ABSTRACT Simple Interventions Improving Sepsis Treatment Dr Anthony Hall and Dr Max Hattaway Tauranga Hospital, NZ Aim: Sepsis is one of the commonest presentations to hospital and is associated with a high morbidity and mortality. We aimed to improve the treatment of those admitted with severe sepsis and septic shock by implementing a “sepsis 6 sticker” in the emergency department and medical admissions unit. Methods: A total of 589 admissions were retrospectively screened over 14 consecutive days from 6th July 2015. All those that met internationally defined criteria for severe sepsis or septic shock within 6 hours of triage were included1, 2. An identical audit was conducted in July 2014 prior to the sepsis interventions. Results: 30 out of 589 patients met criteria (27 out of 624 in 2014). In comparison to the 2014 audit all parameters for sepsis treatment had improved. There was a statistically significant 66 minute average reduction in time to antibiotics (p = 0.007). 93% had blood cultures taken prior to antibiotics vs 78% (p = 0.09). 80% had a blood culture, lactate, fluid bolus (if indicated) and antibiotics within 3 hours as per Surviving Sepsis Campaign targets (vs 33% in 2014). Average time to serum lactate (-26 minutes), blood cultures (-57 minutes) and fluid bolus (-27 minutes) all improved but without statistical significance. Length of stay was unaffected (8.5 vs 9.8 days). One year mortality of the 2015 cohort was 37% vs 41% in 2014. Conclusion: Our simple “sepsis 6 sticker” intervention along with staff education significantly improved the treatment of patients admitted with severe sepsis and septic shock. References: 1) International Guidelines for Management of Severe Sepsis and Septic Shock: 2012
2) Levy MM, Fink MP, Marshall JC, et al: 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003; 31:1250–12 |