title: Improving multidisciplinary severe sepsis management using the Sepsis Six .
abstract: Each year in the UK, it is estimated that more than 100,000 people are admitted to hospital with sepsis and around 37,000 people will die as a result of the condition. We present an audit, re-audit and the implications these have had on the management of severe sepsis using the Sepsis Six, ultimately through actively promoting teamwork to initiate the protocol. This led to a significant improvement in management, decreasing admissions to the intensive care unit (ITU), length of stay in hospital and the number of patient deaths.The initial audit and re-audit were done over 2-month periods. All clerking notes of patients with a medical consultant diagnosis of 'sepsis' on post-take ward round were analysed and further screened for presence of severe sepsis according to national guidelines.There was significant improvement from only 1% of patients being appropriately managed (according to the existing guidelines) to 67% of eligible subjects adhering to the protocol (p<0.0001). Initially, 19% were admitted to the ITU (6% died), improving to 7% on re-audit (with no deaths). Length of hospital stay reduced from 10 to 7 days (p<0.0001).There was a complete change in the management of severe sepsis with trust-wide updated protocols, resulting in a decrease in hospital morbidity and mortality.
authors.affiliation: John Radcliffe Hospital, Oxford, UK abhat@hotmail.com.
authors.forename: Amar
authors.initials: A
authors.lastname: Bhat
authors.affiliation: Wexham Park Hospital, Slough, UK.
authors.forename: Maryam
authors.initials: M
authors.lastname: Asghar
authors.affiliation: Wexham Park Hospital, Slough, UK.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Raulia
authors.affiliation: Wexham Park Hospital, Slough, UK.
authors.forename: Amit Keiran John
authors.initials: AK
authors.lastname: Mandal
mesh_terms: D019468:Disease Management; D004739:England; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D007902:Length of Stay; D008485:Medical Audit; D009313:National Health Programs; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000401:mortality / Q000628:therapy*; D018746:Systemic Inflammatory Response Syndrome / Q000401:mortality / Q000628:therapy*
chemical_list: D019344:Lactic Acid
keywords: Morbidity and mortality; Sepsis Six; sepsis; severe sepsis; teamwork