Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit
<p><strong>Introduction: </strong>Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans’ lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) acc...
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2016-12-01
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| Series: | Emergency |
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| Online Access: | http://journals.sbmu.ac.ir/emergency/article/view/13300 |
| _version_ | 1818842308377837568 |
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| author | Mostafa Alavi-Moghaddam Ali Anvari Reaza Soltani Delgosha Hamid Kariman |
| author_facet | Mostafa Alavi-Moghaddam Ali Anvari Reaza Soltani Delgosha Hamid Kariman |
| author_sort | Mostafa Alavi-Moghaddam |
| collection | DOAJ |
| description | <p><strong>Introduction: </strong>Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans’ lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines.</p><p><strong>Method:</strong> This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations. The mean knowledge score and the compliance rate of studied measures regarding standard protocols were calculated using SPSS version 21.</p><p><strong>Results:</strong> 30 emergency medicine residents were audited (63.3% male). The mean knowledge score of studied residents regarding standard guidelines were 5.07 ± 1.78 (IQR = 2) in pre education and 8.17 ± 1.31 (IQR = 85) in post education phase (p < 0.001). There was excellent compliance with standard in 4 (22%) studied measures, good in 2 (11%), fair in 1 (6%), weak in 2 (11%), and poor in 9 (50%). 64% of poor compliance measures correlated to therapeutic factors. After training, score of 5 measures including checking vital signs in < 20 minute, central vein pressure measurement in < 1 hour, blood culture request, administration of vasopressor agents, and high flow O<sub>2</sub> therapy were improved clinically, but not statistically.</p><p><strong>Conclusion:</strong> The protocol adherence in management of severe sepsis and septic shock for urine output measurement, central venous pressure monitoring, administration of inotrope agents, blood transfusion, intravenous antibiotic and hydration therapy, and high flow O<sub>2 </sub>delivery were disappointingly low. It seems training workshops and implementation of Clinical audit can improve residents’ adherence to current standard guidelines regarding severe sepsis and septic shock.</p> |
| first_indexed | 2024-12-19T04:39:55Z |
| format | Article |
| id | doaj.art-0716a421add749b6933e33dcfa07cc43 |
| institution | Directory Open Access Journal |
| issn | 2345-4563 2345-4571 |
| language | English |
| last_indexed | 2024-12-19T04:39:55Z |
| publishDate | 2016-12-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Emergency |
| spelling | doaj.art-0716a421add749b6933e33dcfa07cc432022-12-21T20:35:38ZengShahid Beheshti University of Medical SciencesEmergency2345-45632345-45712016-12-0151e16e1610.22037/emergency.v5i1.133007095Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical AuditMostafa Alavi-Moghaddam0Ali Anvari1Reaza Soltani Delgosha2Hamid Kariman3Emergency Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Emergency Department, Shohadaye Pakdasht Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Emergency Department, Shohadaye Pakdasht Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranEmergency Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.<p><strong>Introduction: </strong>Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans’ lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines.</p><p><strong>Method:</strong> This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations. The mean knowledge score and the compliance rate of studied measures regarding standard protocols were calculated using SPSS version 21.</p><p><strong>Results:</strong> 30 emergency medicine residents were audited (63.3% male). The mean knowledge score of studied residents regarding standard guidelines were 5.07 ± 1.78 (IQR = 2) in pre education and 8.17 ± 1.31 (IQR = 85) in post education phase (p < 0.001). There was excellent compliance with standard in 4 (22%) studied measures, good in 2 (11%), fair in 1 (6%), weak in 2 (11%), and poor in 9 (50%). 64% of poor compliance measures correlated to therapeutic factors. After training, score of 5 measures including checking vital signs in < 20 minute, central vein pressure measurement in < 1 hour, blood culture request, administration of vasopressor agents, and high flow O<sub>2</sub> therapy were improved clinically, but not statistically.</p><p><strong>Conclusion:</strong> The protocol adherence in management of severe sepsis and septic shock for urine output measurement, central venous pressure monitoring, administration of inotrope agents, blood transfusion, intravenous antibiotic and hydration therapy, and high flow O<sub>2 </sub>delivery were disappointingly low. It seems training workshops and implementation of Clinical audit can improve residents’ adherence to current standard guidelines regarding severe sepsis and septic shock.</p>http://journals.sbmu.ac.ir/emergency/article/view/13300Sepsisshock, septicdisease managementguideline adherenceclinical audit |
| spellingShingle | Mostafa Alavi-Moghaddam Ali Anvari Reaza Soltani Delgosha Hamid Kariman Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit Emergency Sepsis shock, septic disease management guideline adherence clinical audit |
| title | Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit |
| title_full | Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit |
| title_fullStr | Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit |
| title_full_unstemmed | Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit |
| title_short | Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit |
| title_sort | protocol adherence for severe sepsis and septic shock management in the emergency department a clinical audit |
| topic | Sepsis shock, septic disease management guideline adherence clinical audit |
| url | http://journals.sbmu.ac.ir/emergency/article/view/13300 |
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