Improving Sepsis Management in the Acute Admissions Unit

Area of Science:

• Critical Care Medicine
• Healthcare Management
• Quality Improvement in Healthcare

Background:

• Sepsis poses a significant burden on healthcare resources.
• Effective management of sepsis in acute admission units is crucial for patient outcomes.
• Previous audits highlighted deficiencies in sepsis care at Great Western Hospital's Acute Admission Unit (AAU).

Purpose of the Study:

• To audit and improve the management of sepsis patients presenting directly to the AAU at Great Western Hospital (GWH).
• To compare the AAU's sepsis management practices against College of Emergency Medicine (CEM) standards and national benchmarks.
• To evaluate the impact of implemented interventions on sepsis care quality.

Main Methods:

• Retrospective audit of 30 patients diagnosed with severe sepsis or septic shock.
• Data collection focused on adherence to CEM standards for sepsis management, including oxygen, fluid resuscitation, lactate, and blood cultures.
• Comparison of AAU performance with GWH Emergency Department (ED) and national median data.

Main Results:

• Initial audit showed the AAU performed below national standards in key sepsis management areas: high flow oxygen (24%), fluid boluses (52%), lactate measurement (66%), and blood cultures (52%).
• Only 3% of patients received all components of the sepsis bundle.
• Post-intervention re-audit demonstrated significant improvements in Sepsis Six bundle adherence, with an 8% increase in patients receiving all six elements.

Conclusions:

• The initial audit identified critical gaps in sepsis care within the AAU at GWH.
• Implementation of a standardized sepsis proforma and targeted educational programs led to measurable improvements in sepsis management.
• Sustained quality improvement initiatives are essential for optimizing sepsis care and patient outcomes in acute admission settings.