Literature DB >> 25216849

Improving Outcomes in Patients With Sepsis.

Scott B Armen1, Carol V Freer1, John W Showalter1, Tonya Crook1, Cynthia J Whitener1, Cheri West1, Thomas E Terndrup1, Marissa Grifasi1, Christopher J DeFlitch1, Christopher S Hollenbeak2.   

Abstract

Sepsis mortality may be improved by early recognition and appropriate treatment based on evidence-based guidelines. An intervention was developed that focused on earlier identification of sepsis, early antimicrobial administration, and an educational program that was disseminated throughout all hospital units and services. There were 1331 patients with sepsis during the intervention period and 1401 patients with sepsis during the control period. After controlling for expected mortality, patients in the intervention period had 30% lower odds of dying (odds ratio = 0.70, 95% confidence interval [CI] = 0.57 to 0.84). They also had 1.07 fewer days on average in the intensive care unit (95% CI = -1.98 to -0.16), 2.15 fewer hospital days (95% CI = -3.45 to -0.86), and incurred on average $1949 less in hospital costs, although the effect on costs was not statistically significant. Continued incremental improvement and sustainment is anticipated through organizational oversight, continued education, and initiation of an automated electronic sepsis alert function.
© The Author(s) 2014.

Entities:  

Keywords:  evidence-based medicine; interdisciplinary health team; outcomes assessment; quality improvement; sepsis; severe sepsis

Mesh:

Substances:

Year:  2014        PMID: 25216849      PMCID: PMC5731488          DOI: 10.1177/1062860614551042

Source DB:  PubMed          Journal:  Am J Med Qual        ISSN: 1062-8606            Impact factor:   1.852


  29 in total

1.  Improvements in compliance with resuscitation bundles and achievement of end points after an educational program on the management of severe sepsis and septic shock.

Authors:  Kyeongman Jeon; Tae Gun Shin; Min Seob Sim; Gee Young Suh; So Yeon Lim; Hyoung Gon Song; Ik Joon Jo
Journal:  Shock       Date:  2012-05       Impact factor: 3.454

2.  Before-after study of a standardized hospital order set for the management of septic shock.

Authors:  Scott T Micek; Nareg Roubinian; Tim Heuring; Meghan Bode; Jennifer Williams; Courtney Harrison; Theresa Murphy; Donna Prentice; Brent E Ruoff; Marin H Kollef
Journal:  Crit Care Med       Date:  2006-11       Impact factor: 7.598

3.  Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients.

Authors:  M H Kollef; G Sherman; S Ward; V J Fraser
Journal:  Chest       Date:  1999-02       Impact factor: 9.410

4.  The GENESIS project (GENeralized Early Sepsis Intervention Strategies): a multicenter quality improvement collaborative.

Authors:  Chad M Cannon; Christopher V Holthaus; Marc T Zubrow; Pat Posa; Satheesh Gunaga; Vipul Kella; Ron Elkin; Scott Davis; Bonnie Turman; Jordan Weingarten; Truman J Milling; Nathan Lidsky; Victor Coba; Arturo Suarez; James J Yang; Emanuel P Rivers
Journal:  J Intensive Care Med       Date:  2012-08-17       Impact factor: 3.510

5.  The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection.

Authors:  L Leibovici; I Shraga; M Drucker; H Konigsberger; Z Samra; S D Pitlik
Journal:  J Intern Med       Date:  1998-11       Impact factor: 8.989

6.  Implementation of an evidence-based "standard operating procedure" and outcome in septic shock.

Authors:  Andreas Kortgen; Petra Niederprüm; Michael Bauer
Journal:  Crit Care Med       Date:  2006-04       Impact factor: 7.598

7.  Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain.

Authors:  Ricard Ferrer; Antonio Artigas; Mitchell M Levy; Jesús Blanco; Gumersindo González-Díaz; José Garnacho-Montero; Jordi Ibáñez; Eduardo Palencia; Manuel Quintana; María Victoria de la Torre-Prados
Journal:  JAMA       Date:  2008-05-21       Impact factor: 56.272

8.  The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study.

Authors:  Fang Gao; Teresa Melody; Darren F Daniels; Simon Giles; Samantha Fox
Journal:  Crit Care       Date:  2005-11-11       Impact factor: 9.097

9.  An international sepsis survey: a study of doctors' knowledge and perception about sepsis.

Authors:  Martijn Poeze; Graham Ramsay; Herwig Gerlach; Francesca Rubulotta; Mitchel Levy
Journal:  Crit Care       Date:  2004-10-14       Impact factor: 9.097

Review 10.  The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis.

Authors:  Mitchell M Levy; R Phillip Dellinger; Sean R Townsend; Walter T Linde-Zwirble; John C Marshall; Julian Bion; Christa Schorr; Antonio Artigas; Graham Ramsay; Richard Beale; Margaret M Parker; Herwig Gerlach; Konrad Reinhart; Eliezer Silva; Maurene Harvey; Susan Regan; Derek C Angus
Journal:  Intensive Care Med       Date:  2010-01-13       Impact factor: 17.440

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  5 in total

1.  An investigation of sepsis surveillance and emergency treatment on patient mortality outcomes: An observational cohort study.

Authors:  Robert C Amland; Bharat B Sutariya
Journal:  JAMIA Open       Date:  2018-05-15

Review 2.  The Surviving Sepsis Campaign: research priorities for the administration, epidemiology, scoring and identification of sepsis.

Authors:  Mark E Nunnally; Ricard Ferrer; Greg S Martin; Ignacio Martin-Loeches; Flavia R Machado; Daniel De Backer; Craig M Coopersmith; Clifford S Deutschman
Journal:  Intensive Care Med Exp       Date:  2021-07-02

3.  A Multidisciplinary Sepsis Program Enabled by a Two-Stage Clinical Decision Support System: Factors That Influence Patient Outcomes.

Authors:  Robert C Amland; James M Haley; Jason J Lyons
Journal:  Am J Med Qual       Date:  2015-10-21       Impact factor: 1.852

4.  Toward a hemorrhagic trauma severity score: fusing five physiological biomarkers.

Authors:  Ankita Bhat; Daria Podstawczyk; Brandon K Walther; John R Aggas; David Machado-Aranda; Kevin R Ward; Anthony Guiseppi-Elie
Journal:  J Transl Med       Date:  2020-09-14       Impact factor: 5.531

5.  Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.

Authors:  Heena P Santry; Scott A Strassels; Angela M Ingraham; Wendelyn M Oslock; Kevin B Ricci; Anghela Z Paredes; Victor K Heh; Holly E Baselice; Amy P Rushing; Adrian Diaz; Vijaya T Daniel; M Didem Ayturk; Catarina I Kiefe
Journal:  BMC Med Res Methodol       Date:  2020-10-02       Impact factor: 4.615

  5 in total

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