Improvement in Process of Care and Outcome After a Multicenter Severe Sepsis Educational Program in Spain
Abstract
CONTEXT: Concern exists that current guidelines for care of patients with severe sepsis and septic shock are followed variably, possibly due to a lack of adequate education. OBJECTIVE: To determine whether a national educational program based on the Surviving Sepsis Campaign guidelines affected processes of care and hospital mortality for severe sepsis. DESIGN, SETTING, AND PATIENTS: Before and after design in 59 medical-surgical intensive care units (ICUs) located throughout Spain. All ICU patients were screened daily and enrolled if they fulfilled severe sepsis or septic shock criteria. A total of 854 patients were enrolled in the preintervention period (November-December 2005), 1465 patients during the postintervention period (March-June 2006), and 247 patients during the long-term follow-up period 1 year later (November-December 2006) in a subset of 23 ICUs. INTERVENTION: The educational program consisted of training physicians and nursing staff from the emergency department, wards, and ICU in the definition, recognition, and treatment of severe sepsis and septic shock as outlined in the guidelines. Treatment was organized in 2 bundles: a resuscitation bundle (6 tasks to begin immediately and be accomplished within 6 hours) and a management bundle (4 tasks to be completed within 24 hours). MAIN OUTCOME MEASURES: Hospital mortality, differences in adherence to the bundles' process-of-care variables, ICU mortality, 28-day mortality, hospital length of stay, and ICU length o…
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Implementing standardized bundles can help ensure timely and proper sepsis care and has been associated with reductions in mortality.
“Implementing standardized bundles can help ensure timely and proper sepsis care and has been associated with reductions in mortality [11-13].”
From Integrating a Machine Learning System Into Clinical Workflows: Qualitative Study (2020) · cites this paper as [11]
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- Authors
- Ferrer, R.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Corresponding author
- Ferrer, Ricard
- ORCID
- Ferrer, Ricard
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2008-05-21
- Volume
- 299
- Issue
- 19
- Pages
- 2294
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2103053257
- Cited by
- 741
- References
- 1
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 18 · 2023: 17 · 2022: 16 · 2021: 31 · 2020: 34 · 2019: 31 · 2018: 29 · 2017: 51 · 2016: 45 · 2015: 63 · 2014: 53 · 2013: 71 · 2012: 77
- FWCI
- 46.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Keywords
- severe sepsis, septic shock, Surviving Sepsis Campaign guidelines, clinical practice guideline adherence, educational intervention, process of care, in-hospital mortality, ICU mortality, intensive care unit, length of hospital stay, broad-spectrum antibiotics, mechanical ventilation, quality improvement
- MeSH terms
- Aged, Female, Humans, Inservice Training, Intensive Care Units, Length of Stay, Male, Middle Aged, Outcome and Process Assessment, Health Care, Severity of Illness Index, Shock, Septic, Spain, Hospital Mortality, Practice Guidelines as Topic, Sepsis, Guideline Adherence
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