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An audit of compliance with the sepsis resuscitation care bundle in patients admitted to A&E with severe sepsis or septic shock.
Int Emerg Nurs. 2008 Oct; 16(4):250-6.IE

Abstract

Severe sepsis and septic shock are syndromes resulting in a systemic inflammatory response and the dysfunction of one or more organs following infection. The Surviving Sepsis Campaign is an international effort to reduce mortality in severe sepsis and septic shock by 25% by 2009 using a care bundle approach. It comprises evidenced-based interventions to be carried out within 6h of onset of sepsis. We conducted a prospective observational audit of 32 consecutive adult patients with severe sepsis or septic shock admitted via the A&E of a district general hospital. The compliance rate against each element, and overall compliance to the 6-h bundle were obtained. Patients' ages ranged from 55 to 75 years with 53% being male. Overall compliance was 19%. Arterial lactate was undertaken 100% of the time, and only just over half received an appropriate fluid challenge. Administration of an antibiotic was also very slow. Local recommendations include improvements to the track and trigger scoring system in A&E to improve recognition of sick patients, ensuring the doctor responsible for prescribing the antibiotic will administer it, and increasing awareness of the surviving sepsis campaign via education and training of all A&E staff. Given current evidence greater compliance to the care bundle may well improve patient outcomes for this client group.

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Authors+Show Affiliations

Baldwin LN
Outreach Office, C/O ICU, Kent & Sussex Hospital, Mount Ephraim, Tunbridge Wells, Kent TN4 9AT, United Kingdom.
Smith SA
No affiliation info available
Fender V
No affiliation info available
Gisby S
No affiliation info available
Fraser J
No affiliation info available

MeSH

APACHEAgedEmergency Service, HospitalEvidence-Based MedicineFemaleGuideline AdherenceHospitals, GeneralHumansMaleMedical AuditMiddle AgedPractice Guidelines as TopicProspective StudiesSepsisShock, Septic

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18929343

Citation

Baldwin, Lee N., et al. "An Audit of Compliance With the Sepsis Resuscitation Care Bundle in Patients Admitted to A&E With Severe Sepsis or Septic Shock." International Emergency Nursing, vol. 16, no. 4, 2008, pp. 250-6.
Baldwin LN, Smith SA, Fender V, et al. An audit of compliance with the sepsis resuscitation care bundle in patients admitted to A&E with severe sepsis or septic shock. Int Emerg Nurs. 2008;16(4):250-6.
Baldwin, L. N., Smith, S. A., Fender, V., Gisby, S., & Fraser, J. (2008). An audit of compliance with the sepsis resuscitation care bundle in patients admitted to A&E with severe sepsis or septic shock. International Emergency Nursing, 16(4), 250-6. https://doi.org/10.1016/j.ienj.2008.05.008
Baldwin LN, et al. An Audit of Compliance With the Sepsis Resuscitation Care Bundle in Patients Admitted to A&E With Severe Sepsis or Septic Shock. Int Emerg Nurs. 2008;16(4):250-6. PubMed PMID: 18929343.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An audit of compliance with the sepsis resuscitation care bundle in patients admitted to A&E with severe sepsis or septic shock. AU - Baldwin,Lee N, AU - Smith,Sally A, AU - Fender,Veronica, AU - Gisby,Sharon, AU - Fraser,Jayne, Y1 - 2008/08/08/ PY - 2007/12/30/received PY - 2008/05/18/revised PY - 2008/05/18/accepted PY - 2008/10/22/pubmed PY - 2009/2/12/medline PY - 2008/10/22/entrez SP - 250 EP - 6 JF - International emergency nursing JO - Int Emerg Nurs VL - 16 IS - 4 N2 - Severe sepsis and septic shock are syndromes resulting in a systemic inflammatory response and the dysfunction of one or more organs following infection. The Surviving Sepsis Campaign is an international effort to reduce mortality in severe sepsis and septic shock by 25% by 2009 using a care bundle approach. It comprises evidenced-based interventions to be carried out within 6h of onset of sepsis. We conducted a prospective observational audit of 32 consecutive adult patients with severe sepsis or septic shock admitted via the A&E of a district general hospital. The compliance rate against each element, and overall compliance to the 6-h bundle were obtained. Patients' ages ranged from 55 to 75 years with 53% being male. Overall compliance was 19%. Arterial lactate was undertaken 100% of the time, and only just over half received an appropriate fluid challenge. Administration of an antibiotic was also very slow. Local recommendations include improvements to the track and trigger scoring system in A&E to improve recognition of sick patients, ensuring the doctor responsible for prescribing the antibiotic will administer it, and increasing awareness of the surviving sepsis campaign via education and training of all A&E staff. Given current evidence greater compliance to the care bundle may well improve patient outcomes for this client group. SN - 1755-599X UR - https://www.unboundmedicine.com/medline/citation/18929343/An_audit_of_compliance_with_the_sepsis_resuscitation_care_bundle_in_patients_admitted_to_A&E_with_severe_sepsis_or_septic_shock_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1755-599X(08)00063-3 DB - PRIME DP - Unbound Medicine ER -