NYSDA Publications

AHRQ Issues Regulatory Update

Sep 3, 2025

The Agency for Healthcare Research and Quality (AHRQ) has issued its weekly regulatory update, which can be read below.

September 3, 2025 | Issue #973

In This Week's Issue: resources for Sepsis Awareness Month; commonly missed chances for early sepsis diagnosis; test of pediatric sepsis screening tool; antibiotic stewardship in sepsis treatment

September: A Month for Increasing Awareness About Sepsis

Sepsis is one of the leading causes of death in U.S. hospitals.  This September, AHRQ is offering provider resources and data on the seriousness of sepsis during Sepsis Awareness Month.  Sepsis is a medical emergency.  Learning the signs of sepsis for early detection and treatment is crucial.  The free AHRQ Toolkit for Improving Antibiotic Use in Acute Care Hospitals offers best practices for diagnosing and treating sepsis.  This tool reviews approaches for diagnosing and treating sepsis and discusses when to stop antibiotics for patients who may have sepsis.  AHRQ data sources demonstrate both the problem and prevalence of sepsis.  Data from the Healthcare Cost and Utilization Project (HCUP) were used to create a report to Congress that provides an assessment of hospital care for sepsis in the United States.  AHRQ also created an interactive data resource on trends in sepsis hospital care and recently updated the following Statistical Briefs on sepsis with 2022 data:

Finally, the AHRQ Quality Indicators measure performance over time and include a Patient Safety Indicator (PSI 13) for determining postoperative sepsis rates.  Join AHRQ and other partners across the country in supporting Sepsis Awareness Month.  Infection Prevention is Sepsis Prevention™!

Opportunities for Diagnosis and Treatment of Sepsis

Among patients with sepsis, potential missed opportunities for earlier recognition of sepsis are relatively common, according to research published in the journal Critical Care Explorations.  A comparison of nearly 650,000 sepsis cases recorded between 2016 and 2019 with records from prior visits revealed potential missed diagnostic opportunities in over 16 percent of hospital admissions where sepsis was the diagnosis.  Most of these potential missed opportunities occurred in outpatient settings.  Many of these patients reported symptoms an average of 2 days before their diagnosis.  Younger age and receipt of antibiotic, inhaler, and opioid prescriptions—which can mask symptoms of infections that can contribute to developing sepsis—were associated with potential delayed diagnoses.  These findings stress that making a diagnosis and not just treating symptoms could lead to faster sepsis identification.  Access the article.

Timely Shock Treatment in Suspected Pediatric Sepsis Not Improved by Predictive Clinical Decision Support

An AHRQ-funded study in Pediatrics found that a clinical decision support (CDS) tool did not increase the proportion of patients treated for septic shock before shock developed in pediatric emergency departments.  In 1,331 encounters with pediatric patients across four emergency departments, researchers tested the ability of a CDS tool based on machine learning predictive models to shorten the time between suspected sepsis and shock treatment.  While screening tools for pediatric sepsis have been implemented in emergency departments, this was the first prospective study with a control group.  Providers receiving CDS alerts administered standard treatment for sepsis in 39 percent of cases, while providers in the control group gave treatment in 38.9 percent of cases without the assistance of the CDS.  However, all four participating units chose to continue using the CDS tool, citing the reliability and infrequency of its alerts, as well as its value as a backup support for a priority area of patient safety.  Access the abstract.

Case-Based Vignettes Help Advance Antibiotic Stewardship in NICUs

There is both widespread variation in antibiotics use and antibiotics overuse in neonatal intensive care units (NICUs).  However, case-based vignettes that demonstrate safe antibiotics prescribing practices in specific patient scenarios can help promote more antibiotic stewardship–friendly practices in NICU settings, according to an AHRQ-funded study published in the Journal of Perinatology.  The authors surveyed clinicians at 31 NICUs participating in the Optimizing Antibiotic Stewardship in California NICUs (OASCN) collaborative to learn how they would evaluate and manage early-onset sepsis in newborns before and after a 12-month collaborative intervention.  The study found that clinicians in NICUs were less likely to order laboratory testing and more likely to follow stewardship-friendly practices after the intervention.  For example, when given test results for a well-appearing infant that could be associated with a bacterial infection at 12 hours of life, 26 percent of clinicians were likely or very likely at baseline to start antibiotics; this decreased to 14 percent at follow-up.  In addition to validating the use of case-based vignettes to optimize prescribing practices, the study suggested targeting specific antibiotic use practices in the NICU setting.  Review the study.

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AHRQ Stats: Trends in Sepsis-Related In-Hospital Stays

Among adults aged 65 and older, the total number of sepsis nonmaternal inpatient stays steadily increased by 44.2 percent between 2016 and 2022 (from 1,007,000 to 1,452,000 discharges).  The number of stays among those aged 18 to 64 increased in the same time frame, peaking at 1,024,000 in 2021, then dropping to 895,000 in 2022.  (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #306, Overview of Outcomes for Inpatient Stays Involving Sepsis, 2016–2021 and Addendum with 2022 Data.)

New Research and Evidence

AHRQ in the Professional Literature

Allergy alerting and overrides for opioid analogues across two health systems.  Wasserman RL, Goss FR, Seger DL, et al. BMJ Health Care Inform. 2025 May 25;32(1):e101259.  Access the abstract on PubMed®.

Association between the sequence of β-lactam and vancomycin administration and mortality in patients with suspected sepsis.  Kondo Y, Klompas M, McKenna CS, et al. Clin Infect Dis. 2025 Apr 30;80(4):761-9.  Access the abstract on PubMed®.

Using interpersonal continuity of care in home health physical therapy to reduce hospital readmissions.  Engel P, Vorensky M, Squires A, et al. Home Health Care Manag Pract. 2025 Feb;37(1):54-63. Epub 2024 Jul 28.  Access the abstract on PubMed®.

MRI adoption in pediatric appendicitis: trends and outcomes.  Mangus CW, Janke AT, Mahajan P, et al. Hosp Pediatr. 2025 May;15(5):416-22.  Access the abstract on PubMed®.

An objective method to determine nurse staffing for an acute care for elders (ACE) hospital unit: discrete event simulation.  Simmons SF, Hollingsworth EK, Slagle JM, et al. J Am Geriatr Soc. 2025 Jul;73(7):2146-54. Epub 2025 May 9.  Access the abstract on PubMed®.

Integrating a risk prediction score in a clinical decision support to identify patients with health-related social needs in the emergency department.  Mazurenko O, Harle CA, Musey PI, Jr., et al. JAMIA Open. 2025 Aug;8(4):ooaf060. Epub 2025 Jul 4.  Access the abstract on PubMed®.

Machine learning for predicting waitlist mortality in pediatric heart transplantation.  Haregu F, Dixon RJ, McCulloch M, et al. Pediatr Transplant. 2025 Jun;29(4):e70095.  Access the abstract on PubMed®.

Type II diabetes mellitus and COVID-19: exploring insulin management in patients from family medicine clinics.  Opara C, White A, Fulda KG, et al. Pharmacy. 2025 Jul 4;13(4):93.  Access the abstract on PubMed®.