Western University of Health Sciences, College of Pharmacy, Pomona, CA, USA.
Int J Clin Pract. 2012 Jul;66(7):705-10. doi: 10.1111/j.1742-1241.2012.02939.x.
To assess clinical outcomes associated with the implementation of the sepsis management guideline in a community-based hospital. In addition, evaluate the utility and effectiveness of a Sepsis Education Program.
This is an observational cohort study of patients presenting to the Emergency Department at a community-based teaching centre meeting severe sepsis or septic shock criteria. A quality improvement programme consisting of a comprehensive Sepsis Education Program based on recommendations from the Surviving Sepsis Campaign was implemented and evaluated. Patients were identify by the admission diagnosis and were evaluated over two time periods (7/2003-6/2004 and 7/2005-6/2006) and to show clinical outcomes before and after implementation of the sepsis guideline/quality improvement programme.
A total of 96 patients with severe sepsis (34 control group and 62 SSC group) were included. Both groups had similar intensive care unit (ICU)-length of stay (3 vs. 3 days, p = 0.647). Patients who required mechanical ventilation (MV) had similar MV time (4 vs. 3.5 days p = 0.349). A greater percentage of survival was found in the SSC group [45% vs. 73% (p = 0.006)]. Patient received similar care with regards to appropriate early antibiotics (85% vs. 90%, p 0.459). The main difference between the two group was the early fluid resuscitation (2 l vs. 3 l, p = 0.006) over the first 3 h and a difference remained significant at 6 h (4.2 l vs. 6.3 l, p = 0.013).
In a community based teaching hospital, implementing the surviving sepsis campaign guideline through an education programme was feasible and resulted in early therapy with aggressive fluid administration and appropriate antibiotics. The Sepsis Education Program resulted in early therapeutic interventions and contributed to the survival benefits.
评估在一家社区医院实施脓毒症管理指南相关的临床结果。此外，评估脓毒症教育计划的实用性和有效性。
这是一项针对符合严重脓毒症或感染性休克标准的社区教学中心急诊科就诊患者的观察性队列研究。实施了一项基于拯救脓毒症运动建议的全面脓毒症教育计划的质量改进计划，并对其进行了评估。通过入院诊断识别患者，并在两个时间段（2003 年 7 月至 2004 年 6 月和 2005 年 7 月至 2006 年 6 月）进行评估，以显示实施脓毒症指南/质量改进计划前后的临床结果。
共纳入 96 例严重脓毒症患者（对照组 34 例，SSC 组 62 例）。两组 ICU 住院时间相似（3 天对 3 天，p=0.647）。需要机械通气（MV）的患者 MV 时间相似（4 天对 3.5 天，p=0.349）。SSC 组的存活率更高[45%对 73%（p=0.006）]。在接受适当的早期抗生素治疗方面，患者接受了相似的治疗[85%对 90%，p=0.459]。两组之间的主要区别在于前 3 小时内早期液体复苏（2 l 对 3 l，p=0.006），6 小时时仍有显著差异（4.2 l 对 6.3 l，p=0.013）。
在一家社区教学医院，通过教育计划实施拯救脓毒症运动指南是可行的，并导致了早期积极液体治疗和适当使用抗生素。脓毒症教育计划促成了早期治疗干预，并有助于提高生存率。
