Improving Outcomes in Patients With Sepsis
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 hosp...
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| Veröffentlicht in: | American journal of medical quality 2016-01, Vol.31 (1), p.56-63 |
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| container_title | American journal of medical quality |
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| creator | Armen, Scott B. Freer, Carol V. Showalter, John W. Crook, Tonya Whitener, Cynthia J. West, Cheri Terndrup, Thomas E. Grifasi, Marissa DeFlitch, Christopher J. Hollenbeak, Christopher S. |
| description | 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. |
| doi_str_mv | 10.1177/1062860614551042 |
| format | Article |
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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.</description><identifier>ISSN: 1062-8606</identifier><identifier>EISSN: 1555-824X</identifier><identifier>DOI: 10.1177/1062860614551042</identifier><identifier>PMID: 25216849</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Academic Medical Centers - organization & administration ; Algorithms ; Anti-Infective Agents - administration & dosage ; Clinical Protocols ; Comorbidity ; Evidence-Based Practice ; Female ; Hospital Charges ; Hospital Mortality ; Humans ; Inservice Training - organization & administration ; Intensive Care Units - economics ; Intensive Care Units - organization & administration ; Length of Stay ; Male ; Patient Care Bundles ; Quality Improvement - organization & administration ; Sepsis - mortality ; Sepsis - therapy ; Treatment Outcome</subject><ispartof>American journal of medical quality, 2016-01, Vol.31 (1), p.56-63</ispartof><rights>The Author(s) 2014</rights><rights>The Author(s) 2014.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-1d48f7b41117939dc35f5f1382c280f279e45811eddcf3a6e8129d7a4e2df9ca3</citedby><cites>FETCH-LOGICAL-c467t-1d48f7b41117939dc35f5f1382c280f279e45811eddcf3a6e8129d7a4e2df9ca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1062860614551042$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1062860614551042$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,780,784,885,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25216849$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Armen, Scott B.</creatorcontrib><creatorcontrib>Freer, Carol V.</creatorcontrib><creatorcontrib>Showalter, John W.</creatorcontrib><creatorcontrib>Crook, Tonya</creatorcontrib><creatorcontrib>Whitener, Cynthia J.</creatorcontrib><creatorcontrib>West, Cheri</creatorcontrib><creatorcontrib>Terndrup, Thomas E.</creatorcontrib><creatorcontrib>Grifasi, Marissa</creatorcontrib><creatorcontrib>DeFlitch, Christopher J.</creatorcontrib><creatorcontrib>Hollenbeak, Christopher S.</creatorcontrib><title>Improving Outcomes in Patients With Sepsis</title><title>American journal of medical quality</title><addtitle>Am J Med Qual</addtitle><description>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.</description><subject>Academic Medical Centers - organization & administration</subject><subject>Algorithms</subject><subject>Anti-Infective Agents - administration & dosage</subject><subject>Clinical Protocols</subject><subject>Comorbidity</subject><subject>Evidence-Based Practice</subject><subject>Female</subject><subject>Hospital Charges</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Inservice Training - organization & administration</subject><subject>Intensive Care Units - economics</subject><subject>Intensive Care Units - organization & administration</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Patient Care Bundles</subject><subject>Quality Improvement - organization & administration</subject><subject>Sepsis - mortality</subject><subject>Sepsis - therapy</subject><subject>Treatment Outcome</subject><issn>1062-8606</issn><issn>1555-824X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUtLAzEUhYMotlb3rmSWIozm5jGT2QhSfBQKFVR0F9JMpk3pPExmCv57U1qLCoKrBM53D-eei9Ap4EuANL0CnBCR4AQY54AZ2UN94JzHgrC3_fAPcrzWe-jI-wXGhHMGh6hHOIFEsKyPLkZl4-qVrWbRpGt1XRof2Sp6VK01VeujV9vOoyfTeOuP0UGhlt6cbN8Berm7fR4-xOPJ_Wh4M441S9I2hpyJIp0yCAkzmuWa8oIXQAXRROCCpJlhXACYPNcFVYkRQLI8VcyQvMi0ogN0vfFtumlpch1yOLWUjbOlch-yVlb-VCo7l7N6JXlKgQkRDM63Bq5-74xvZWm9NsulqkzdeQlpQmhCgZJ_oJzhDIe6Aoo3qHa1984Uu0SA5foa8vc1wsjZ9012A1_1ByDeAF7NjFzUnatCs38bfgKJ0ZDO</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Armen, Scott B.