Rationale: Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. Objectives: To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. Methods: A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. Measurements and Main Results: A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. Conclusions: The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.

1st Department of Anesthesiology and Intensive Therapy Medical University of Lublin Lublin Poland

4th Department of Internal Medicine National and Kapodistrian University of Athens Medical School Athens Greece

Anestesia e Rianimazione dei Trapianti Dipartimento Chirurgico Polispecialistico ASST Grande Ospedale Metropolitano Niguarda Milano Milan Italy

Clinic for Anesthesiology Reanimation and Intensive Care University Clinical Center Niš Nis Serbia

Clinical Department of Anesthesiology and Intensive Therapy Wroclaw Medical University Wroclaw Poland

Department of Anesthesia and Intensive Care Medicine 3rd Faculty of Medicine Charles University Prague Prague Czech Republic

Department of Anesthesia and Intensive Care Tampere University Hospital Wellbeing Services County of Pirkanmaa and Tampere University Tampere Finland

Department of Anesthesiology and Intensive Care Medicine Faculty of Medicine University Hospital Ostrava and University of Ostrava Ostrava Czech Republic

Department of Anesthesiology and Intensive Care Prof Dr CC Iliescu Emergency Institute for Cardiovascular Diseases Bucharest Romania

Department of Anesthesiology and Operative Intensive Care Medicine Charité University Medicine Berlin Berlin Germany

Department of Anesthesiology Intensive Care Medicine Emergency Medicine and Pain Medicine University Medicine Greifswald Greifswald Germany

Department of Anesthesiology Resuscitation and Intensive Care Zagreb University Hospital Centre Zagreb Croatia

Department of Critical Care King's College London Guy's and St Thomas' Hospital London United Kingdom

Department of Critical Care Medicine Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India

Department of Emergency Medicine and Traumatology Tanta University Tanta Egypt

Department of Emergency Medicine Odense University Hospital Odense Denmark

Department of Infectious Diseases Italian National Institute of Health Rome Italy

Department of Internal Medicine Clinical Pharmacy and Pharmacology University Medical Center Groningen University of Groningen Groningen The Netherlands

Department of Internal Medicine Hacettepe University Ankara Turkey

Department of Laboratory Medicine Section for Medical Microbiology Nord Trøndelag Hospital Trust Levanger Norway

Department of Medical Microbiology St Olav's Hospital Trondheim University Hospital Trondheim Norway

Department of Perioperative Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland

Departments of Biomedicine and Clinical Research University of Basel Basel Switzerland

Division of Infection Medicine Department of Clinical Sciences Lund Faculty of Medicine Lund University Lund Sweden; and

Division of Internal Medicine University Hospital Basel Basel Switzerland

Emergency Department Antwerp University Hospital Antwerp Belgium

Emergency Medicine Department Tours University School of Medicine and Tours University Hospital Centre Hospitalier Universitaire de Tours Tours France

Faculty of Social Sciences and Health Care Constantine the Philosopher University in Nitra Nitra Slovakia

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology North West State Medical University named after 1 I Mechnikov St Petersburg Russia

Friedrich Loeffler Institute of Medical Microbiology University Medicine Greifswald Greifswald Germany

Institute of Bioinformatics University Medicine Greifswald Greifswald Germany

Institute of Medical Microbiology University Hospital Münster Münster Germany

Intensive Care Department Vall d'Hebron University Hospital SODIR Research Group Vall d'Hebron Research Institute Medicine Department Autonomous University of Barcelona Barcelona Spain

Intensive Care Medicine Service Sao Joao Local Health Unit Faculty of Medicine University of Porto Porto Portugal

Medical Data Management Medaman Geel Belgium

Pediatric Intensive Care Unit Children Hospital Bambino Gesú Institute for Health and Research Rome Italy

Sabadell University Hospital Research and Innovation Institute Parc Tauli CIBER Respiratory Diseases Autonomous University of Barcelona Sabadell Spain

Service de Réanimation Hôpital Raymond Poincaré Assistance Publique Hôpitaux de Paris Garches France

The Hellenic Institute for the Study of Sepsis Athens Greece

Université Versailles Saint Quentin Versailles France

University of Medicine and Pharmacy Carol Davila Bucharest Romania

Am J Respir Crit Care Med. 2025 Apr;211(4):546-547. doi: 10.1164/rccm.202501-0106ED. PubMed

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