ACT Directorate, Cwm Taf University Health Board, Royal Glamorgan Hospital, Llantrisant, UK.
Cwm Taf University Health Board, Royal Glamorgan Hospital, Llantrisant, UK.
Nurs Crit Care. 2019 Jan;24(1):33-39. doi: 10.1111/nicc.12358. Epub 2018 Jul 24.
The Sepsis Six bundle is designed to facilitate early intervention with three diagnostic and three therapeutic steps to be delivered within 1 h to patients with suspected sepsis.
To investigate the effects of delivering the 'Sepsis Six' bundle by the Critical Care Outreach team on patient outcomes.
In a prospective observational study, all adult patients on the general wards from June 2012 to January 2014 with sepsis who were screened and treated by the Critical Care Outreach team were included.
The main outcome measure was the change in National Early Warning Score following the delivery of the Sepsis Six bundle within 24 h. Secondary outcomes were 90-day mortality and overall bundle compliance.
A total of 207 patients were included in the analysis. Overall bundle compliance was 84%. National Early Warning Scores decreased significantly 24 h after administering the Sepsis Six, from 7·4 ± 2·6 to 3·1 ± 2·4 (p < 0·001). The distribution of the National Early Warning Score changed significantly. Mortality was lower at 90 days when patients who presented with signs of sepsis within 48 h of hospital admission were compared with those who presented with signs of sepsis after 48 h of hospital admission (14·5% versus 35·4% p < 0·03) despite similar baseline physiological variables.
We found better outcomes after the administration of Sepsis Six. Reliable delivery of the bundle, defined as 80% of patients receiving the standard of care, is achievable, and our quality improvement data suggest that it is likely to be sustainable in our environment.
Sepsis Six can reduce physiological impairment, monitored by the National Early Warning Scores. Consistent delivery of the bundle can lead to better patient outcomes.
Sepsis Six 包旨在通过在 1 小时内为疑似脓毒症患者提供三个诊断和三个治疗步骤，促进早期干预。
调查由重症监护拓展团队实施“Sepsis Six”包对患者结局的影响。
在一项前瞻性观察研究中，纳入了 2012 年 6 月至 2014 年 1 月期间所有在普通病房的成年脓毒症患者，这些患者由重症监护拓展团队进行筛查和治疗。
主要观察指标是在 24 小时内实施 Sepsis Six 包后，国家早期预警评分的变化。次要结局指标为 90 天死亡率和整体捆绑依从性。
共纳入 207 例患者进行分析。整体捆绑依从率为 84%。实施 Sepsis Six 后 24 小时，国家早期预警评分从 7.4±2.6 显著下降至 3.1±2.4（p<0.001）。国家早期预警评分的分布明显改变。在入院后 48 小时内出现脓毒症迹象的患者与入院后 48 小时后出现脓毒症迹象的患者相比，90 天死亡率更低（14.5%比 35.4%，p<0.03），尽管两组的基线生理变量相似。
我们发现实施 Sepsis Six 后患者的结局更好。可以实现捆绑式治疗的可靠实施，定义为 80%的患者接受标准护理，我们的质量改进数据表明，在我们的环境中，这种捆绑式治疗可能是可持续的。
Sepsis Six 可以通过国家早期预警评分监测来减轻生理损伤。捆绑式治疗的一致实施可以改善患者结局。
