them evaluated, and that’s really the heart of it.
And so when you speak about infection prevention and sepsis prevention, I’m sort of like really all game for counseling the patient even more and their loved ones.
Nicole Kupchik: Oh, absolutely. I mean, I think that’s key. ’cause I just don’t feel like in the hospital we do it. Uh, I don’t, I have not done a very good job of that all to say that.
No.
Pat Posa: I can tell you in, in, um, in the, my, the hospital that I work at, but also in the state of Michigan in general, that’s a big gap. Right? And so one of the things that we’re doing as part of this collaborative is we’re doing site visits where we’ll walk the sepsis process and. We’ll, uh, you know, follow a patient, uh, simulated patient, um, through the ED process to the [00:34:00] ICU and, and then to the floor.
And, you know, part of what we’re asking is what are you educating the patient along the way about I. And, uh, what kind of information do you give them when they go home? Um, do you tell them about the high, higher risk of getting another infection and getting sepsis, and what should you watch for and when should you call your doctor and when should you come, um, into a.
Uh, you know, an urgent care or even an emergency. What signs are you looking for and what can you do similar to what you said Dr. Ho about, you know, good hand washing and, uh, making sure that you’re drinking enough fluids, et cetera. And that’s a significant gap. And then also educating people about the possibility of post sepsis syndrome so that they go home and they.
Don’t think they’re crazy because they can’t remember anything or they’re can’t sleep at night. That, um, so I, it is a big gap. Nicole and I, I think, [00:35:00] uh, just about every healthcare. Organization could probably improve on that because giving it into, in their discharge summary, right, in their packet that you give them without going through and explaining it, and it’s in the last 10 minutes before you’re reeling them out the door, that that’s not when they’re gonna retain it.
It needs to be something that’s done like, like you talked about Dr. Ho, where when you round on your patients and, and you’re talking to them and giving them that information in. Bits and pieces through their stay so that it becomes, um, something that they can ask questions about, but also then become, uh, more knowledgeable.
And it’s not, I’m trying to remember these 25 things you just told me and it just went. And actually
Nicole Kupchik: retain it. Yeah. Yeah. Alright, well I just wanna thank you both for being here today. Um, I, I think this is gonna be helpful, I think to, for both providers who just can maybe think a bit more [00:36:00] globally, but also to the public and just kind of knowing the signs of and symptoms or if they’ve had sepsis.
Just knowing that, you know, the risk of reinfection is higher than the general public and to seek help early. So again, just thanks to you both. I feel honored to be able to interview Pat Za and Dr. Ho, thank you for joining the podcast today.
Pat Posa: Well, thanks for having us. This has been fun. And infection prevention is sepsis prevention, so catch it early.
Yes.
Cindy Hou: Um, wise words right there. You know, I think a mic drop.
Nicole Kupchik: Yep. Boom. Boom.
Wow. I really wanna thank Pat and Dr. Cindy Ho for joining us. It was just, it was, I think it was just really interesting to reflect on the pandemic a bit and just talk about what’s happening in the post sepsis world, what follow up looks like for patients. And I can’t [00:37:00] even imagine having three family members survive sepsis.
But I wanna thank everyone for joining me on today’s episode of the Sepsis Spectrum. If you like the show, we wanna hear about it. Please leave a review wherever you’re enjoying this podcast. It helps a lot. Visit sepsis podcast.org to share any stories of your own, any questions or concerns, or even any episode ideas.
We’ll take them all. To learn more about Sepsis Alliance visit sepsis. Dot org. The sepsis spectrum is brought to you by Sepsis Alliance. I’m your host, Nicole Kubick. Our executive producers are Allison Strickland, Hannah SaaS, Claudia Orth, and Alex Colvin. Our producers are Aaron Corny, Rob Goldman, Shahnti Brooke, and me Nicole Kch.
Our post-production producer is Tim Scott. Our editor and engineer is Jason Portizo, and our music is by Omer Ben-Zvi. To learn about Sepsis Alliance’s podcast, legal disclaimer and compliance policies, you can visit sepsis [00:38:00] podcast.org/disclaimers. The sepsis spectrum is a human content and sepsis alliance production.
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