Compliance With the Surviving Sepsis Campaign Bundle: A Multicenter Study From Turkey

İlhan Bahar, Hafize Oksuz, Nimet Şenoğlu, Hilmi Demirkiran, Mustafa Aydoğan, Yakup Tomak, Mehmet Çömez, Sinem Bayrakçı, Edip Gönüllü, Mustafa Berktaş, İlhan Bahar, Hafize Oksuz, Nimet Şenoğlu, Hilmi Demirkiran, Mustafa Aydoğan, Yakup Tomak, Mehmet Çömez, Sinem Bayrakçı, Edip Gönüllü, Mustafa Berktaş

Abstract

Objectives Sepsis bundle compliance is not clear. We evaluated rates of compliance with sepsis bundle protocols among health care providers in Turkey. Methods Our study was carried out retrospectively. Forty-five intensive care units (ICU) participated in this study between March 2, 2018 and October 1, 2018. Results One hundred thirty-eight ICUs were contacted and 45 ICUs agreed to participate. The time taken for the diagnosis of sepsis was less than six hours in 384 (59.8%) patients, while it was more than six hours in 258 (40.2%) patients. The median [interquartile range (IQR)] times for initial antibiotic administration, culturing, vasopressor initiation, and second lactate measurement were 120.0 (60-300) minutes, 24 (12-240) minutes, 40 (20-60) minutes, and 24 (18-24) hours, respectively. The rate of compliance with tissue and organ perfusion follow-up in the first six hours was 0%. The rates of three- and six-hour sepsis bundle protocol compliance were both 0%. The ICU mortality rates for sepsis and septic shock were 22% and 78%, respectively. The ICU mortality rates for sepsis and septic shock were 22% and 78%, respectively. Conclusions The rate of compliance with sepsis bundle protocols was evaluated in Turkey for the first time and determined to be 0%.

Keywords: bundle; compliance; guideline; sepsis; turkey.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2021, Bahar et al.

Figures

Figure 1. Data collection from intensive care…
Figure 1. Data collection from intensive care units

References

    1. Epidemiology of severe sepsis. Mayr FB, Yende S, Angus DC. Virulence. 2014;5:4–11.
    1. Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Rhodes A, Evans LE, Alhazzani W, et al. Intensive Care Med. 2017;43:304–377.
    1. The surviving sepsis campaign bundle: 2018 update. Levy MM, Evans LE, Rhodes A. Intensive Care Med. 2018;44:925–928.
    1. A closer look at sepsis-associated mortality. Evans L. JAMA Netw Open. 2019;2:0.
    1. The surviving sepsis campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study) Rhodes A, Phillips G, Beale R, et al. Intensive Care Med. 2015;41:1620–1628.
    1. Focus on sepsis: new concepts and findings in sepsis care. Timsit JF, Ruppe E, Ferrer R. Intensive Care Med. 2018;44:1997–1999.
    1. WHO: Sepsis. [Apr;2021 ]; 2020 7:13–2021.
    1. The global burden of sepsis: barriers and potential solutions. Rudd KE, Kissoon N, Limmathurotsakul D, et al. Crit Care. 2018;22:232.
    1. Current statement of intensive care units in Turkey: data obtained from 67 Centers. Ediboğlu Ö, Moçin ÖY, Özyılmaz E, et al. Turk Thorac J. 2018;19:209–215.
    1. Water, sanitation, and hygiene in rural health-care facilities: a cross-sectional study in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Guo A, Bowling JM, Bartram J, Kayser G. Am J Trop Med Hyg. 2017;97:1033–1042.
    1. Sepsis and septic shock in low-income and middle-income countries: need for a different paradigm. Rello J, Leblebicioglu H. Int J Infect Dis. 2016;48:120–122.
    1. Reducing the global burden of sepsis. Dugani S, Veillard J, Kissoon N. CMAJ. 2017;189:0.
    1. WORLDBANK: data for upper middle income, Turkey. [Apr;2021 ]; 2021 :2021.
    1. Surviving sepsis campaign: association between performance metrics and outcomes in a 7.5-year study. Levy MM, Rhodes A, Phillips GS, et al. Crit Care Med. 2015;43:3–12.
    1. Association between the New York sepsis care mandate and in-hospital mortality for pediatric sepsis. Evans IVR, Phillips GS, Alpern ER, et al. JAMA. 2018;320:358–367.
    1. Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study. Baykara N, Akalın H, Arslantaş MK, et al. Crit Care. 2018;22:93.
    1. The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Calandra T, Cohen J. Crit Care Med. 2005;33:1538–1548.
    1. Impact of 6-hour sepsis resuscitation bundle compliance on hospital mortality in a Saudi hospital. Memon JI, Rehmani RS, Alaithan AM, El Gammal A, Lone TM, Ghorab K, Abdulbasir A. Crit Care Res Pract. 2012;2012:273268.
    1. Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. Phua J, Koh Y, Du B, et al. BMJ. 2011;342:0.
    1. Implementation of sepsis bundles in intensive care units of Bangladesh: a prospective observational study. Faruq MO, Ahsan AA, Nazim Uddin M, et al. Bangladesh Crit Care J. 2013;1:8–17.
    1. Trial of early, goal-directed resuscitation for septic shock. Mouncey PR, Osborn TM, Power GS, et al. N Engl J Med. 2015;372:1301–1311.
    1. Impact of weekly case-based tele-education on quality of care in a limited resource medical intensive care unit. Kovacevic P, Dragic S, Kovacevic T, et al. Crit Care. 2019;23:220.
    1. Effect of performance improvement programs on compliance with sepsis bundles and mortality: a systematic review and meta-analysis of observational studies. Damiani E, Donati A, Serafini G, et al. PLoS One. 2015;10:0.
    1. A multimodal sepsis quality-improvement initiative including 24/7 screening and a dedicated sepsis response team-reduced readmissions and mortality. Alnababteh MH, Huang SS, Ryan A, McGowan KM, Yohannes S. Crit Care Explor. 2020;2:0.
    1. Validation of a screening tool for the early identification of sepsis. Moore LJ, Jones SL, Kreiner LA, et al. J Trauma. 2009;66:1539–1547.
    1. Septic shock: a multidisciplinary response team and weekly feedback to clinicians improve the process of care and mortality. Schramm GE, Kashyap R, Mullon JJ, Gajic O, Afessa B. Crit Care Med. 2011;39:252–258.

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