</creator><creator>Freer, Carol V.</creator><creator>Showalter, John W.</creator><creator>Crook, Tonya</creator><creator>Whitener, Cynthia J.</creator><creator>West, Cheri</creator><creator>Terndrup, Thomas E.</creator><creator>Grifasi, Marissa</creator><creator>DeFlitch, Christopher J.</creator><creator>Hollenbeak, Christopher S.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20160101</creationdate><title>Improving Outcomes in Patients With Sepsis</title><author>Armen, Scott B. ; Freer, Carol V. ; Showalter, John W. ; Crook, Tonya ; Whitener, Cynthia J. ; West, Cheri ; Terndrup, Thomas E. ; Grifasi, Marissa ; DeFlitch, Christopher J. ; Hollenbeak, Christopher S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-1d48f7b41117939dc35f5f1382c280f279e45811eddcf3a6e8129d7a4e2df9ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Academic Medical Centers - organization & administration</topic><topic>Algorithms</topic><topic>Anti-Infective Agents - administration & dosage</topic><topic>Clinical Protocols</topic><topic>Comorbidity</topic><topic>Evidence-Based Practice</topic><topic>Female</topic><topic>Hospital Charges</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Inservice Training - organization & administration</topic><topic>Intensive Care Units - economics</topic><topic>Intensive Care Units - organization & administration</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Patient Care Bundles</topic><topic>Quality Improvement - organization & administration</topic><topic>Sepsis - mortality</topic><topic>Sepsis - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Armen, Scott B.</creatorcontrib><creatorcontrib>Freer, Carol V.</creatorcontrib><creatorcontrib>Showalter, John W.</creatorcontrib><creatorcontrib>Crook, Tonya</creatorcontrib><creatorcontrib>Whitener, Cynthia J.</creatorcontrib><creatorcontrib>West, Cheri</creatorcontrib><creatorcontrib>Terndrup, Thomas E.</creatorcontrib><creatorcontrib>Grifasi, Marissa</creatorcontrib><creatorcontrib>DeFlitch, Christopher J.</creatorcontrib><creatorcontrib>Hollenbeak, Christopher S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of medical quality</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Armen, Scott B.</au><au>Freer, Carol V.</au><au>Showalter, John W.</au><au>Crook, Tonya</au><au>Whitener, Cynthia J.</au><au>West, Cheri</au><au>Terndrup, Thomas E.</au><au>Grifasi, Marissa</au><au>DeFlitch, Christopher J.</au><au>Hollenbeak, Christopher S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improving Outcomes in Patients With Sepsis</atitle><jtitle>American journal of medical quality</jtitle><addtitle>Am J Med Qual</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>31</volume><issue>1</issue><spage>56</spage><epage>63</epage><pages>56-63</pages><issn>1062-8606</issn><eissn>1555-824X</eissn><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. 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| subjects | Academic Medical Centers - organization & administration Algorithms Anti-Infective Agents - administration & dosage Clinical Protocols Comorbidity Evidence-Based Practice Female Hospital Charges Hospital Mortality Humans Inservice Training - organization & administration Intensive Care Units - economics Intensive Care Units - organization & administration Length of Stay Male Patient Care Bundles Quality Improvement - organization & administration Sepsis - mortality Sepsis - therapy Treatment Outcome |
| title | Improving Outcomes in Patients With Sepsis |
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