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Feasibility of introduction and implementation of the Surviving Sepsis Campaign bundle in a Singapore emergency department.
Eur J Emerg Med. 2013 Oct; 20(5):344-9.EJ

Abstract

OBJECTIVES

The Surviving Sepsis Campaign has been shown to improve the outcome of patients with severe sepsis or septic shock in Europe and North America. We aim to examine the impact of implementing the severe sepsis resuscitation bundle as part of standard care at the National University Hospital Emergency Department (ED) and assess its feasibility in Singapore.

MATERIALS AND METHODS

Adult patients presenting to the ED with severe sepsis and septic shock from 1 July 2008 to 31 December 2009 were included. Implementation of the bundle was divided into six quartiles: Baseline, Education and four Quality Improvement quartiles. The primary outcome of interest was bundle compliance. Other clinical outcomes include mortality and difference in treatment between the two groups.

RESULTS

One hundred and seventeen patients were included. The median age was 58 years and the median APACHE II score was 20. The overall in-hospital mortality was 26.5%. Compliance to all items of the bundle was 0, 10, 24, 24, 7 and 40%, respectively, over six quartiles. Patients who received the entire bundle had a crude mortality of 11.1%, which is 18.2% lower than those who received only some or none of the bundle components. Patients receiving the entire bundle tend to receive about 1 litre more intravenous fluids in the ED.

CONCLUSION

There was zero compliance to the severe sepsis resuscitation bundle at baseline. Quality improvement initiatives resulted in better compliance and outcome for patients, showing that such a protocol of management is feasible in a typical Singapore ED.

Authors+Show Affiliations

Department of Emergency Medicine, National University Health System, Singapore, Singapore. win_sen_kuan@nuhs.edu.sgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23211272

Citation

Kuan, Win-Sen, et al. "Feasibility of Introduction and Implementation of the Surviving Sepsis Campaign Bundle in a Singapore Emergency Department." European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, vol. 20, no. 5, 2013, pp. 344-9.
Kuan WS, Mahadevan M, Tan JH, et al. Feasibility of introduction and implementation of the Surviving Sepsis Campaign bundle in a Singapore emergency department. Eur J Emerg Med. 2013;20(5):344-9.
Kuan, W. S., Mahadevan, M., Tan, J. H., Guo, J., & Ibrahim, I. (2013). Feasibility of introduction and implementation of the Surviving Sepsis Campaign bundle in a Singapore emergency department. European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, 20(5), 344-9. https://doi.org/10.1097/MEJ.0b013e32835c2ba3
Kuan WS, et al. Feasibility of Introduction and Implementation of the Surviving Sepsis Campaign Bundle in a Singapore Emergency Department. Eur J Emerg Med. 2013;20(5):344-9. PubMed PMID: 23211272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of introduction and implementation of the Surviving Sepsis Campaign bundle in a Singapore emergency department. AU - Kuan,Win-Sen, AU - Mahadevan,Malcolm, AU - Tan,Jun-Hao, AU - Guo,Jiwei, AU - Ibrahim,Irwani, PY - 2012/12/6/entrez PY - 2012/12/6/pubmed PY - 2014/4/3/medline SP - 344 EP - 9 JF - European journal of emergency medicine : official journal of the European Society for Emergency Medicine JO - Eur J Emerg Med VL - 20 IS - 5 N2 - OBJECTIVES: The Surviving Sepsis Campaign has been shown to improve the outcome of patients with severe sepsis or septic shock in Europe and North America. We aim to examine the impact of implementing the severe sepsis resuscitation bundle as part of standard care at the National University Hospital Emergency Department (ED) and assess its feasibility in Singapore. MATERIALS AND METHODS: Adult patients presenting to the ED with severe sepsis and septic shock from 1 July 2008 to 31 December 2009 were included. Implementation of the bundle was divided into six quartiles: Baseline, Education and four Quality Improvement quartiles. The primary outcome of interest was bundle compliance. Other clinical outcomes include mortality and difference in treatment between the two groups. RESULTS: One hundred and seventeen patients were included. The median age was 58 years and the median APACHE II score was 20. The overall in-hospital mortality was 26.5%. Compliance to all items of the bundle was 0, 10, 24, 24, 7 and 40%, respectively, over six quartiles. Patients who received the entire bundle had a crude mortality of 11.1%, which is 18.2% lower than those who received only some or none of the bundle components. Patients receiving the entire bundle tend to receive about 1 litre more intravenous fluids in the ED. CONCLUSION: There was zero compliance to the severe sepsis resuscitation bundle at baseline. Quality improvement initiatives resulted in better compliance and outcome for patients, showing that such a protocol of management is feasible in a typical Singapore ED. SN - 1473-5695 UR - https://www.unboundmedicine.com/medline/citation/23211272/Feasibility_of_introduction_and_implementation_of_the_Surviving_Sepsis_Campaign_bundle_in_a_Singapore_emergency_department_ L2 - https://doi.org/10.1097/MEJ.0b013e32835c2ba3 DB - PRIME DP - Unbound Medicine ER -