Assessment of outcomes of implementing the Sepsis Code in the emergency department of a tertiary hospital

• Published in: Journal of healthcare quality research Vol. 35; no. 5; p. 281
• Main Authors: Pinilla Rello, A, Huarte Lacunza, R, Magallón Martínez, A, Marrón Tundidor, R, Martínez Álvarez, R, Bustamante Rodríguez, E, Parrilla Herranz, P
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.09.2020
• Subjects: Anti-bacterial agents; Hemocultivos; Mortality; Antibiótico; Hospital emergency department; Mortalidad; Protocolo clínico; Clinical protocols; Sepsis; Urgencias hospitalarias; Blood culture
• ISSN: 2603-6479
• DOI: 10.1016/j.jhqr.2020.06.008

A Sepsis Code (CS) is a comprehensive multidisciplinary system which has the aim of optimising the identification and intervention times of patients with sepsis, as well as improving their monitoring and treatment adjustments in order to reduce their mortality. To present the outcomes of the first year of introducing the CS in the emergency department of a tertiary hospital. A single-centre retrospective descriptive observational study was conducted on all patients in whom the CS was activated in the emergency department of a tertiary hospital during the first year of implementation. The variables included: demographics, CS activation, comorbidities, focus of infection, microbiology, antibiotic treatment, and mortality. CS was activated in 555 patients, of which 302 (54.4%) had a definitive diagnosis of sepsis or septic shock on discharge from the emergency department. The degree of completion of the protocol variables was variable (41.8-95%).The large majority (86.1%) of the patients received antibiotics in the first hour, and in 76.2% blood cultures were collected prior to the antibiotic. Of the blood cultures performed, 13.3% of the isolated germs were multi-resistant and the level of contamination of blood cultures was 9.1%. All patients received empirical treatment and recommendations were followed in patients with septic shock in 28.3%. During follow-up, 64.4% the antibiotic treatment was targeted, and 39.5% received sequential therapy. In-hospital mortality was 32.2%. Areas of improvement in the completion of the variables, contamination of blood cultures, and empirical treatment received were detected, with the strong points being the early administration of the antibiotic and the collection of blood cultures.