Enhancing Sepsis Care at an Academic Emergency Department in a Resource-Constrained Setting: A Quality Improvement...

Area of Science:

• Critical Care Medicine
• Quality Improvement Science
• Emergency Medicine

Background:

• Early recognition and management of sepsis and septic shock are critical for patient survival.
• Quality improvement (QI) programs have demonstrated efficacy in enhancing sepsis care processes and outcomes.

Purpose of the Study:

• To improve the proportion of patients receiving antibiotics within one hour of triage.
• To enhance compliance with sepsis bundles and critical care protocols.

Main Methods:

• A multidisciplinary sepsis task force was established to oversee a 24-month quality improvement program.
• A novel sepsis screening criterion was developed by integrating elements from SIRS, qSOFA, and NEWS.
• A sepsis flowsheet was implemented in the emergency department for enhanced monitoring and care delivery.

Main Results:

• Antibiotic administration within 1 hour of triage increased from 44% to 84%.
• Intravenous crystalloid administration and serum lactic acid measurement within 3 hours improved from 62% to 94%.
• Vasopressor initiation within 6 hours improved from 76% to 94%, with a decrease in mortality from 32% to 21%.

Conclusions:

• Structured quality improvement programs can significantly impact both the process and outcomes of sepsis care.
• The implemented program demonstrated substantial improvements in sepsis management and patient survival rates.