Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study
Abstract Background Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is challenging in the Emergency Department (ED) because of highly dynamic patie...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12873-018-0155-8 |
| _version_ | 1818041784085774336 |
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| author | Sami Alsolamy Atheer Al-Sabhan Najla Alassim Musharaf Sadat Eman Al Qasim Hani Tamim Yaseen M Arabi |
| author_facet | Sami Alsolamy Atheer Al-Sabhan Najla Alassim Musharaf Sadat Eman Al Qasim Hani Tamim Yaseen M Arabi |
| author_sort | Sami Alsolamy |
| collection | DOAJ |
| description | Abstract Background Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is challenging in the Emergency Department (ED) because of highly dynamic patient conditions and is likely relevant in conditions that requires time-sensitive therapies, such as sepsis. We aimed to examine the management and outcomes of patients presenting with sepsis and septic shock to the ED during nursing handover. Methods This retrospective cohort study was conducted at a 115-bed ED and more than 200,000 annual ED visits, within a 900-bed academic tertiary care center. Data on Surviving Sepsis Campaign (SSC) bundle elements and hospital mortality were collected for all ≥14-year-old patients who presented to the ED with a diagnosis of sepsis and septic shock between January 1, 2011 and October 30, 2013. Our primary outcome was time to antibiotics, were other SSC bundle elements and mortality counted as secondary outcomes. Patients were divided into two groups: 1) handover time group, comprising patients who presented an hour before or after the start of handover time (6–8 AM/PM), and 2) non-handover time group, comprising patients who presented over the remaining 20 h. Results During the study period, 1330 patients presented with sepsis or septic shock (228, handover time group; 1102, non-handover time group). No significant differences were found between the handover time and non-handover time groups, respectively, in median time to antibiotic administration (100 [interquartile range (IQR) 57–172] vs. 95 [IQR 50–190] minutes; P = 0.07), median time to serum lactate result (162 [IQR 108–246] vs. 156 [IQR 180–246] minutes; P = 0.33) and median time to obtain blood culture (54 [IQR 36–119] vs. 52 [IQR 28–103] minutes; P = 0.52), and hospital mortality rate (29.4% vs. 28.9%; P = 0.89). Conclusion No significant differences were found in median time of SSC bundle elements or hospital mortality between patients who presented during the handover and non-handover times. |
| first_indexed | 2024-12-10T08:35:55Z |
| format | Article |
| id | doaj.art-63611796f95f49b4ae5d6e0401846788 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-10T08:35:55Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-63611796f95f49b4ae5d6e04018467882022-12-22T01:55:58ZengBMCBMC Emergency Medicine1471-227X2018-01-011811510.1186/s12873-018-0155-8Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort studySami Alsolamy0Atheer Al-Sabhan1Najla Alassim2Musharaf Sadat3Eman Al Qasim4Hani Tamim5Yaseen M Arabi6Emergency Medicine and Intensive Care Department, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical CityEmergency Medicine Department, King Abdulaziz Medical CityEmergency Medicine Department, King Abdulaziz Medical CityIntensive Care Department, King Abdulaziz Medical CityKing Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research CenterKing Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research CenterIntensive Care Department, King Abdulaziz Medical CityAbstract Background Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is challenging in the Emergency Department (ED) because of highly dynamic patient conditions and is likely relevant in conditions that requires time-sensitive therapies, such as sepsis. We aimed to examine the management and outcomes of patients presenting with sepsis and septic shock to the ED during nursing handover. Methods This retrospective cohort study was conducted at a 115-bed ED and more than 200,000 annual ED visits, within a 900-bed academic tertiary care center. Data on Surviving Sepsis Campaign (SSC) bundle elements and hospital mortality were collected for all ≥14-year-old patients who presented to the ED with a diagnosis of sepsis and septic shock between January 1, 2011 and October 30, 2013. Our primary outcome was time to antibiotics, were other SSC bundle elements and mortality counted as secondary outcomes. Patients were divided into two groups: 1) handover time group, comprising patients who presented an hour before or after the start of handover time (6–8 AM/PM), and 2) non-handover time group, comprising patients who presented over the remaining 20 h. Results During the study period, 1330 patients presented with sepsis or septic shock (228, handover time group; 1102, non-handover time group). No significant differences were found between the handover time and non-handover time groups, respectively, in median time to antibiotic administration (100 [interquartile range (IQR) 57–172] vs. 95 [IQR 50–190] minutes; P = 0.07), median time to serum lactate result (162 [IQR 108–246] vs. 156 [IQR 180–246] minutes; P = 0.33) and median time to obtain blood culture (54 [IQR 36–119] vs. 52 [IQR 28–103] minutes; P = 0.52), and hospital mortality rate (29.4% vs. 28.9%; P = 0.89). Conclusion No significant differences were found in median time of SSC bundle elements or hospital mortality between patients who presented during the handover and non-handover times.http://link.springer.com/article/10.1186/s12873-018-0155-8SepsisHandoverNursing |
| spellingShingle | Sami Alsolamy Atheer Al-Sabhan Najla Alassim Musharaf Sadat Eman Al Qasim Hani Tamim Yaseen M Arabi Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study BMC Emergency Medicine Sepsis Handover Nursing |
| title | Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study |
| title_full | Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study |
| title_fullStr | Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study |
| title_full_unstemmed | Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study |
| title_short | Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study |
| title_sort | management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover a retrospective cohort study |
| topic | Sepsis Handover Nursing |
| url | http://link.springer.com/article/10.1186/s12873-018-0155-8 |
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