Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 18;18(1):3.
doi: 10.1186/s12873-018-0155-8.

Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study

Sami Alsolamy  1 , Atheer Al-Sabhan  2 , Najla Alassim  2 , Musharaf Sadat  3 , Eman Al Qasim  4 , Hani Tamim  4   5 , Yaseen M Arabi  6   7   8   9
Affiliations

Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study

Sami Alsolamy et al. BMC Emerg Med. .

Abstract

Background: Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is challenging in the Emergency Department (ED) because of highly dynamic patient conditions and is likely relevant in conditions that requires time-sensitive therapies, such as sepsis. We aimed to examine the management and outcomes of patients presenting with sepsis and septic shock to the ED during nursing handover.

Methods: This retrospective cohort study was conducted at a 115-bed ED and more than 200,000 annual ED visits, within a 900-bed academic tertiary care center. Data on Surviving Sepsis Campaign (SSC) bundle elements and hospital mortality were collected for all ≥14-year-old patients who presented to the ED with a diagnosis of sepsis and septic shock between January 1, 2011 and October 30, 2013. Our primary outcome was time to antibiotics, were other SSC bundle elements and mortality counted as secondary outcomes. Patients were divided into two groups: 1) handover time group, comprising patients who presented an hour before or after the start of handover time (6-8 AM/PM), and 2) non-handover time group, comprising patients who presented over the remaining 20 h.

Results: During the study period, 1330 patients presented with sepsis or septic shock (228, handover time group; 1102, non-handover time group). No significant differences were found between the handover time and non-handover time groups, respectively, in median time to antibiotic administration (100 [interquartile range (IQR) 57-172] vs. 95 [IQR 50-190] minutes; P = 0.07), median time to serum lactate result (162 [IQR 108-246] vs. 156 [IQR 180-246] minutes; P = 0.33) and median time to obtain blood culture (54 [IQR 36-119] vs. 52 [IQR 28-103] minutes; P = 0.52), and hospital mortality rate (29.4% vs. 28.9%; P = 0.89).

Conclusion: No significant differences were found in median time of SSC bundle elements or hospital mortality between patients who presented during the handover and non-handover times.

Keywords: Handover; Nursing; Sepsis.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Institutional Review Board of Ministry of National Guard-Health affairs, and given this study does not disclose patient identity and pose no risk to the patients the informed consent requirement was waived.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The distribution of median time-to-antibiotic administration by hour of day with the arrival in ED
See this image and copyright information in PMC

References

    1. Krogstad U, Hofoss D, Hjortdahl P. Continuity Of hospital care: beyond the question of personal contact. BMJ. 2002;324:36–38. doi: 10.1136/bmj.324.7328.36. - DOI - PMC - PubMed
    1. Odell A. Communication theory and the shift handover report. Br J Nurs. 1996;5:1323–1326. doi: 10.12968/bjon.1996.5.21.1323. - DOI - PubMed
    1. Thomas EJ, Studdert DM, Burstin HR, et al. Incidence and types of adverse events and negligent care in Utah and Colorado. Med Care. 2000;38:261–271. doi: 10.1097/00005650-200003000-00003. - DOI - PubMed
    1. Ye K, McD Taylor D, Knott JC, Dent A, MacBean CE. Handover in the emergency department: deficiencies and adverse effects. Emerg Med Australas. 2007;19:433–441. doi: 10.1111/j.1742-6723.2007.00984.x. - DOI - PubMed
    1. Gage W. Evaluating handover practice in an acute NHS trust. Nurs Stand. 2013;27:43–50. doi: 10.7748/ns2013.07.27.48.43.e7753. - DOI - PubMed