부산대학교 도서관

Objective: To evaluate the impact of a sepsis bundle after an educational strategy and quality of care improvement on hospital mortality. Methods: Design: A prospective study of adults with severe sepsis and septic shock admitted to a tertiary academic public hospital. Setting: Carried out from 2013 to 2017. Interventions: Healthcare providers caring for the patients received an educational intervention and an update on the bundle concepts. In addition, improvements in quality of care were implemented with priority to the early identification of sepsis, collection of blood lactate, blood cultures and infusion of antibiotics. Results: Severe septic pts (ss) were 986 and septic shock (SS) pts were 1232. Age was 58±17 (ss) and 60±16 (SS) yrs. APACHE II score was 21±7 (ss) and 26±8 (SS). SOFA score was 5±3 (ss) and 8±3 (SS). The main source of infection were the lungs. Adherence to blood cultures collection increased from 45% to 55%. Blood lactate collection increased from 50% to 75% (p<0.01). Time to start antibiotics decreased from 6 to 2 hours (p<0.001). Adherence to start antibiotics in the first hour after diagnosis increased from 21% to 42% (p<0.01). Most importantly, mortality rates for severe sepsis decreased from 45% to 39% and for septic shock from 59% to 46% (p<0.01). Conclusion: The implementation of a sepsis bundle may reduce mortality in an academic public hospital. [ABSTRACT FROM AUTHOR]