Surviving sepsis: a trust-wide approach. A multi-disciplinary team approach to implementing evidence-based guidelines.
OBJECTIVE
To share an experience of examining the true extent of the number of patients with severe sepsis being admitted, and the overall compliance with existing treatment guidelines in a district general hospital (DGH).


BACKGROUND
Because of its aggressive, multi-factorial nature, sepsis is a rapid killer. Mortality associated with severe sepsis remains unacceptably high: 30-50%. When shock is present, mortality is reported to be even higher: 50-60%. The rapid diagnosis and management of sepsis is vital to successful treatment. The International Surviving Sepsis Campaign (SSC) was developed to help meet the challenges of sepsis and to improve its management, diagnosis and treatment. The overall aim is to reduce mortality from sepsis by 25% by 2009.


METHODS
Data on the number of patients admitted with severe sepsis to the DGH were previously unknown. The aim of the baseline audits was to determine the true extent of the problem and baseline mortality rates, resulting in an action plan to provide evidence-based care to patients with sepsis regardless of where in the hospital they were located.


RESULTS
It was found that 11% of the patients audited presented with signs of severe sepsis and demonstrated elements of poor compliance with some elements of existing treatment guidelines as set out by the resuscitation component of the Surviving Sepsis Care Bundle.


CONCLUSIONS
As an international campaign introduced predominantly within critical care, within this DGH the SSC teams' innovative approach has resulted in: * Better educated staff; * Objectives agreed within multi-disciplinary teams; * The appropriate assessment of resources; * Standardization of practice in terms of patients presenting with severe sepsis.
Gerber
Karin
K
Critical Care Outreach, Royal Berkshire NHS Foundation Trust, London Road, Reading, Berkshire RG1 5AN, UK. karingerbersa@hotmail.com
D054869:Clinical Audit; D003422:Critical Care / Q000458:organization & administration; D019091:Critical Pathways / Q000458:organization & administration*; D004059:Diffusion of Innovation; D004636:Emergency Service, Hospital / Q000458:organization & administration; D055317:Evidence-Based Practice / Q000458:organization & administration; D019983:Guideline Adherence / Q000458:organization & administration*; D017052:Hospital Mortality; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D017053:Infection Control / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D010564:Personnel, Hospital / Q000193:education; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D013222:State Medicine / Q000458:organization & administration; D017749:Total Quality Management / Q000458:organization & administration; D006113:United Kingdom / Q000453:epidemiology