Ways to Improve Sepsis Care in ICU

A research paper outlines "best practice” standards and measures that can improve outcomes and morbidity in sepsis patients in intensive care units (ICUs). The paper was the result of research by doctors and specialists from various healthcare organizations to develop, test, and disseminate quality care measures for sepsis.

By using the following checklist, clinical teams have documented improvements in patient outcomes and morbidity. By using only five of these interventions consistently, the authors of the paper predict that hospitals might prevent 172,000 deaths annually from sepsis.

1) Vancomycin received within 24 hours of ICU admission
2) Mean time to vancomycin initiation
3) Recommended antibiotic received within 24 hours of ICU admission
4) Mean time to antibiotic initiation
5) Blood cultures collected within 24 hours of ICU admission
6) Steroids received within 24 hours of ICU admission
7) Corticotropin stimulation test completed within 24 hours of ICU
admission
8) Activated protein C eligibility assessed within 24 hours of ICU
admission
9) Activated protein C received within 48 hours of ICU admission
10)Vancomycin discontinued within 96 hours of ICU admission
11)Glucose control

Sepsis care is one of the biggest problems in ICUs, departments that are responsible for as much as 30% of all hospital costs, say the researchers. Studies show there are between 500,000 and one million cases of sepsis and severe sepsis annually in U.S. hospitals alone. The annual mortality rate for these patients is 15-30%.

The research paper was prepared by Peter J. Pronovost, M.D., Ph.D., and Sean M. Berenholtz, M.D., MHS, both of Johns Hopkins Medical Institutions (Baltimore, MD, USA), as part of a larger effort by the VHA Inc., a national cooperative of leading not-for-profit healthcare organizations, Johns Hopkins, and the Joint Commission on Accreditation of Healthcare Organizations.




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