Policy analysis of sepsis management: The role of advanced practice nurses in protocol adherence and advocacy

Sepsis is one of the leading causes of mortality in the inpatient setting. Despite evolving clinical definitions, regulatory misalignment between Centers for Medicare & Medicaid Services (CMS) SEP-1 measures and Sepsis-3 guidelines creates barriers to optimal care. Advanced practice registered nurses (APRNs) are leaders who promote protocol adherence and policy advocacy. This policy analysis explores how regulatory challenges affect sepsis management and highlights the role of APRNs as change agents in evidence-based practice. A policy analysis was conducted by reviewing CMS SEP-1 regulations, Surviving Sepsis Campaign guidelines, and state-level mandates. A literature search was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Embase to identify systemic barriers and policy inconsistencies affecting sepsis management. Policies were evaluated for clinical alignment, regulatory implications, and their impact on APRN leadership opportunities. Findings were synthesized to develop recommendations to improve APRN-driven sepsis care initiatives. Misalignment between clinical practice and CMS guidelines complicates sepsis management, requiring APRNs to navigate administrative demands while maintaining patient-centered care. Policy reforms must better align SEP-1 with evolving clinical evidence and prioritize early recognition without compromising individualized patient care. Advanced practice registered nurses can lead quality-improvement efforts and legislative advocacy for updated sepsis protocols. Empowering APRNs through leadership in protocol adherence, policy reform, and advocacy initiatives is essential to improving sepsis outcomes. An evidence-based, patient-centered approach will enhance sepsis care delivery and promote health equity across health care settings.