SEP-1 Guidelines May Be Too Restrictive

Hospitals are required to report compliance with the SEP-1 quality bundle as a core sepsis measure. Components of SEP-1 include blood cultures (within 3 hours), initial (3 hours) and repeat (6 hours) lactate measurement, early antibiotics and fluid resuscitation (3 hours), and vasopressors for persistent hypotension and repeat volume assessment (6 hours). Any violation is a SEP-1 failure, irrespective of the number of components completed successfully.

To measure the association between mortality and compliance with specific SEP-1 bundle components, these authors retrospectively reviewed records for 851 patients who met criteria for severe sepsis/septic shock at seven U.S. hospitals from 2015 to 2017. Analyses took into account patient chara…