The Utility of a Quality Improvement Bundle in Bridging the Gap between Research and Standard Care in the Management of Severe Sepsis and Septic Shock in the Emergency Department

Academic Emergency Medicine

Volumn 14, Issue 11, 2007, Pages 1079-1086

  Nguyen, H Bryant ^a   Lynch, Elizabeth Lea ^a   Mou, Joshua A ^a   Lyon, Kristopher ^a   Wittlake, William A ^a   Corbett, Stephen W ^a  

^a LOMA LINDA UNIVERSITY   (United States)

Author keywords

bundle; early goal directed therapy; implementation; septic shock; severe sepsis

Indexed keywords

ANTIBIOTIC AGENT; CORTICOSTEROID; DROTRECOGIN; HYPERTENSIVE FACTOR; INOTROPIC AGENT;

ARTICLE; CLINICAL PRACTICE; EMERGENCY PHYSICIAN; EMERGENCY WARD; HEALTH CARE; HUMAN; MORTALITY; PRIORITY JOURNAL; RESEARCH; RESUSCITATION; SEPSIS; SEPTIC SHOCK; SURVIVAL;

DIFFUSION OF INNOVATION; EMERGENCY SERVICE, HOSPITAL; HEALTH SERVICES RESEARCH; HOSPITAL MORTALITY; HUMANS; KNOWLEDGE; ODDS RATIO; PATIENT CARE TEAM; QUALITY OF HEALTH CARE; SEPSIS; SHOCK, SEPTIC;

EID: 35348999464     PISSN: 10696563     EISSN: None     Source Type: Journal    
DOI: 10.1197/j.aem.2007.06.024     Document Type: Article

References (43)

