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Standardization of Severe Sepsis Management: A Survey of Methodologies in Academic and Community Settings
- Source :
-
Journal of Emergency Medicine (0736-4679) . Feb2010, Vol. 38 Issue 2, p122-132. 11p. - Publication Year :
- 2010
-
Abstract
- Abstract: Background: Evidence-based therapies for severe sepsis include early antibiotics, early goal-directed therapy, corticosteroids, recombinant human activated protein C, glucose control, and lung protective strategies. Objective: The objective of this study was to analyze methods, challenges, and outcomes observed by hospitals that implemented a hospital-wide sepsis management protocol incorporating evidence-based therapies. Methods: In a cross-sectional multi-center telephone survey over a 4-month period, clinicians (participants) responsible for developing a hospital sepsis protocol were questioned regarding its development and outcomes. Results: Participants completing surveys represented 40 hospitals (20 academic and 20 community). Twenty-seven percent of protocol champions were Emergency physicians or nurses. Sixty-three percent reported protocol development time of 6–12 months. Eighty-eight percent of participants reported protocol initiation in the Emergency Department. Three participants reported hiring a nurse educator to implement the protocol. Ninety-five percent of participants measure lactate as part of patient screening. Protocol therapies reported included early antibiotics (98%), early goal directed-therapy (EGDT) (98%), corticosteroids (80%), and activated protein C (73%). Contributions to success included having a protocol champion (85%) and sepsis education program (65%). Twenty-one participants had recorded patient-level data, totaling 2319 protocol patients, compared to 1719 non-protocol patients, with in-hospital mortality of 23% and 44%, respectively. Conclusions: Implementation of a sepsis management protocol incorporating evidence-based therapies can be accomplished in both academic and community hospitals, with minimal additional staffing. The presence of a protocol champion and education program is crucial to success, and may result in improved patient outcome. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 07364679
- Volume :
- 38
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Journal of Emergency Medicine (0736-4679)
- Publication Type :
- Academic Journal
- Accession number :
- 48137378
- Full Text :
- https://doi.org/10.1016/j.jemermed.2007.10.087