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RES1
A Safety Profile For The Surviving Sepsis Campaign Initiative
By: Pyle, K., Hewett, M., Lepman, D. & Pierson, G.; Hoag Memorial Hospital Presbyterian, Newport Beach, CA
For further information, please contact: kirsten.pyle@hoaghospital.org
Purpose: A study was conducted to assess the safety of The Surviving Sepsis Campaign (SSC).
Background/Significance: The adoption of the SSC guidelines were instituted in 2005. A comprehensive quality data set was collected in a non-academic, non-trauma 510 bed community hospital.
Methods: Data were analyzed from the Cerner Project IMPACT database. Retrospective data collection was performed in 2004 (n = 121) and compared with 2005 (n = 112). Complications not related to procedures and co-morbid conditions were tracked as well as returns to critical care and readmissions. A 2-tailed test was performed for each measure. Dramatic resource use and quality improvements we celebrated have already been shown in the literature, therefore not published here.
Results: Improvements were noted with the following: atrial fibrillation/flutter requiring interventions decreased from 14% to 5.4% (p=0.04), decubitus skin ulcers decreased from 3.3% to 0% (NSD), cardiogenic pulmonary edema/congestive heart failure decreased from 1.7% to 0% (NSD), venothromboembolisms declined from 1.7% to 0% (NSD), heparin induced thrombocytopenia decreased from 3.3% to 0% (NSD), gastrointestinal ileus were reduced from 11.6% to 0.9% (p=<0.05), ventilator-associated pneumonia was reduced from 8.9% to 0% (p=0.01), acute pancreatitis reduced from 3.3% to 1.8% (NSD), sustained ventricular tachycardia fell from 0.8% to 0% (NSD), multiple admissions fell from 5.2% to 1.8% (NSD) and the number of readmissions fell from 5 to 3 (NSD). Caution is noted with the following areas: gastrointestinal bleeding increased from 2.5% to 4.5% (NSD), intracranial hemorrhages increased from 0% to 0.9% (NSD), myocardial infarctions increased from 0% to 1.8% (NSD), Foley-associated urinary tract infections increased from 2.5% to 4.5% (NSD), and cerebrovascular accidents increase from 0% to 1.8% (NSD).
Conclusions: With a systematic approach, the SSC may be instituted in a safe and effective method with minimum untoward events.
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