Critical Care Outreach, Royal Berkshire NHS Foundation Trust, London Road, Reading, Berkshire RG1 5AN, UK.
Nurs Crit Care. 2010 May-Jun;15(3):141-51. doi: 10.1111/j.1478-5153.2009.00378.x.
To share an experience of examining the true extent of the number of patients with severe sepsis being admitted, and the overall compliance with existing treatment guidelines in a district general hospital (DGH).
Because of its aggressive, multi-factorial nature, sepsis is a rapid killer. Mortality associated with severe sepsis remains unacceptably high: 30-50%. When shock is present, mortality is reported to be even higher: 50-60%. The rapid diagnosis and management of sepsis is vital to successful treatment. The International Surviving Sepsis Campaign (SSC) was developed to help meet the challenges of sepsis and to improve its management, diagnosis and treatment. The overall aim is to reduce mortality from sepsis by 25% by 2009.
Data on the number of patients admitted with severe sepsis to the DGH were previously unknown. The aim of the baseline audits was to determine the true extent of the problem and baseline mortality rates, resulting in an action plan to provide evidence-based care to patients with sepsis regardless of where in the hospital they were located.
It was found that 11% of the patients audited presented with signs of severe sepsis and demonstrated elements of poor compliance with some elements of existing treatment guidelines as set out by the resuscitation component of the Surviving Sepsis Care Bundle.
As an international campaign introduced predominantly within critical care, within this DGH the SSC teams' innovative approach has resulted in: * Better educated staff; * Objectives agreed within multi-disciplinary teams; * The appropriate assessment of resources; * Standardization of practice in terms of patients presenting with severe sepsis.
分享在一家地区综合医院检查严重脓毒症患者人数和整体遵循现有治疗指南情况的经验。
由于脓毒症具有侵袭性和多因素的特点，因此是一种快速杀手。严重脓毒症相关的死亡率仍然高得不可接受：30-50%。当出现休克时，死亡率据报道甚至更高：50-60%。快速诊断和治疗脓毒症对于成功治疗至关重要。国际拯救脓毒症运动（SSC）的制定是为了帮助应对脓毒症的挑战，改善其管理、诊断和治疗。总体目标是到 2009 年将脓毒症的死亡率降低 25%。
以前并不知道该地区综合医院收治严重脓毒症患者的人数。基线审核的目的是确定问题的真实程度和基线死亡率，从而制定行动计划，为无论在医院何处的脓毒症患者提供基于证据的护理。
发现审核的患者中有 11%出现严重脓毒症迹象，并表现出对某些现有治疗指南（复苏部分的拯救脓毒症护理包中规定）的某些元素存在较差的遵循情况。
作为一项主要在重症监护领域推出的国际运动，在这家地区综合医院，SSC 团队的创新方法已经取得了以下成果：* 提高了员工的教育水平；* 多学科团队内达成了目标；* 对资源进行了适当评估；* 对出现严重脓毒症的患者进行了标准化治疗。
