Implementation and outcomes of a severe sepsis protocol in an Australian tertiary hospital.
OBJECTIVE
To evaluate the effect of implementation of a sepsis protocol.


METHODS
Before and after cohort study.


METHODS
Level III ICU in a tertiary regional hospital, February - July, 2006 (before intervention) and 2007 (after).


METHODS
Adult patients who fulfilled criteria for severe sepsis or septic shock within 48 hours of ICU admission.


METHODS
Implementation of a locally modified sepsis protocol.


METHODS
Delivery of process of care components, and ICU and hospital mortality.


RESULTS
A total of 110 patients were included in the study: 44 in the pre-protocol group, and 66 in the post-protocol group. Demographic variables and severity of illness variables were similar in the two groups except for a lower incidence of respiratory sepsis in the post-protocol group. Post-protocol, there was a shorter time to initiation of appropriate antibiotics, and an increase in the use of vasopressors, deep vein thrombosis prophylaxis, and nutritional support, with no difference in ICU or hospital mortality. There was no difference in resuscitation endpoints at 6, 24, and 72 hours.


CONCLUSIONS
Implementation of a sepsis protocol led to a change in the delivery of care with no reduction in mortality in patients with severe sepsis and septic shock admitted to a Level III ICU in a tertiary hospital.
Orford
Neil R
NR
Geelong Hospital, Geelong, VIC, Australia. neilo@barwonhealth.org.au
Faulkner
Chris
C
Flintoff
Wendy
W
Eddey
David
D
Lamb-Jenkins
Jill
J
Henry
Margaret
M
Corke
Charlie
C
Stow
Peter
P
Green
David
D
D000368:Aged; D001315:Australia; D002985:Clinical Protocols; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D018805:Sepsis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012772:Shock, Septic / Q000401:mortality / Q000503:physiopathology / Q000628:therapy