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Sepsis bundle

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https://www.readbyqxmd.com/read/28439131/compliance-with-updated-sepsis-bundles-to-meet-new-sepsis-core-measure-in-a-tertiary-care-hospital
#1
Taylor H Ramsdell, April N Smith, Eric Kerkhove
Background: The updated Surviving Sepsis Campaign care bundles are associated with improved outcomes in patients with sepsis, yet adherence to the bundles remains inconsistent. The Centers for Medicare & Medicaid Services has adopted similar care bundles as a core measure that went into effect with October 1, 2015 discharges. Objective: The aim of this study was to assess bundle compliance, length of stay (LOS), and in-hospital mortality before and after introduction of the new sepsis core measure. Methods: A retrospective cohort study was conducted in 158 patients with a diagnosis of severe sepsis or septic shock from April 2015 to February 2016...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28419753/systematic-review-of-gender-differences-in-sepsis-management-and-outcomes
#2
Kim Reina Failla, Cynthia D Connelly
PURPOSE: Contributors to disparities in sepsis management have been attributed to genetic susceptibility, differences in clinical presentation, and healthcare delivery. The influence of gender on survival or mortality of patients with sepsis-related diagnoses is unclear. The purpose of the current study was to systematically review published research to identify factors and outcomes associated with sepsis management and outcomes based on gender differences. METHODS: Covering a period from 2006 to 2016, a literature search was conducted on four electronic data bases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCO, MedlinePlus, and PubMed...
April 18, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28404756/infusion-compatible-antibiotic-formulations-for-rapid-administration-to-improve-outcomes-in-cancer-outpatients-with-severe-sepsis-and-septic-shock-the-sepsis-stat-pack
#3
Jason D Goldman, Amelia Gallaher, Rupali Jain, Zach Stednick, Manoj Menon, Michael J Boeckh, Paul S Pottinger, Stephen M Schwartz, Corey Casper
Background: Patients with cancer are at high risk for severe sepsis and septic shock (SS/SSh), and a delay in receiving effective antibiotics is strongly associated with mortality. Delays are due to logistics of clinic flow and drug delivery. In an era of increasing antimicrobial resistance, combination therapy may be superior to monotherapy for patients with SS/SSh. Patients and Methods: At the Seattle Cancer Care Alliance, we implemented the Sepsis STAT Pack (SSP) program to simplify timely and effective provision of empiric antibiotics and other resuscitative care to outpatients with cancer with suspected SS/SSh before hospitalization...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28398913/sepsis-in-obstetrics-treatment-prognosis-and-prevention
#4
Sheryl E Parfitt, Mary L Bogat, Cheryl Roth
Sepsis during pregnancy is one of the five leading causes of maternal mortality worldwide. Early recognition and prompt treatment of maternal sepsis is necessary to improve patient outcomes. Patient education on practices that reduce infections may be helpful in decreasing rates of sepsis. Education of nurses about early signs and symptoms of sepsis in pregnancy and use of obstetric-specific tools can assist in timely identification and better outcomes. Although the Surviving Sepsis Campaign (SSC) criteria for diagnosis of sepsis in the general population are not pertinent for obstetric patients, their treatment bundles (guidelines) are applicable and can be used to guide care of obstetric patients who develop sepsis...
April 10, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28382954/early-traditional-chinese-medicine-bundle-therapy-for-the-prevention-of-sepsis-acute-gastrointestinal-injury-in-elderly-patients-with-severe-sepsis
#5
Yifei Wang, Yunhua Zhang, Ronglin Jiang
This study aimed to study the effect of early traditional Chinese medicine bundle therapy on the prevention of sepsis-associated acute gastrointestinal injury (AGI). This was a multicenter, prospective, observational, non-randomized cohort study of 296 consecutive patients with severe sepsis during 2013/3 and 2014/11; 150 patients received standard treatments (controls) and 146 received traditional Chinese medicine bundle therapy (intervention group) (herbal decoction gavage based on syndrome differentiation, Chinese acupuncture, application of mirabilite, and defecation mixture)...
April 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28376891/prevention-of-neonatal-late-onset-sepsis-a-randomised-controlled-trial
#6
Gary Alcock, Helen G Liley, Lucy Cooke, Peter H Gray
BACKGROUND: Late-onset sepsis (LOS), defined as sepsis occurring after 48 h of age causes substantial mortality and morbidity in very low birth weight infants. Risk factors for LOS include immaturity, intravascular catheters, mechanical ventilation, and prolonged parenteral nutrition (PN). Little attention has been paid to studying the effects of PN administration methods. The aim of the study was to compare a bundle of measures for PN line management incorporating a strict aseptic technique with standard line management on LOS in very low birth weight infants...
