Enhancing Sepsis Care at an Academic Emergency Department in a Resource-Constrained Setting: A Quality Improvement Initiative.

IF 1.7 3区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of Patient Safety Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI:10.1097/PTS.0000000000001289

Haytham Noureldeen, Abdullah Bakhsh, Adel Alshabasy, Maha Alawi, Ahmad Bakhribah, Nihad Nasrallah, Ohoud Aljuhani, Rahaf Margushi, Rafal Bantan, Raneem Bokhari, Sarah Idris, Lamis Alshamrani, Abeer Samman, Elaf Alharthi, Ali Alothman

{"title":"Enhancing Sepsis Care at an Academic Emergency Department in a Resource-Constrained Setting: A Quality Improvement Initiative.","authors":"Haytham Noureldeen, Abdullah Bakhsh, Adel Alshabasy, Maha Alawi, Ahmad Bakhribah, Nihad Nasrallah, Ohoud Aljuhani, Rahaf Margushi, Rafal Bantan, Raneem Bokhari, Sarah Idris, Lamis Alshamrani, Abeer Samman, Elaf Alharthi, Ali Alothman","doi":"10.1097/PTS.0000000000001289","DOIUrl":null,"url":null,"abstract":"Objectives: The early recognition of sepsis and septic shock is crucial for improved patient outcomes. Quality improvement programs have ameliorated processes and outcomes in the care of patients with sepsis and septic shock. This study aimed to improve the proportion of patients receiving antibiotics within 1 hour of triage and compliance with sepsis bundles.Methods: A multidisciplinary sepsis task force was created to monitor and improve sepsis care. The program lasted 24 months from January 1, 2018, to December 31, 2019. A unique screening criterion was created by combining items from the systemic inflammatory response syndrome, quick sequential organ failure assessment, and National Early Warning Score systems. Thereafter, a sepsis flowsheet was implemented in the emergency department for monitoring. The measures between the first 12 months and the last 12 months were compared.Results: The proportion of patients receiving antibiotics within 1 hour of triage improved from 44% to 84%, intravenous crystalloid administration within 3 hours improved from 62% to 94%, serum lactic acid measurement within 3 hours improved from 62% to 94%, and vasopressor initiation within 6 hours improved from 76% to 94%. The mortality rates decreased from 32% to 21% between the 2 study periods.Conclusions: This program emphasizes the impact of a structured quality improvement program on the process and outcomes of care.","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"24-29"},"PeriodicalIF":1.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Patient Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PTS.0000000000001289","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/16 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: The early recognition of sepsis and septic shock is crucial for improved patient outcomes. Quality improvement programs have ameliorated processes and outcomes in the care of patients with sepsis and septic shock. This study aimed to improve the proportion of patients receiving antibiotics within 1 hour of triage and compliance with sepsis bundles.

Methods: A multidisciplinary sepsis task force was created to monitor and improve sepsis care. The program lasted 24 months from January 1, 2018, to December 31, 2019. A unique screening criterion was created by combining items from the systemic inflammatory response syndrome, quick sequential organ failure assessment, and National Early Warning Score systems. Thereafter, a sepsis flowsheet was implemented in the emergency department for monitoring. The measures between the first 12 months and the last 12 months were compared.

Results: The proportion of patients receiving antibiotics within 1 hour of triage improved from 44% to 84%, intravenous crystalloid administration within 3 hours improved from 62% to 94%, serum lactic acid measurement within 3 hours improved from 62% to 94%, and vasopressor initiation within 6 hours improved from 76% to 94%. The mortality rates decreased from 32% to 21% between the 2 study periods.

Conclusions: This program emphasizes the impact of a structured quality improvement program on the process and outcomes of care.

查看原文本刊更多论文

在资源有限的情况下加强学术急诊科的败血症护理：质量改进计划。

目的：早期识别败血症和脓毒性休克对改善患者预后至关重要。质量改进计划改善了脓毒症和脓毒性休克患者的治疗过程和结果。本研究旨在提高患者在分诊后 1 小时内接受抗生素治疗的比例，以及脓毒症捆绑治疗的依从性：方法：成立了一个多学科脓毒症工作组，以监测和改善脓毒症护理。该计划从 2018 年 1 月 1 日开始至 2019 年 12 月 31 日结束，为期 24 个月。通过将全身炎症反应综合征、快速序贯器官衰竭评估和国家预警评分系统中的项目相结合，创建了一个独特的筛查标准。此后，在急诊科实施脓毒症流程表进行监测。对前 12 个月和后 12 个月的测量结果进行了比较：结果：患者在分诊后 1 小时内接受抗生素治疗的比例从 44% 提高到 84%，3 小时内静脉注射晶体液的比例从 62% 提高到 94%，3 小时内测量血清乳酸的比例从 62% 提高到 94%，6 小时内开始使用血管加压药的比例从 76% 提高到 94%。在两个研究期间，死亡率从 32% 降至 21%：该计划强调了结构化质量改进计划对护理过程和结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Patient Safety HEALTH CARE SCIENCES & SERVICES-

CiteScore

4.60

自引率

13.60%

发文量

302

期刊介绍： Journal of Patient Safety (ISSN 1549-8417; online ISSN 1549-8425) is dedicated to presenting research advances and field applications in every area of patient safety. While Journal of Patient Safety has a research emphasis, it also publishes articles describing near-miss opportunities, system modifications that are barriers to error, and the impact of regulatory changes on healthcare delivery. This mix of research and real-world findings makes Journal of Patient Safety a valuable resource across the breadth of health professions and from bench to bedside.