Friday, October 24, 2014

Surviving Sepsis with the Sepsis Protocol

Does Your Hospital Use the The Surviving Sepsis Campaign?
This campaign was created to help healthcare workers implement the recommended guidelines for Severe Sepsis patients in the Emergency Room (ER) and Intensive Care Units (ICU). 

The Surviving Sepsis Campaign kits include posters, pocket guides, bundle cards, lapel pins and a list of resources to aid your implementation efforts using the most recent edition of the international sepsis guidelines.  The Surviving Sepsis Campaign has developed pre-packaged kits to help clinicians within institutions to improve sepsis identification, management and treatment. 
"The Surviving Sepsis Campaign (SSC) partnered with the Institute for Healthcare 
Improvement (IHI) to incorporate its “bundle concept” into the diagnosis and treatment 
of patients with severe sepsis and septic shock. We believe that improvement in 
the delivery of care should be measured one patient at a time through a series of 
incremental steps that will eventually lead to systemic change within institutions and 
larger health care systems. "

Are You A LEADER??
L Learn about sepsis and quality improvement by attending local and national sepsis 
E Establish a baseline in order to convince others that improvement is necessary and 
to make your measurements relevant. 
A Ask for buy-in from institutional leadership and seek initial support from the emergency 
department (ED) and ICU staff and directors, quality improvement personnel, nursing 
staff, and others. 
D Develop an institution-specific protocol comprising all bundle elements. 
E Educate stakeholders in the ED and ICU and floors according to shift schedules. 
R Remediate errors and anticipate obstacles along the way. 

What is the First Step??
"The first step in improving the care of patients with severe sepsis and septic shock is 
making a solid commitment to improving that care. This commitment includes a strong 
and well-worded aim statement that sets an aggressive global aim. It is critical that the 
overall aim has a measurable objective and a specified time frame."

What Can You DO??
  1. Time from ED triage to presumptive diagnosis of severe sepsis is less than 2 hours
  2. Time from ED triage to all patients’ meeting severe sepsis criteria having a serum lactate is < than 3 hours
  3. Time from ED triage to appropriate antibiotics given is less than 1 hour
  4. If hypotensive or if lactate > 4.0 mmol, immediate fluid resuscitation is started (at least 30 mL/kg normal saline or lactated ringers solution within 1 hour)
  5. If MAP < 65 mmHg and not responsive to adequate (at least 30 mL/kg) fluid resuscitation, vasopressors are started immediately
  6. If blood pressure or serum lactate not responsive to fluid, a central venous pressure monitor is instituted within the first 6 hours

What About Bundles?
"​The Surviving Sepsis Campaign Bundles are the core of the sepsis improvement efforts. Using "bundles" simplifies the complex processes of the care of patients with severe sepsis. A bundle is a selected set of elements of care distilled from evidence-based practice guidelines that, when implemented as a group, have an effect on outcomes beyond implementing the individual elements alone."
Bundle Implementation
Your hospital's sepsis protocol may be customized, however, it must meet the standards created by the bundle. Enhancing reliability of these bundle elements allows teams to focus on aspects of the changes they are implementing to create a reliable system that achieves the goal of 25 percent reduction in mortality due to sepsis called for by the Surviving Sepsis Campaign.

Hear His Story??

To Learn more and get all of the Surviving Sepsis Campaign resources visit their site here.

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