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. 2015 Oct 20:3:e1290.
doi: 10.7717/peerj.1290. eCollection 2015.

Multifaceted interventions to decrease mortality in patients with severe sepsis/septic shock-a quality improvement project

Brittany Siontis  1 , Jennifer Elmer  2 , Richard Dannielson  2 , Catherine Brown  2 , John Park  2 , Salim Surani  3 , Kannan Ramar  4
Affiliations

Multifaceted interventions to decrease mortality in patients with severe sepsis/septic shock-a quality improvement project

Brittany Siontis et al. PeerJ. .

Abstract

Despite knowledge that EGDT improves outcomes in septic patients, staff education on EGDT and compliance with the CPOE order set has been variable. Based on results of a resident survey to identify barriers to decrease severe sepsis/septic shock mortality in the medical intensive care unit (MICU), multifaceted interventions such as educational interventions to improve awareness to the importance of early goal-directed therapy (EGDT), and the use of the Computerized Physician Order Entry (CPOE) order set, were implemented in July 2013. CPOE order set was established to improve compliance with the EGDT resuscitation bundle elements. Orders were reviewed and compared for patients admitted to the MICU with severe sepsis/septic shock in July and August 2013 (controls) and 2014 (following the intervention). Similarly, educational slide sets were used as interventions for residents before the start of their ICU rotations in July and August 2013. While CPOE order set compliance did not significantly improve (78% vs. 76%, p = 0.74), overall EGDT adherence improved from 43% to 68% (p = 0.0295). Although there was a trend toward improved mortality, this did not reach statistical significance. This study shows that education interventions can be used to increase awareness of severe sepsis/septic shock and improve overall EGDT adherence.

Keywords: Critical care; ICU; ICU mortality; Quality initiative; Sepsis; Surviving sepsis.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Barriers based on survey of internal medicine residents.
See this image and copyright information in PMC

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References

    1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Critical Care Medicine. 2001;29:1303–1310. doi: 10.1097/00003246-200107000-00002. - DOI - PubMed
    1. Coba V, Whitmill M, Mooney R, Horst HM, Brandt MM, Digiovine B, Mlynarek M, McLellan B, Boleski G, Yang J, Conway W, Jordan J. Resuscitation bundle compliance in severe sepsis and septic shock: improves survival, is better late than never. Journal of Intensive Care Medicine. 2011;26:304–313. doi: 10.1177/0885066610392499. - DOI - PubMed
    1. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM, Surviving Sepsis Campaign Management Guidelines C Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Critical Care Medicine. 2004;32:858–873. doi: 10.1097/01.CCM.0000117317.18092.E4. - DOI - PubMed
    1. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb S, Beale RJ, Vincent JL, Moreno R, Surviving Sepsis Campaign Guidelines Committee including The Pediatric S Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Medicine. 2013;39:165–228. doi: 10.1007/s00134-012-2769-8. - DOI - PMC - PubMed
    1. Djurkovic S, Baracaldo JC, Guerra JA, Sartorius J, Haupt MT. A survey of clinicians addressing the approach to the management of severe sepsis and septic shock in the United States. Journal of Critical Care. 2010;25:658.e1–658.e6. doi: 10.1016/j.jcrc.2010.04.005. - DOI - PubMed

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