Sepsis policy, guidelines, and standards in Canada: a jurisdictional scoping review

INTRODUCTION: Sepsis, the body's life-threatening response to infection, is associated with significant morbidity and mortality. In 2017, the World Health Assembly passed a resolution urging member states to recognize sepsis as a public health priority. Our objective was to identify and describe sepsis policies, guidelines, and health professional training standards in Canada. METHODS: We conducted a scoping review and an environmental scan, including systematic searches of published and grey literature. Policies, guidelines, or training standards related to identifying, managing, or reporting sepsis, published since 2010 and available in English/French, were included. We extracted data on the organization(s) involved in the development, information on the source, including the target patient population, measures of inclusive engagement, and whether the source considered at-risk, equity-denied, and/or Indigenous communities. RESULTS: We identified 32 sources of evidence, including sepsis policies or guidelines for 38% (5/13) of provinces and territories, the inclusion of sepsis as a training competency in 16% (11/67) of the Royal College of Canada medical specialties/subspecialties competency standards, and two Canadian Hospital Accreditation Standards. Only 6% (2/32) of the sources considered the role of social determinants of health, and 13% (4/32) engaged individuals with lived sepsis experience or members of the public. CONCLUSIONS: We identified existing sepsis policies, guidelines, and standards that reveal significant gaps across provinces and territories, particularly the lack of attention to social determinants of health and the exclusion of individuals with lived experience. Coordinated national policy efforts are urgently needed to reduce the burden of sepsis in Canada.