title: Early Recognition and Management of Maternal Sepsis.
abstract: Although septic shock is rare in pregnancy, it is an important contributor to maternal mortality. A woman in the perinatal period can appear deceptively well before rapidly deteriorating to septic shock. We evaluated compliance with early goal-directed therapy before, during, and after the implementation of a standardized physician order set and interprofessional education. A retrospective study included 97 women with positive screening results for sepsis from April 2014 to January 2015. When comparing preintervention and postintervention results in women with sepsis, statistical significance was achieved for blood lactate level testing (p = .029), administering a broad-spectrum antibiotic (p = .006), repeat lactate level testing (p = .034), and administering a broad-spectrum antibiotic in women with severe sepsis and septic shock (p = .010). Education and a sepsis protocol using a multidisciplinary approach improves compliance with sepsis bundles, which are a group of interventions that, when used together, are intended to improve health outcomes.
authors.affiliation: Anderson Lucchetti Women's & Children's Center in Sacramento, CA, and at Kaiser Permanente in South Sacramento, CA. Electronic address: lsolvera@sbcglobal.net.
authors.forename: Lori
authors.initials: L
authors.lastname: Olvera
authors.affiliation: California State University, Fresno, in Fresno, CA.
authors.forename: Danette
authors.initials: D
authors.lastname: Dutra
mesh_terms: D042241:Early Diagnosis; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D006764:Hospitals, Community; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D018743:Perinatal Care / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018805:Sepsis / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: maternal sepsis; quality improvement project; retrospective study; septic shock; standardized physician order set