1.Assessment of compliance to 2016 surviving Sepsis campaign bundles among adult patients admitted at ManilaMed–Medical Center Manila diagnosed with Sepsis
Cherry Lois M. Benjamin ; Evalyn Roxas
Philippine Journal of Internal Medicine 2019;57(1):12-18
Introduction:
Sepsis is an emerging problem that needs to be recognized early and addressed promptly with hydration and appropriate antibiotics. This study aims to assess the adherence to surviving sepsis campaign (SSC) bundle within three hours and six hours, length of hospital stay and mortality among adult patients admitted at ManilaMed–Medical Center Manila diagnosed with sepsis.
Methods:
A retrospective cohort study was performed in all adult patients admitted at ManilaMed–Medical Center Manila diagnosed with sepsis and septic shock from January to September 2017. Parameters for SSC bundle for three and six hours were used to assess compliance. Outcomes such as length of hospital stay and mortality were determined.
Results:
This study included a total of 85 subjects and majority are females (56%). Mean age of study subject was 67.5±17.67 years. Adherence to SSC bundle in three and six hours were observed particularly in blood cultures (45%), administering broad-spectrum antibiotics (69%), fluid resuscitation at 30 mL/kg for hypotensive patients (22%) and administering vasopressors (78%) to maintain systemic perfusion. However, adherence to other parameters of the bundle was not observed, namely: measurement and re-measurement of lactate levels and measurement of CVP and SCVO2. In terms of outcome, the average length of hospital stay is 11 days and mortality was 42%.
Discussion:
Sepsis is a fatal disease if not promptly recognized and addressed. The SSC bundle was formulated to guide clinicians and other healthcare providers in managing sepsis or septic shock patients. Some of the parameters are absent or are not routinely done in some institution, maximizing the resources that are present is ideal.
Conclusion
The compliance rate is deemed submaximal since eyeing for a 90-100% compliance rate is recommendable in a tertiary hospital. Emphasis on early identification, obtaining blood cultures and timely initiation of antimicrobials should be done.
Sepsis
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Compliance