Status of sepsis care in Romanian hospitals: insights from the European Sepsis Care Survey

Abstract

Background. Early recognition of sepsis, standardised management protocols and hospital quality improvement initiatives are considered essential components of modern sepsis care. However, data regarding implementation of these measures in Romanian hospitals remain limited.

Aim. To evaluate sepsis screening, standardised sepsis management, quality improvement initiatives and selected organisational infrastructure components in Romanian hospitals participating in the European Sepsis Care Survey (ESCS), and to compare Romanian results with hospitals from other European Union countries.

Methods. This secondary analysis included Romanian acute care hospitals participating in the ESCS, a multinational cross-sectional survey conducted between 2021 and 2022. Data regarding sepsis screening, standardised management, quality improvement initiatives and organisational infrastructure were analysed across emergency departments (EDs), wards and intensive care units (ICUs). Romanian hospitals were compared with hospitals from European Union countries excluding Romania.

Results. Thirty-six Romanian hospitals were included, representing approximately 18% of the national acute care bed capacity. Sepsis screening implementation in EDs did not significantly differ from the European comparator group, while differences were observed for wards and ICUs. Standardised sepsis management implementation differed across hospital sectors, with significant differences observed for wards but not for EDs or ICUs. Romanian hospitals reported quality improvement initiatives in 39.4% of cases compared with 22.1% in the European comparator group, although no hospital reported regularly conducted hospital-wide sepsis programmes. Additional differences were observed regarding sepsis bundle implementation, antimicrobial stewardship and organisational infrastructure.

Conclusions. Romanian hospitals participating in the ESCS demonstrated variability in implementation of sepsis screening, standardised management and quality improvement initiatives across hospital sectors. These findings may support future national efforts aimed at improving organisational preparedness and sepsis care implementation.