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The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study.
Emerg Med J. 2011 Jun; 28(6):507-12.EM

Abstract

BACKGROUND

Severe sepsis is likely to account for around 37,000 deaths annually in the UK. Five years after the international Surviving Sepsis Campaign (SSC) care bundles were published, care standards in the management of patients with severe sepsis are achieved in fewer than one in seven patients.

METHODS

This was a prospective observational cohort study across a 500-bed acute general hospital, to assess the delivery and impact of two interventions: the SSC resuscitation bundle and a new intervention designed to facilitate delivery, the sepsis six. Process measures included compliance with the bundle and the sepsis six; the outcome measure was mortality at hospital discharge.

RESULTS

Data from 567 patients were suitable for analysis. Compliance with the bundle increased from baseline. 84.6% of those receiving the sepsis six (n = 220) achieved the resuscitation bundle compared with only 5.8% of others. Delivery of the interventions had an association with reduced mortality: for the sepsis six (n = 220), 20.0% compared with 44.1% (p < 0.001); for the resuscitation bundle (n = 204), 5.9% compared with 51% (p < 0.001). Those receiving the sepsis six were much more likely to receive the full bundle. Those seen by the sepsis team had improved compliance with bundles and reduced mortality.

CONCLUSIONS

This study supports the SSC resuscitation bundle, and is suggestive of an association with reduced mortality although does not demonstrate causation. It demonstrates that simplified pathways, such as the sepsis six, and education programmes such as survive sepsis can contribute to improving the rate of delivery of these life-saving interventions.

Authors+Show Affiliations

Good Hope Hospital, Heart of England NHS Foundation Trust, Sutton Coldfield B75 7RR, UK. sepsisteam@googlemail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21036796

Citation

Daniels, Ron, et al. "The Sepsis Six and the Severe Sepsis Resuscitation Bundle: a Prospective Observational Cohort Study." Emergency Medicine Journal : EMJ, vol. 28, no. 6, 2011, pp. 507-12.
Daniels R, Nutbeam T, McNamara G, et al. The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study. Emerg Med J. 2011;28(6):507-12.
Daniels, R., Nutbeam, T., McNamara, G., & Galvin, C. (2011). The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study. Emergency Medicine Journal : EMJ, 28(6), 507-12. https://doi.org/10.1136/emj.2010.095067
Daniels R, et al. The Sepsis Six and the Severe Sepsis Resuscitation Bundle: a Prospective Observational Cohort Study. Emerg Med J. 2011;28(6):507-12. PubMed PMID: 21036796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study. AU - Daniels,Ron, AU - Nutbeam,Tim, AU - McNamara,Georgina, AU - Galvin,Clare, Y1 - 2010/10/29/ PY - 2010/11/2/entrez PY - 2010/11/3/pubmed PY - 2011/9/29/medline SP - 507 EP - 12 JF - Emergency medicine journal : EMJ JO - Emerg Med J VL - 28 IS - 6 N2 - BACKGROUND: Severe sepsis is likely to account for around 37,000 deaths annually in the UK. Five years after the international Surviving Sepsis Campaign (SSC) care bundles were published, care standards in the management of patients with severe sepsis are achieved in fewer than one in seven patients. METHODS: This was a prospective observational cohort study across a 500-bed acute general hospital, to assess the delivery and impact of two interventions: the SSC resuscitation bundle and a new intervention designed to facilitate delivery, the sepsis six. Process measures included compliance with the bundle and the sepsis six; the outcome measure was mortality at hospital discharge. RESULTS: Data from 567 patients were suitable for analysis. Compliance with the bundle increased from baseline. 84.6% of those receiving the sepsis six (n = 220) achieved the resuscitation bundle compared with only 5.8% of others. Delivery of the interventions had an association with reduced mortality: for the sepsis six (n = 220), 20.0% compared with 44.1% (p < 0.001); for the resuscitation bundle (n = 204), 5.9% compared with 51% (p < 0.001). Those receiving the sepsis six were much more likely to receive the full bundle. Those seen by the sepsis team had improved compliance with bundles and reduced mortality. CONCLUSIONS: This study supports the SSC resuscitation bundle, and is suggestive of an association with reduced mortality although does not demonstrate causation. It demonstrates that simplified pathways, such as the sepsis six, and education programmes such as survive sepsis can contribute to improving the rate of delivery of these life-saving interventions. SN - 1472-0213 UR - https://www.unboundmedicine.com/medline/citation/21036796/The_sepsis_six_and_the_severe_sepsis_resuscitation_bundle:_a_prospective_observational_cohort_study_ L2 - https://emj.bmj.com/lookup/pmidlookup?view=long&amp;pmid=21036796 DB - PRIME DP - Unbound Medicine ER -