title: Improving the Recognition of, and Response to In-Hospital Sepsis.
abstract: Sepsis is an important cause of patient morbidity and mortality worldwide. Although the associated mortality seems to be decreasing, approximately 20 % of patients with organ dysfunction die in hospital. Since 1991 diagnostic criteria for sepsis focused on the systemic inflammatory response syndrome (SIRS). However, the utility of such criteria has been questioned, and alternative criteria have recently been proposed. It is likely that administration of early appropriate antibiotics and resolution of shock reduce sepsis-associated mortality. Accordingly, strategies need to be developed to improve the early recognition of, and response to patients with sepsis. Such system approaches may include improved acquisition and documentation of vital signs, enhanced recognition of shock, and integration of laboratory and microbiological results using clinical informatics. Hospitals should have guidelines for escalating care of septic patients, antibiotics stewardship programs, and systems to audit morbidity and mortality associated with sepsis.
authors.affiliation: Western Hospital-Footscray, 160 Gordon Street, Footscray, VIC, 3011, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Chan
authors.affiliation: Department of Intensive Care Medicine, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville, SA, 5011, Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Peake
authors.affiliation: Austin Hospital, The University of Melbourne, Studley Road, Heidelberg, VIC, 3084, Australia.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.affiliation: Intensive Care Unit, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia. Daryl.Jones@austin.org.au.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. Daryl.Jones@austin.org.au.
authors.forename: Daryl
authors.initials: D
authors.lastname: Jones
keywords: Deteriorating patient; Early intervention; Rapid response team; Sepsis; Severe sepsis