Implementing a Sepsis Resuscitation Bundle Improved Clinical Outcome: A Before-and-After Study
10.4266/kjccm.2014.29.4.250
- Author:
Jeongmin KIM
1
;
Sungwon NA
;
Young Chul YOO
;
Shin Ok KOH
Author Information
1. Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. nswksj@yuhs.ac
- Publication Type:Original Article
- Keywords:
critical pathways;
education;
interdisciplinary communication;
sepsis
- MeSH:
Adult;
Anti-Bacterial Agents;
Compliance;
Critical Pathways;
Diagnosis;
Education;
Emergency Service, Hospital;
Hemodynamics;
Humans;
Intensive Care Units;
Interdisciplinary Communication;
Mortality;
Resuscitation;
Sepsis;
Shock, Septic
- From:The Korean Journal of Critical Care Medicine
2014;29(4):250-256
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Unlike other diseases, the management of sepsis has not been fully integrated in our daily practice. The aim of this study was to determine whether repeated training could improve compliance with a 6-h resuscitation bundle in patients with severe sepsis and septic shock. METHODS: Repeated education regarding a sepsis bundle was provided to the intensive care unit and emergency department residents, nurses, and faculties in a single university hospital. The educational program was led by a multidisciplinary team. A total of 175 adult patients with severe sepsis or septic shock were identified (88 before and 87 after the educational program). Hemodynamic resuscitation bundle and timely antibiotics administration were measured for all cases and mortality at 28 days after sepsis diagnosis was evaluated. RESULTS: The compliance rate for the sepsis resuscitation bundle before the educational program was poor (0%), and repeated training improved it to 80% (p < 0.001). The 28-day mortality was significantly lower in the intervention group (16% vs. 32%, p = 0.040). Within the intervention group, patients for whom the resuscitation bundle was successfully completed had a significantly lower 28-day mortality than other patients (11% vs. 41%, p = 0.004). CONCLUSIONS: Repeated education led by a multidisciplinary team and interdisciplinary communication improved the compliance rate of the 6-h resuscitation bundle in severe sepsis and septic shock patients. Compliance with the sepsis resuscitation bundle was associated with improved 28-day mortality in the study population.
