title: Implementation of early goal-directed therapy for septic patients in the emergency department: a review of the literature.
abstract: BACKGROUND
  The Surviving Sepsis Campaign outlines the elements of early goal-directed therapy when treating patients with sepsis in the emergency department. The success of these guidelines relies on their implementation in order to attain optimal patient outcomes. The purpose of this article is to review the literature regarding the implementation of the sepsis guidelines in emergency departments.
  
  
  METHODS
  Using the search terms systemic inflammatory response syndrome, emergency service, and sepsis, the Cumulative Index of Nursing and Allied Health, MEDLINE, and Cochrane database were searched for information pertaining to implementing early goal-directed therapy for sepsis in the emergency department.
  
  
  RESULTS
  Studies that discussed collaboration, preplanning, and education were able to implement monitoring of central venous pressure, mean arterial pressure, and central venous oxygen saturation. However, nursing interventions recommended by the Surviving Sepsis Campaign such as measuring urine output and obtaining blood cultures were less often considered.
  
  
  CONCLUSIONS
  This review provides some factors important for the successful implementation of the Surviving Sepsis Campaign guidelines. Operational and system issues significantly influenced the success of implementing sepsis protocols or bundles. More research is needed to overcome barriers to implementing early goal-directed therapy and to uncover which elements of the guidelines are most important and feasible to achieve optimal patient outcomes.
authors.affiliation: St. Vincent Hospital, 2001 W 86th St, Indianapolis, IN 44260, USA. sturi@indy.rr.com
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Turi
authors.forename: Diane
authors.initials: D
authors.lastname: Von Ah
mesh_terms: D015400:Clinical Nursing Research; D042241:Early Diagnosis; D004636:Emergency Service, Hospital; D019983:Guideline Adherence / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D017063:Outcome Assessment, Health Care; D012151:Resuscitation / Q000592:standards; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality / Q000451:nursing* / Q000628:therapy*