Enhancing sepsis care at an academic emergency department in a resource-constrained setting: A quality improvement initiative (January 2025)

Summary

The early recognition of sepsis and septic shock is crucial for improved patient outcomes. Quality improvement programs have ameliorated processes and outcomes in the care of patients with sepsis and septic shock. This study in the Journal of Patient Safety aimed to improve the proportion of patients receiving antibiotics within one hour of triage and compliance with sepsis bundles. A multidisciplinary sepsis task force was created to monitor and improve sepsis care. The program lasted 24 months from January 2018 to December 2019. A unique screening criterion was created by combining items from the systemic inflammatory response syndrome, quick sequential organ failure assessment, and National Early Warning Score systems. After this initial stage, a sepsis flowsheet was implemented in the emergency department for monitoring. The measures between the first 12 months and the last 12 months were compared and showed that:

• the proportion of patients receiving antibiotics within one hour of triage improved from 44% to 84%.
• intravenous crystalloid administration within three hours improved from 62% to 94%.
• serum lactic acid measurement within three hours improved from 62% to 94%.
• vasopressor initiation within six hours improved from 76% to 94%.
• mortality rates decreased from 32% to 21% between the 2 study periods.