BACKGROUND: It is well known that poor sepsis outcomes are related to delays in diagnosis and treatment. OBJECTIVES: The aim of this study was to compare the mortality rate between two groups of patients, one group presenting before and one group presenting after implementation of the Surviving Sepsis Campaign (SSC) sepsis performance improvement bundles in the Emergency Department (ED). METHODS: This was a prospective study. The studied population included severe sepsis and septic shock patients entered in the SSC database who were admitted to the ED between June 2008 and December 2009. Patients were divided into two groups based on when they presented to the ED. Key treatment interventions, admission to the intensive care unit, and in-hospital mortality were compared. In addition, a survey was completed by the treating physicians to identify reasons for failures to comply with indicators. RESULTS: One hundred ninety-five (195) patients with severe sepsis and septic shock were enrolled in the study. Mortality was significantly higher at 44.8% in the baseline group (Group 1) compared to 31.6% in the group studied after the SSC protocol was instituted (Group 2) (p < 0.05). Compliance with all elements of the sepsis resuscitation bundle was 1% in Group 1 and 9% in Group 2 (p < 0.05). Compliance with all elements of the management bundle was 1% in Group 1 and 12.8% in Group 2. The most frequently reported reasons by physicians for failure to comply with the bundles were: "did not think it was needed" and "unsure of reason." CONCLUSION: The results revealed a significant drop in mortality after implementing the SSC protocol and sepsis performance improvement bundles in the ED. The barriers to implementing sepsis guidelines are knowledge, attitude, and behavioral barriers.
BACKGROUND: It is well known that poor sepsis outcomes are related to delays in diagnosis and treatment. OBJECTIVES: The aim of this study was to compare the mortality rate between two groups of patients, one group presenting before and one group presenting after implementation of the Surviving Sepsis Campaign (SSC) sepsis performance improvement bundles in the Emergency Department (ED). METHODS: This was a prospective study. The studied population included severe sepsis and septic shockpatients entered in the SSC database who were admitted to the ED between June 2008 and December 2009. Patients were divided into two groups based on when they presented to the ED. Key treatment interventions, admission to the intensive care unit, and in-hospital mortality were compared. In addition, a survey was completed by the treating physicians to identify reasons for failures to comply with indicators. RESULTS: One hundred ninety-five (195) patients with severe sepsis and septic shock were enrolled in the study. Mortality was significantly higher at 44.8% in the baseline group (Group 1) compared to 31.6% in the group studied after the SSC protocol was instituted (Group 2) (p < 0.05). Compliance with all elements of the sepsis resuscitation bundle was 1% in Group 1 and 9% in Group 2 (p < 0.05). Compliance with all elements of the management bundle was 1% in Group 1 and 12.8% in Group 2. The most frequently reported reasons by physicians for failure to comply with the bundles were: "did not think it was needed" and "unsure of reason." CONCLUSION: The results revealed a significant drop in mortality after implementing the SSC protocol and sepsis performance improvement bundles in the ED. The barriers to implementing sepsis guidelines are knowledge, attitude, and behavioral barriers.
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: Mitchell M Levy; Andrew Rhodes; Gary S Phillips; Sean R Townsend; Christa A Schorr; Richard Beale; Tiffany Osborn; Stanley Lemeshow; Jean-Daniel Chiche; Antonio Artigas; R Phillip Dellinger Journal: Intensive Care Med Date: 2014-10-01 Impact factor: 17.440
Authors: Faheem W Guirgis; Lisa Jones; Rhemar Esma; Alice Weiss; Kaitlin McCurdy; Jason Ferreira; Christina Cannon; Laura McLauchlin; Carmen Smotherman; Dale F Kraemer; Cynthia Gerdik; Kendall Webb; Jin Ra; Frederick A Moore; Kelly Gray-Eurom Journal: J Crit Care Date: 2017-04-08 Impact factor: 3.425
Authors: H Bryant Nguyen; Anja Kathrin Jaehne; Namita Jayaprakash; Matthew W Semler; Sara Hegab; Angel Coz Yataco; Geneva Tatem; Dhafer Salem; Steven Moore; Kamran Boka; Jasreen Kaur Gill; Jayna Gardner-Gray; Jacqueline Pflaum; Juan Pablo Domecq; Gina Hurst; Justin B Belsky; Raymond Fowkes; Ronald B Elkin; Steven Q Simpson; Jay L Falk; Daniel J Singer; Emanuel P Rivers Journal: Crit Care Date: 2016-07-01 Impact factor: 9.097
Authors: Yaseen M Arabi; Hasan M Al-Dorzi; Ahmed Alamry; Ra'ed Hijazi; Sami Alsolamy; Majid Al Salamah; Hani M Tamim; Saad Al-Qahtani; Abdulaziz Al-Dawood; Abdellatif M Marini; Fatimah H Al Ehnidi; Shihab Mundekkadan; Amal Matroud; Mohamed S Mohamed; Saadi Taher Journal: Ann Intensive Care Date: 2017-05-30 Impact factor: 6.925