; and (ii) to ensure that professional staff of the hospital with direct patient care responsibilities and, as determined appropriate by the hospital, staff of the hospital with indirect patient care responsibilities (including laboratory and pharmacy staff) periodically receive training (which shall be updated in accordance with any substantial update made under clause (i) to the evidence-based sepsis protocols of the hospital) to implement such evidence-based sepsis protocols. . (b) Evidence-Based sepsis protocols defined Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ) is amended by adding at the end the following new subsection: (kkk) Evidence-Based sepsis protocols The term evidence-based sepsis protocols means, with respect to a hospital, protocols based on generally accepted standards of care for the early recognition and treatment of individuals with sepsis, severe sepsis, or septic shock and that include each of the following: (1) A process for identifying (including through screenings) and providing treatment for adults with sepsis, severe sepsis, or septic shock, taking into account whether such treatment is being provided as an inpatient hospital service or in the emergency department of the hospital. (2) A process for identifying (including through screenings) and providing treatment for children with sepsis, severe sepsis, or septic shock, taking into account whether such treatment is being provided as an inpatient hospital service or in the emergency department of the hospital. (3) A process and explicit criteria for excluding certain individuals, such as an individual with an exclusionary clinical condition (as specified by the hospital) or an individual who has elected palliative care, from the process described in paragraph (1) or (2). (4) Guidelines for hemodynamic support with explicit physiologic and treatment goals, a methodology for invasive and non-invasive hemodynamic monitoring, and timeframe goals. (5) With respect to children (including infants), guidelines for fluid