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Impact of sepsis bundle strategy on outcomes of patients suffering from severe sepsis and septic shock in china.
J Emerg Med. 2013 Apr; 44(4):735-41.JE

Abstract

BACKGROUND

It is well known that poor sepsis outcomes are related to delays in diagnosis and treatment.

OBJECTIVES

The aim of this study was to compare the mortality rate between two groups of patients, one group presenting before and one group presenting after implementation of the Surviving Sepsis Campaign (SSC) sepsis performance improvement bundles in the Emergency Department (ED).

METHODS

This was a prospective study. The studied population included severe sepsis and septic shock patients entered in the SSC database who were admitted to the ED between June 2008 and December 2009. Patients were divided into two groups based on when they presented to the ED. Key treatment interventions, admission to the intensive care unit, and in-hospital mortality were compared. In addition, a survey was completed by the treating physicians to identify reasons for failures to comply with indicators.

RESULTS

One hundred ninety-five (195) patients with severe sepsis and septic shock were enrolled in the study. Mortality was significantly higher at 44.8% in the baseline group (Group 1) compared to 31.6% in the group studied after the SSC protocol was instituted (Group 2) (p < 0.05). Compliance with all elements of the sepsis resuscitation bundle was 1% in Group 1 and 9% in Group 2 (p < 0.05). Compliance with all elements of the management bundle was 1% in Group 1 and 12.8% in Group 2. The most frequently reported reasons by physicians for failure to comply with the bundles were: "did not think it was needed" and "unsure of reason."

CONCLUSION

The results revealed a significant drop in mortality after implementing the SSC protocol and sepsis performance improvement bundles in the ED. The barriers to implementing sepsis guidelines are knowledge, attitude, and behavioral barriers.

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Authors+Show Affiliations

Wang Z
Department of Emergency Medicine, Beijing Shi-Ji-Tan Hospital, Beijing, China.
Xiong Y
No affiliation info available
Schorr C
No affiliation info available
Dellinger RP
No affiliation info available

MeSH

AdultAgedAttitude of Health PersonnelChinaClinical ProtocolsFemaleGuideline AdherenceHealth Knowledge, Attitudes, PracticeHospital MortalityHumansMaleMiddle AgedPractice Guidelines as TopicProspective StudiesSepsisShock, Septic

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23332802

Citation

Wang, Zhen, et al. "Impact of Sepsis Bundle Strategy On Outcomes of Patients Suffering From Severe Sepsis and Septic Shock in China." The Journal of Emergency Medicine, vol. 44, no. 4, 2013, pp. 735-41.
Wang Z, Xiong Y, Schorr C, et al. Impact of sepsis bundle strategy on outcomes of patients suffering from severe sepsis and septic shock in china. J Emerg Med. 2013;44(4):735-41.
Wang, Z., Xiong, Y., Schorr, C., & Dellinger, R. P. (2013). Impact of sepsis bundle strategy on outcomes of patients suffering from severe sepsis and septic shock in china. The Journal of Emergency Medicine, 44(4), 735-41. https://doi.org/10.1016/j.jemermed.2012.07.084
Wang Z, et al. Impact of Sepsis Bundle Strategy On Outcomes of Patients Suffering From Severe Sepsis and Septic Shock in China. J Emerg Med. 2013;44(4):735-41. PubMed PMID: 23332802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of sepsis bundle strategy on outcomes of patients suffering from severe sepsis and septic shock in china. AU - Wang,Zhen, AU - Xiong,Yingxia, AU - Schorr,Christa, AU - Dellinger,R P, Y1 - 2013/01/16/ PY - 2011/12/14/received PY - 2012/03/21/revised PY - 2012/07/01/accepted PY - 2013/1/22/entrez PY - 2013/1/22/pubmed PY - 2013/9/14/medline SP - 735 EP - 41 JF - The Journal of emergency medicine JO - J Emerg Med VL - 44 IS - 4 N2 - BACKGROUND: It is well known that poor sepsis outcomes are related to delays in diagnosis and treatment. OBJECTIVES: The aim of this study was to compare the mortality rate between two groups of patients, one group presenting before and one group presenting after implementation of the Surviving Sepsis Campaign (SSC) sepsis performance improvement bundles in the Emergency Department (ED). METHODS: This was a prospective study. The studied population included severe sepsis and septic shock patients entered in the SSC database who were admitted to the ED between June 2008 and December 2009. Patients were divided into two groups based on when they presented to the ED. Key treatment interventions, admission to the intensive care unit, and in-hospital mortality were compared. In addition, a survey was completed by the treating physicians to identify reasons for failures to comply with indicators. RESULTS: One hundred ninety-five (195) patients with severe sepsis and septic shock were enrolled in the study. Mortality was significantly higher at 44.8% in the baseline group (Group 1) compared to 31.6% in the group studied after the SSC protocol was instituted (Group 2) (p < 0.05). Compliance with all elements of the sepsis resuscitation bundle was 1% in Group 1 and 9% in Group 2 (p < 0.05). Compliance with all elements of the management bundle was 1% in Group 1 and 12.8% in Group 2. The most frequently reported reasons by physicians for failure to comply with the bundles were: "did not think it was needed" and "unsure of reason." CONCLUSION: The results revealed a significant drop in mortality after implementing the SSC protocol and sepsis performance improvement bundles in the ED. The barriers to implementing sepsis guidelines are knowledge, attitude, and behavioral barriers. SN - 0736-4679 UR - https://www.unboundmedicine.com/medline/citation/23332802/Impact_of_sepsis_bundle_strategy_on_outcomes_of_patients_suffering_from_severe_sepsis_and_septic_shock_in_china_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0736-4679(12)01416-3 DB - PRIME DP - Unbound Medicine ER -