title: Clinical pathway intervention compliance and effectiveness when used in the treatment of patients with severe sepsis and septic shock at an Intensive Care Unit in Spain.
abstract: The purpose of this quasi-experimental study was to assess levels of compliance with the intervention bundles contained in a clinical pathway used in the treatment of patients with severe sepsis and septic shock, and to analyze the pathway's impact on survival and duration of hospital stays. We used data on 125 patients in an Intensive Care Unit, divided into a control group (N=84) and an intervention group (N=41). Levels of compliance increased from 13.1% to 29.3% in 5 resuscitation bundle interventions and from 14.3% to 22% in 3 monitoring bundle interventions. In-hospital mortality at 28 days decreased by 11.2% and the duration of hospital stay was reduced by 5 days. Although compliance was low, the intervention enhanced adherence to the instructions given in the clinical pathway and we observed a decline in mortality at 28 days and shorter hospital stays.
authors.affiliation: Departamento de Enfermería, Facultad de Ciencias de Salud, Universidad de Alicante, Spain. ana.laguna@ua.es
authors.forename: Ana
authors.initials: A
authors.lastname: Laguna-Pérez
authors.forename: Elisa
authors.initials: E
authors.lastname: Chilet-Rosell
authors.forename: Miguel
authors.initials: M
authors.lastname: Delgado Lacosta
authors.forename: Carlos
authors.initials: C
authors.lastname: Alvarez-Dardet
authors.forename: Joaquín
authors.initials: J
authors.lastname: Uris Selles
authors.forename: Carmen Luz
authors.initials: CL
authors.lastname: Muñoz-Mendoza
mesh_terms: D019091:Critical Pathways; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000453:epidemiology / Q000628:therapy*; D012772:Shock, Septic / Q000453:epidemiology / Q000628:therapy*; D013030:Spain; D015996:Survival Rate