Colleagues share the tools they have developed in their own institutions as they implement the Surviving Sepsis Campaign. Here you’ll find locally-created protocols, checklists, policies, and similar documents so you don’t have to start from scratch. If you have items to share based on the 2016 guidelines and guidelines and bundles, please email PDFs to firstname.lastname@example.org. Permissions from your institution may be required. Permissions from your institution may be required.
Campaign Screening Tool Sample
The Surviving Sepsis Campaign provides a paper screening tool to assist when evaluating patients in the hospital emergency department, medical/surgical/telemetry wards, or in the ICU.
Severe Sepsis/Septic Shock Progress Note - Cookeville Regional Medical Center
Severe Sepsis/Septic Shock Clinical Pathway - Cookeville Regional Medical Center
Pediatric Initial Sepsis Response Plan - Wesley Children’s Hospital
Sepsis Screen Flowchart - Wesley Children’s Hospital
Sepsis Alert Checklist - Wesley Healthcare
Adult Sepsis Management Pathway - St. Helens and Knowsley Hospitals
ICU Severe Sepsis Screening Tool - Saint Joseph Mercy Health System
Patient Units Severe Sepsis Screening Tool - Saint Joseph Mercy Health System
Sepsis Pocket Card - Saint Joseph Mercy Health System
Sepsis Recognition and Treatment Protocols - Stony Brook
Sepsis Pediatric Order Set - Stony Brook
Pediatric ICU Screening Tool - Stony Brook
Perinatal Screening Tool - Dignity Health