Evaluation of Sepsis Management in a Regional Community Hospital

Sepsis remains a leading cause of global mortality. Despite established guidelines by the Surviving Sepsis Campaign (SSC), adherence to time compliance with the SSC bundle is often inconsistent. In New Brunswick hospitals, this compliance has not been studied. This study evaluates compliance with the SSC bundle in a regional community hospital in New Brunswick (NB), Canada, and its impact on clinical outcomes.

A retrospective, single-center observational study was conducted to review sepsis and septic shock cases over 6 months. Patients were categorized into two groups: group A (sepsis or septic shock diagnosed at initial assessment) and Group B (diagnosed retrospectively based on SSC screening criteria and a Sequential Organ Failure Assessment score ≥2). The primary outcome was time compliance with SSC bundle components, while secondary outcomes included mortality, length of hospital stay, and quantity of crystalloid fluid administered.

Of 44 patient charts reviewed, 20 met inclusion criteria (13 Group A and 7 Group B). Initial ordering compliance for the SSC bundle within 1 h was 45%, but processing compliance was only 5%. In an extended analysis, the time frame for antibiotic administration was broadened to 3 h, increasing overall compliance with the SSC bundle to 15%. When the analysis was extended to 3 hours for all bundle measures, ordering compliance rose to 60%, and processing compliance increased to 40%. Median time to antibiotic administration was 188 min, and median time to fluid initiation was 69 min. No significant differences in primary or secondary outcomes were observed between Group A and Group B.

Delays in processing SSC bundle components highlight critical gaps in sepsis care. Implementing standardized protocols, enhancing communication, and utilizing real-time alert systems could improve compliance and patient outcomes in NB hospitals.