April 4, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28368074/management-of-carbapenem-resistant-k-pneumoniae-in-allogenic-stem-cell-transplant-recipients-the-turin-bundle
#7
Francesco Giuseppe De Rosa, Silvia Corcione, Stefania Raviolo, Benedetto Bruno, Alessandro Busca
Carbapenem resistance has evolved rapidly since 2001 and the distribution of Carbapenemase-producing Klebsiella pneumoniae (CR-Kp) is currently a public health concern worldwide. In the haematological setting, especially in allogenic transplant, CR-KP infections were associated with a mortality up to 65%. Aim of this report is to describe the management of patients colonized by CR-Kp and undergoing allo-HSCT with a multiple-step intervention strategy: the "Turin bundle". Steps included oral gentamicin (GO) within 20 days before allo-HSCT, avoidance of levofloxacin prophylaxis during neutropenia, treatment of febrile neutropenia with tigecycline 100 mg bid and piperacillin-tazobactam at standard dosages and early appropriate combination therapy for patients with severe sepsis...
April 3, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28330584/central-line-associated-sepsis-in-children-receiving-parenteral-nutrition-in-oman
#8
Tawfiq T Al Lawati, Adawaiya Al Jamie, Nasra Al Mufarraji
Parenteral Nutrition (PN) is used when gut fails to provide complete nutrition. Central line Associate Blood Stream Infection (CLABSI) a major complication of this therapy. The objective of the study was to report the incidence of CLABSI and associated mortality in children receiving PN in the Royal Hospital and study the indication and duration of PN use. All children from the age of 0-48 months who received TPN outside NICU from the period between 1/1/2011 till 31/12/2014 were included. Data were retrieved from the hospital electronic data base...
March 16, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#9
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28328652/delayed-second-dose-antibiotics-for-patients-admitted-from-the-emergency-department-with-sepsis-prevalence-risk-factors-and-outcomes
#10
Daniel Leisman, Victor Huang, Qiuping Zhou, Jeanie Gribben, Andrea Bianculli, Michelle Bernshteyn, Mary Frances Ward, Sandra M Schneider
OBJECTIVE: 1) Determine frequency and magnitude of delays in second antibiotic administration among patients admitted with sepsis; 2) Identify risk factors for these delays; and 3) Exploratory: determine association between delays and patient-centered outcomes (mortality and mechanical ventilation after second dose). DESIGN: Retrospective, consecutive sample sepsis cohort over 10 months. SETTING: Single, tertiary, academic medical center. PATIENTS: All patients admitted from the emergency department with sepsis or septic shock (defined: infection, ≥ 2 systemic inflammatory response syndrome criteria, hypoperfusion/organ dysfunction) identified by a prospective quality initiative...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28275488/early-management-of-sepsis-with-emphasis-on-early-goal-directed-therapy-ame-evidence-series-002
#11
REVIEW
Zhongheng Zhang, Yucai Hong, Nathan J Smischney, Han-Pin Kuo, Panagiotis Tsirigotis, Jordi Rello, Win Sen Kuan, Christian Jung, Chiara Robba, Fabio Silvio Taccone, Marc Leone, Herbert Spapen, David Grimaldi, Sven Van Poucke, Steven Q Simpson, Patrick M Honore, Stefan Hofer, Pietro Caironi
Severe sepsis and septic shock are major causes of morbidity and mortality in patients entering the emergency department (ED) or intensive care unit (ICU). Despite substantial efforts to improve patient outcome, treatment of sepsis remains challenging to clinicians. In this context, early goal directed therapy (EGDT) represents an important concept emphasizing both early recognition of sepsis and prompt initiation of a structured treatment algorithm. As part of the AME evidence series on sepsis, we conducted a systematic review of all randomized controlled EGDT trials...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28202189/does-the-presence-of-a-urinary-catheter-predict-severe-sepsis-in-a-bacteraemic-cohort
#12
M Melzer, C Welch
BACKGROUND: Sepsis is a major cause of mortality with an estimated 37,000 deaths in the UK each year. This study aimed to determine host factors that can predict severe sepsis in a bacteraemic cohort. METHODS: From December 2012 to November 2013, demographic, clinical and microbiological data were collected on consecutive patients with bacteraemia at a London teaching hospital. These data were used to categorize patients as having severe or non-severe sepsis. Multi-variate logistic regression was used to determine the association between host factors and severe sepsis...
