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Title

Outcomes of Hospitalized Patients With Sepsis Before and After Implementation of a Sepsis Care Improvement Initiative at a Community Hospital.

Authors

Richardson, Kenneth J.; Mullen, Chanda L.; Sacha, Gretchen L.; Wasowski, Erik M.

Abstract

Purpose: Prompt treatment of sepsis and septic shock is critical as delays increase mortality risk. Various tools, such as electronic alerts, standardized order sets, and rapid response teams, are used to expedite sepsis bundled care, yet their individual effects on outcomes and antimicrobial timing are unclear. This study evaluated the impact of an Inpatient Code Sepsis protocol, featuring an overhead page and order set, on mortality in hospitalized patients with sepsis and septic shock. Methods: A retrospective cohort study was conducted at a 371-bed hospital from July 1, 2020, to July 31, 2023. Hospitalized adults (≥18 years) diagnosed with sepsis and septic shock before and after the Inpatient Code Sepsis protocol implementation were included. The primary outcome was 30-day all-cause mortality; secondary outcomes were hospital length of stay, 30-day readmission, and time to antibiotic administration. Patients were excluded if they were identified for sepsis without infection, had sepsis due to non-bacterial causes, lost to follow-up within 30 days of admission, received empiric antibiotics in an emergency department or outside hospital, or were missing antibiotic administration time. Results: A total of 138 patients were included in the analysis. Mortality within 30 days did not significantly differ preprotocol and postprotocol (p = 0.381). However, a significant reduction in time to antibiotic administration was noted postimplementation (p < 0.05). Hospital length of stay and 30-day readmission showed no significant changes. Conclusion: The Inpatient Code Sepsis protocol did not impact 30-day mortality but did improve the time to antibiotic administration.

Subjects

MEDICAL protocols; ANTIBIOTICS; HUMAN services programs; HOSPITAL care; EVALUATION of human services programs; MEDICAL care; PATIENT readmissions; PATIENT care; HOSPITALS; TREATMENT effectiveness; HOSPITAL mortality; RETROSPECTIVE studies; SEPTIC shock; LONGITUDINAL method; SEPSIS; MEDICAL records; ACQUISITION of data; QUALITY assurance; HOSPITAL health promotion programs; LENGTH of stay in hospitals; TIME; EVALUATION

Publication

Journal of Pharmacy Technology, 2024, Vol 40, Issue 6, p263

ISSN

8755-1225

Publication type

Academic Journal

DOI

10.1177/87551225241283193

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