title: Improving Outcomes in Patients With Sepsis.
abstract: Sepsis mortality may be improved by early recognition and appropriate treatment based on evidence-based guidelines. An intervention was developed that focused on earlier identification of sepsis, early antimicrobial administration, and an educational program that was disseminated throughout all hospital units and services. There were 1331 patients with sepsis during the intervention period and 1401 patients with sepsis during the control period. After controlling for expected mortality, patients in the intervention period had 30% lower odds of dying (odds ratio = 0.70, 95% confidence interval [CI] = 0.57 to 0.84). They also had 1.07 fewer days on average in the intensive care unit (95% CI = -1.98 to -0.16), 2.15 fewer hospital days (95% CI = -3.45 to -0.86), and incurred on average $1949 less in hospital costs, although the effect on costs was not statistically significant. Continued incremental improvement and sustainment is anticipated through organizational oversight, continued education, and initiation of an automated electronic sepsis alert function.
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Armen
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Carol V
authors.initials: CV
authors.lastname: Freer
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: John W
authors.initials: JW
authors.lastname: Showalter
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Tonya
authors.initials: T
authors.lastname: Crook
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Whitener
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Cheri
authors.initials: C
authors.lastname: West
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Terndrup
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Marissa
authors.initials: M
authors.lastname: Grifasi
authors.affiliation: The Pennsylvania State University, Hershey, PA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: DeFlitch
authors.affiliation: The Pennsylvania State University, Hershey, PA chollenbeak@psu.edu.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D000465:Algorithms; D000890:Anti-Infective Agents / Q000008:administration & dosage; D002985:Clinical Protocols; D015897:Comorbidity; D055317:Evidence-Based Practice; D005260:Female; D017722:Hospital Charges; D017052:Hospital Mortality; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D007362:Intensive Care Units / Q000191:economics / Q000458:organization & administration*; D007902:Length of Stay; D008297:Male; D064872:Patient Care Bundles; D058996:Quality Improvement / Q000458:organization & administration*; D018805:Sepsis / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents
keywords: evidence-based medicine; interdisciplinary health team; outcomes assessment; quality improvement; sepsis; severe sepsis