April 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28126452/early-sepsis-bundle-compliance-for-non-hypotensive-patients-with-intermediate-versus-severe-hyperlactemia
#13
Daniel E Leisman, Jason A Zemmel D'Amore, Jeanie L Gribben, Mary Frances Ward, Kevin D Masick, Andrea R Bianculli, Kathryn H Bradburn, John K D'Angelo, Martin E Doerfler
OBJECTIVE: To compare the association of 3-h sepsis bundle compliance with hospital mortality in non-hypotensive sepsis patients with intermediate versus severe hyperlactemia. METHODS: This was a cohort study of all non-hypotensive, hyperlactemic sepsis patients captured in a prospective quality-improvement database, treated October 2014 to September 2015 at five tertiary-care centers. We defined sepsis as 1) infection, 2) ≥2 SIRS criteria, and 3) ≥1 organ dysfunction criterion...
January 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28114654/targeting-staphylococcus-aureus-in-pediatric-surviving-sepsis-bundles-reply
#14
Brendan J McMullan, Asha C Bowen, Steven Y C Tong
No abstract text is available yet for this article.
March 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28114621/targeting-staphylococcus-aureus-in-pediatric-surviving-sepsis-bundles
#15
Luregn J Schlapbach, Graeme MacLaren
No abstract text is available yet for this article.
March 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28067711/early-goal-directed-therapy-for-sepsis-a-novel-solution-for-discordant-survival-outcomes-in-clinical-trials
#16
Andre C Kalil, Daniel W Johnson, Steven J Lisco, Junfeng Sun
OBJECTIVES: Early goal-directed therapy has shown discordant survival outcomes in sepsis studies. We aim to find the reasons for this discordance. DESIGN: Random-effects and Bayesian hierarchical analyses. SETTING: Studies that evaluated early goal-directed therapy. SUBJECTS: Patients with severe sepsis and/or septic shock. INTERVENTIONS: Early goal-directed therapy. MEASUREMENTS AND MAIN RESULTS: A total of 19,998 patients were included in the main analysis: 31 observational (n = 15,656) and six randomized (n = 4,342) studies...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28059916/does-hospital-transfer-impact-outcomes-after-colorectal-surgery
#17
Christopher J Chow, Wolfgang B Gaertner, Christine C Jensen, Bradford Sklow, Robert D Madoff, Mary R Kwaan
BACKGROUND: With increasing public reporting of outcomes and bundled payments, hospitals and providers are scrutinized for morbidity and mortality. The impact of patient transfer before colorectal surgery has not been well characterized in a risk-adjusted fashion. OBJECTIVE: We hypothesized that hospital-to-hospital transfer would independently predict morbidity and mortality beyond traditional predictor variables. DESIGN: We constructed a retrospective cohort of 158,446 patients who underwent colorectal surgery using the 2009-2013 American College of Surgeons National Surgical Quality Improvement Program database...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28029501/declining-mortality-due-to-severe-sepsis-and-septic-shock-in-spanish-intensive-care-units-a-two-cohort-study-in-2005-and-2011
#18
B Sánchez, R Ferrer, D Suarez, E Romay, E Piacentini, G Gomà, M L Martínez, A Artigas
OBJECTIVE: To analyze the evolution of sepsis-related mortality in Spanish Intensive Care Units (ICUs) following introduction of the Surviving Sepsis Campaign (SSC) guidelines and the relationship with sepsis process-of-care. DESIGN: A prospective cohort study was carried out, with the inclusion of all consecutive patients presenting severe sepsis or septic shock admitted to 41 Spanish ICUs during two time periods: 2005 (Edusepsis study pre-intervention group) and 2011 (ABISS-Edusepsis study pre-intervention group)...
January 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/27941371/survival-benefit-and-cost-savings-from-compliance-with-a-simplified-3-hour-sepsis-bundle-in-a-series-of-prospective-multisite-observational-cohorts
#19
Daniel E Leisman, Martin E Doerfler, Mary Frances Ward, Kevin D Masick, Benjamin J Wie, Jeanie L Gribben, Eric Hamilton, Zachary Klein, Andrea R Bianculli, Meredith B Akerman, John K D'Angelo, Jason A D'Amore
OBJECTIVES: To determine mortality and costs associated with adherence to an aggressive, 3-hour sepsis bundle versus noncompliance with greater than or equal to one bundle element for severe sepsis and septic shock patients. DESIGN: Prospective, multisite, observational study following three sequential, independent cohorts, from a single U.S. health system, through their hospitalization. SETTING: Cohort 1: five tertiary and six community hospitals...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27940455/sepsis-for-the-anaesthetist
#20
M E Nunnally
Sepsis is as a dysregulated systemic response to infection. Morbidity and mortality of the syndrome are very high worldwide. Recent definitions have redefined criteria for sepsis. The new definition (Sepsis-3) classifies sepsis as infection with organ dysfunction (the old 'severe sepsis'). Septic patients are at risk for secondary injuries, thus aggressive source control, resuscitation, and antibiotic therapy are the mainstays of management. Central to sepsis physiology is vasodilated shock. Many patients respond to i...
December 2016: British Journal of Anaesthesia
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