1. Rivers E., Nguyen B., Havstad S., et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345 (2001) 1368-1377
2. Kumar A., Roberts D., Wood K.E., et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34 (2006) 1589-1596
3. Jones A.E. Evidence-based therapies for sepsis care in the emergency department: striking a balance between feasibility and necessity. Acad Emerg Med 13 (2006) 82-83
4. Gaieski D., and Goyal M. The implementation of new therapies for severe sepsis: some questions raised by "early goal-directed therapy, corticosteroid, and recombinant human activated protein c for the treatment of severe sepsis and septic shock in the emergency department". [letter]. Acad Emerg Med 13 (2006) 997-999
5. De Miguel-Yanes J.M., Andueza-Lillo J.A., Gonzalez-Ramallo V.J., Pastor L., and Munoz J. Failure to implement evidence-based clinical guidelines for sepsis at the ED. Am J Emerg Med 24 (2006) 553-559
6. Gao F., Melody T., Daniels D.F., Giles S., and Fox S. The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study. Crit Care 9 (2005) R764-R770
7. Dellinger R.P., Carlet J.M., Masur H., et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 32 (2004) 858-873
8. Surviving Sepsis Campaign and Institute for Healthcare Improvement. Sepsis Bundle. Available at: http://www.ihi.org/IHI/Topics/CriticalCare/Sepsis. Accessed May 2007.
9. Osborn T.M., Nguyen H.B., and Rivers E.P. Emergency medicine and the Surviving Sepsis Campaign: an international approach to managing severe sepsis and septic shock. Ann Emerg Med 46 (2005) 228-231
10. Nguyen H.B., Rivers E.P., Abrahamian F.M., et al. Severe sepsis and septic shock: review of the literature and emergency department management guidelines. Ann Emerg Med 48 (2006) 28-54
11. Reinhart K., Brunkhorst F., Bone H., et al. Diagnosis and therapy of sepsis. Guidelines of the German Sepsis Society Inc. and the German Interdisciplinary Society for Intensive and Emergency Medicine. Internist (Berl) 47 (2006) 356 358-60, 362-8
12. Pottecher T., Calvat S., Dupont H., Durand-Gasselin J., and Gerbeaux P. Haemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference. 13 October 2005, Paris, France. Crit Care 10 (2006) 311
13. Institute for Healthcare Improvement. Bundle up for safety. Available at: http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories/bundleupforsafety.htm. Accessed May 2007.
14. Levy M.M., Pronovost P.J., Dellinger R.P., et al. Sepsis change bundles: converting guidelines into meaningful change in behavior and clinical outcome. Crit Care Med 32 (2004) S595-S597
15. Nguyen H.B., and Rivers E. The clinical practice of early goal-directed therapy in severe sepsis and septic shock. Adv Sepsis 4 (2005) 126-133
16. Jones A.E., and Kline J.A. Use of goal-directed therapy for severe sepsis and septic shock in academic emergency departments. [letter]. Crit Care Med 33 (2005) 1888-1889
17. Shapiro N.I., Howell M.D., Talmor D., et al. Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med 45 (2005) 524-528
18. Bernard G.R., Vincent J.L., Laterre P.F., et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344 (2001) 699-709
19. Abraham E., Laterre P.F., Garg R., et al. Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med 353 (2005) 1332-1341
20. Annane D., Sebille V., Charpentier C., et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288 (2002) 862-871
21. Trzeciak S., and Dellinger R.P. Other supportive therapies in sepsis: an evidence-based review. Crit Care Med 32 (2004) S571-S577
22. Rello J., Lorente C., Bodi M., Diaz E., Ricart M., and Kollef M.H. Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia?: a survey based on the opinions of an international panel of intensivists. Chest 122 (2002) 656-661
23. Kortgen A., Niederprum P., and Bauer M. Implementation of an evidence-based "standard operating procedure" and outcome in septic shock. Crit Care Med 34 (2006) 943-949
24. Shapiro N.I., Howell M.D., Talmor D., et al. Implementation and outcomes of the Multiple Urgent Sepsis Therapies (MUST) protocol. Crit Care Med 34 (2006) 1025-1032
25. Trzeciak S., Dellinger R.P., Abate N.L., et al. Translating research to clinical practice: a 1-year experience with implementing early goal-directed therapy for septic shock in the emergency department. Chest 129 (2006) 225-232
26. Micek S.T., Roubinian N., Heuring T., et al. Before-after study of a standardized hospital order set for the management of septic shock. Crit Care Med 34 (2006) 2707-2713
27. Nguyen H.B., Corbett S.W., Steele R., et al. Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality. Crit Care Med 35 (2007) 1105-1112
28. Houck P.M., Bratzler D.W., Nsa W., Ma A., and Bartlett J.G. Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-acquired pneumonia. Arch Intern Med 164 (2004) 637-644
29. Nguyen H.B., Rivers E.P., Knoblich B.P., et al. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med 32 (2004) 1637-1642
30. Pathman D.E., Konrad T.R., Freed G.L., Freeman V.A., and Koch G.G. The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations. Med Care 34 (1996) 873-889
31. Nguyen HB. The STOP Sepsis Bundle Toolkit. Available at: http://www.llu.edu/llumc/emergency/patientcare. Accessed Nov 2006.
32. Gallagher E.J., Rodriguez K., and Touger M. Agreement between peripheral venous and arterial lactate levels. Ann Emerg Med 29 (1997) 479-483
33. Fong J., and Devlin J.W. Characterizing compliance variability among three different severe sepsis bundles at an academic medical center. [abstract]. Crit Care Med 34 (2007) A99
34. Douglas I.S., Marchlowska P., Rains R., Kinsella M.T., Golden S., and Randall A. A statewide implementation of surviving sepsis campaign bundles by the Colorado Critical Care Collaborative. [abstract]. Crit Care Med 34 (2007) A99
35. Schorr C.A., Trzeciak S., Fakorede F., Parrillo J.E., and Dellinger R.P. Surviving sepsis campaign performance improvement program: demonstration of process change. [abstact]. Crit Care Med 34 (2007) A107
36. Ferrer R. Impact of sepsis care bundles on hospital mortality in Spain. [abstract]. Crit Care Med 34 (2007) A108
37. Kinsella M.T., Biltoft J.M., Marez H., Glaser D., Kwong N., and Restrepo C.I. Improving mortality from severe sepsis by implementation of surviving sepsis guidelines at a community teaching hospital. [abstract]. Crit Care Med 34 (2007) A109
38. Kalhan R., Mikkelsen M., Dedhiya P., et al. Underuse of lung protective ventilation: analysis of potential factors to explain physician behavior. Crit Care Med 34 (2006) 300-306
39. Plank J., Blaha J., Cordingley J., et al. Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients. Diabetes Care 29 (2006) 271-276
40. Speroff T., and O'Connor G.T. Study designs for PDSA quality improvement research. Qual Manag Health Care 13 (2004) 17-32
41. Speroff T., James B.C., Nelson E.C., Headrick L.A., and Brommels M. Guidelines for appraisal and publication of PDSA quality improvement. Qual Manag Health Care 13 (2004) 33-39
42. Deming W.E. The New Economics for Industry, Government, Education. 2nd ed. (2000), MIT Press, Cambridge, MA
43. Langley G.L., Nolan K.M., Nolan T.W., Norman C.L., and Provost L.P. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (1996), Jossey-Bass, San Francisco, CA