Decreasing mortality in severe sepsis and septic shock patients by implementing a sepsis bundle in a hospital setting

Sandra Christina Pereira Lima Shiramizo; Alexandre R Marra; Marcelino Souza Durão Jr; Ângela T Paes; Michael B Edmond; Oscar Fernando Pavão dos Santos

doi:10.1371/journal.pone.0026790

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Decreasing mortality in severe sepsis and septic shock patients by implementing a sepsis bundle in a hospital setting

Journal article

Open access

Peer reviewed

Decreasing mortality in severe sepsis and septic shock patients by implementing a sepsis bundle in a hospital setting

Sandra Christina Pereira Lima Shiramizo, Alexandre R Marra, Marcelino Souza Durão Jr, Ângela T Paes, Michael B Edmond and Oscar Fernando Pavão dos Santos

PloS one, Vol.6(11), e26790

2011

DOI: 10.1371/journal.pone.0026790

PMCID: PMC3207817

PMID: 22073193

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Abstract

The Surviving Sepsis Campaign (SSC) guidelines for the management of severe sepsis (SS) and septic shock (SSh) have been recommended to reduce morbidity and mortality. A quasi-experimental study was conducted in a medical-surgical ICU. Multiple interventions to optimize SS and SSh shock patients' clinical outcomes were performed by applying sepsis bundles (6- and 24-hour) in May 2006. We compared bundle compliance and patient outcomes before (July 2005-April 2006) and after (May 2006-December 2009) implementation of the interventions. A total of 564 SS and SSh patients were identified. Prior to the intervention, compliance with the 6 hour-sepsis resuscitation bundle was only 6%. After the intervention, compliance was as follows: 8.2% from May to December 2006, 9.3% in 2007, 21.1% in 2008 and 13.7% in 2009. For the 24 hour-management bundle, baseline compliance was 15.0%. After the intervention, compliance was 15.1% from May to December 2006, 21.4% in 2007, 27.8% in 2008 and 44.4% in 2009. The in-hospital mortality was 54.0% from July 2005 to April 2006, 41.1% from May to December 2006, 39.3% in 2007, 41.4% in 2008 and 16.2% in 2009. These results suggest reducing SS and SSh patient mortality is a complex process that involves multiple performance measures and interventions.

Intensive Care Units

Humans

Middle Aged

Male

Shock, Septic - mortality

Shock, Septic - therapy

Sepsis - mortality

Guideline Adherence

Hospitals

Sepsis - therapy

Aged, 80 and over

Female

Aged

Details

Title: Subtitle: Decreasing mortality in severe sepsis and septic shock patients by implementing a sepsis bundle in a hospital setting
Creators: Sandra Christina Pereira Lima Shiramizo - Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Alexandre R Marra
Marcelino Souza Durão Jr
Ângela T Paes
Michael B Edmond
Oscar Fernando Pavão dos Santos
Resource Type: Journal article
Publication Details: PloS one, Vol.6(11), e26790
DOI: 10.1371/journal.pone.0026790
PMID: 22073193
PMCID: PMC3207817
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: Public Library of Science; United States
Language: English
Date published: 2011
Academic Unit: Internal Medicine
Record Identifier: 9983905641702771

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