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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
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Sepsis Bundle Compliance Before and After the Implementation of a Protocolized Sepsis Program.

Rebecca Valean1, Jenna Holzhausen1, Erika Waldsmith1

  • 1Department of Pharmaceutical Services, William Beaumont University Hospital, Royal Oak, USA.

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Summary

Implementing a protocolized sepsis algorithm improved early sepsis bundle compliance and reduced hospital stays. While hour-3 bundle compliance showed a positive trend, further research is needed to confirm impacts on mortality.

Keywords:
antibiotic usagefluid resuscitationsepsis and shock physiologysepsis bundlessevere sepsis

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Area of Science:

  • Emergency Medicine
  • Critical Care Medicine
  • Health Services Research

Background:

  • Protocolized sepsis management, or sepsis bundles, are increasingly adopted to improve patient outcomes.
  • Prompt treatment of severe sepsis and septic shock is crucial for reducing morbidity and mortality.

Purpose of the Study:

  • To evaluate the impact of a protocolized sepsis algorithm,
  • Code Sepsis,
  • on Centers for Medicare & Medicaid Services (CMS) hour-3 bundle compliance.

Main Methods:

  • Retrospective, single-center study comparing patients before and after Code Sepsis implementation.
  • Included patients aged ≥ 18 with severe sepsis or septic shock receiving antibiotics within 24 hours.
  • Primary outcome: hour-3 bundle compliance; Secondary outcomes: hour-1 and hour-6 bundle compliance, hospital length of stay, mortality.

Main Results:

  • Hour-1 bundle compliance significantly improved post-implementation (10% vs. 24%, p=0.03).
  • Hour-3 bundle compliance trended toward improvement (25% vs. 41%, p=0.07).
  • Hospital length of stay was significantly reduced (8 days vs. 5 days, p=0.005).

Conclusions:

  • Code Sepsis implementation was associated with improved early sepsis bundle compliance and reduced hospital length of stay.
  • A trend toward improved hour-3 bundle compliance was observed.
  • Further prospective studies are needed to confirm the impact on mortality.