PURPOSES: We had previously demonstrated surviving sepsis campaign guidelines had not had enough impact at our Emergency Department. BASIC PROCEDURES: Actions directed to increase the qualification of our staff and residents, to facilitate guidelines divulgation and to improve spatial conditions by creating a High Dependency Unit were implemented as a bundle. The impact of these actions on the achievement of early objectives of the campaign and on mortality was analyzed. MAIN FINDINGS: Following campaign guidelines was more frequent after the implementation of these actions, as shown by less restrictive fluids administration for more severe cases (P = .001), earlier administration of antibiotics (P = .001) and lactate determination rate (46% vs. 12%). In-hospital mortality difference did not reach statistical difference. Physicians were able to identify high-risk patients on clinical grounds. PRINCIPAL CONCLUSIONS: The bundle of actions has had a moderate beneficial effect on our Emergency Department. High Dependency Units are useful for managing patients not fulfilling criteria for Intensive Care Unit admission.
PURPOSES: We had previously demonstrated surviving sepsis campaign guidelines had not had enough impact at our Emergency Department. BASIC PROCEDURES: Actions directed to increase the qualification of our staff and residents, to facilitate guidelines divulgation and to improve spatial conditions by creating a High Dependency Unit were implemented as a bundle. The impact of these actions on the achievement of early objectives of the campaign and on mortality was analyzed. MAIN FINDINGS: Following campaign guidelines was more frequent after the implementation of these actions, as shown by less restrictive fluids administration for more severe cases (P = .001), earlier administration of antibiotics (P = .001) and lactate determination rate (46% vs. 12%). In-hospital mortality difference did not reach statistical difference. Physicians were able to identify high-risk patients on clinical grounds. PRINCIPAL CONCLUSIONS: The bundle of actions has had a moderate beneficial effect on our Emergency Department. High Dependency Units are useful for managing patients not fulfilling criteria for Intensive Care Unit admission.
Authors: Michael J Ward; Jeremy S Boyd; Nicole J Harger; John M Deledda; Carol L Smith; Susan M Walker; Jeffrey D Hice; Kimberly W Hart; Christopher J Lindsell; Stewart W Wright Journal: World J Emerg Med Date: 2012-06-12
Authors: Zhongheng Zhang; Yucai Hong; Nathan J Smischney; Han-Pin Kuo; Panagiotis Tsirigotis; Jordi Rello; Win Sen Kuan; Christian Jung; Chiara Robba; Fabio Silvio Taccone; Marc Leone; Herbert Spapen; David Grimaldi; Sven Van Poucke; Steven Q Simpson; Patrick M Honore; Stefan Hofer; Pietro Caironi Journal: J Thorac Dis Date: 2017-02 Impact factor: 2.895
Authors: Sandra Christina Pereira Lima Shiramizo; Alexandre R Marra; Marcelino S Durão; Ângela T Paes; Michael B Edmond; Oscar Fernando Pavão dos Santos Journal: PLoS One Date: 2011-11-03 Impact factor: 3.240
Authors: F J Candel; M Borges Sá; S Belda; G Bou; J L Del Pozo; O Estrada; R Ferrer; J González Del Castillo; A Julián-Jiménez; I Martín-Loeches; E Maseda; M Matesanz; P Ramírez; J T Ramos; J Rello; B Suberviola; A Suárez de la Rica; P Vidal Journal: Rev Esp Quimioter Date: 2018-06-25 Impact factor: 1.553