Decreasing mortality in severe sepsis and septic shock patients by implementing a sepsis bundle in a hospital setting.

<h4>Background</h4>The Surviving Sepsis Campaign (SSC) guidelines for the management of severe sepsis (SS) and septic shock (SSh) have been recommended to reduce morbidity and mortality.<h4>Materials and methods</h4>A quasi-experimental study was conducted in a medical-surgic...

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Autores principales: Sandra Christina Pereira Lima Shiramizo, Alexandre R Marra, Marcelino S Durão, Ângela T Paes, Michael B Edmond, Oscar Fernando Pavão dos Santos
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2011
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Acceso en línea:https://doaj.org/article/6696a0332b4547beb8f60022c01b90f3
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Sumario:<h4>Background</h4>The Surviving Sepsis Campaign (SSC) guidelines for the management of severe sepsis (SS) and septic shock (SSh) have been recommended to reduce morbidity and mortality.<h4>Materials and methods</h4>A quasi-experimental study was conducted in a medical-surgical ICU. Multiple interventions to optimize SS and SSh shock patients' clinical outcomes were performed by applying sepsis bundles (6- and 24-hour) in May 2006. We compared bundle compliance and patient outcomes before (July 2005-April 2006) and after (May 2006-December 2009) implementation of the interventions.<h4>Results</h4>A total of 564 SS and SSh patients were identified. Prior to the intervention, compliance with the 6 hour-sepsis resuscitation bundle was only 6%. After the intervention, compliance was as follows: 8.2% from May to December 2006, 9.3% in 2007, 21.1% in 2008 and 13.7% in 2009. For the 24 hour-management bundle, baseline compliance was 15.0%. After the intervention, compliance was 15.1% from May to December 2006, 21.4% in 2007, 27.8% in 2008 and 44.4% in 2009. The in-hospital mortality was 54.0% from July 2005 to April 2006, 41.1% from May to December 2006, 39.3% in 2007, 41.4% in 2008 and 16.2% in 2009.<h4>Conclusion</h4>These results suggest reducing SS and SSh patient mortality is a complex process that involves multiple performance measures and interventions.