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Sepsis Guideline Implementation: Benefits, Pitfalls and Possible Solutions

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Annual Update in Intensive Care and Emergency Medicine 2014

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM,volume 2014))

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Abstract

Clinical practice guidelines are useful in improving quality of care and outcomes, reducing inappropriate variation in practice, promoting efficient use of resources, informing and empowering patients and informing public policy. However, difficulties arise when guidelines are poorly introduced into routine daily practice and, as a consequence, many patients do not receive the care intended or receive harmful or unnecessary care [1].

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References

  1. Grol R, Grimshaw J (2003) From best evidence to best practice: effective implementation of change in patients’ care. Lancet 36:1225–1230

    Article  Google Scholar 

  2. Kissoon N, Carcillo JA, Espinosa V et al (2011) World Federation of Pediatric and Intensive Care Societies: Global Sepsis Initiative. Pediatr Crit Care Med 12:494–503

    Article  PubMed  Google Scholar 

  3. Dunser MW, Festic E, Dondorp A et al (2012) Recommendations for sepsis management in resource-limited settings. Intensive Care Med 38:557–574

    Article  PubMed Central  PubMed  Google Scholar 

  4. Dellinger RP, Levy MM, Rhodes A et al (2013) Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock 2012. Intensive Care Med 39:165–228

    Article  CAS  PubMed  Google Scholar 

  5. Plambech MZ, Lurie AI, Ipsen HL (2012) Initial successful implementation of sepsis guidelines in an emergency department. Dan Med J 59:A4545

    PubMed  Google Scholar 

  6. Jacob ST, Lim M, Banura P et al (2013) Integrating sepsis management recommendations into clinical care guidelines for district hospitals in resource-limited settings: the necessity to augment new guidelines with future research. BMC Med 11:107

    Article  PubMed Central  PubMed  Google Scholar 

  7. Baelani I, Jochberger S, Laimer T et al (2012) Identifying resource needs for sepsis care and guideline implementation in the Democratic Republic of the Congo: a cluster survey of 66 hospitals in four eastern provinces. Middle East J Anesthesiol 21:559–575

    PubMed  Google Scholar 

  8. Na S, Kuan WS, Mahadevan M et al (2012) Implementation of early goal-directed therapy and the surviving sepsis campaign resuscitation bundle in Asia. Int J Qual Health Care 24(5):452–462

    Article  PubMed  Google Scholar 

  9. Han YY, Carcillo JA, Dragotta MA et al (2003) Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome. Pediatrics 112:793–799

    Article  PubMed  Google Scholar 

  10. De Oliveira CF, deOliveira DS, Gottschald AF et al (2008) ACCM/PALS hemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation. Intensive Care Med 34:1065–1075

    Article  PubMed  Google Scholar 

  11. Cruz AT, Perry AM, Williams EA et al (2011) Implementation of goal-directed therapy for children with suspected sepsis in the emergency department. Pediatrics 127:e758–e766

    Article  PubMed  Google Scholar 

  12. Larsen GY, Mecham N, Greenbert R (2011) An emergency department septic shock protocol and care guideline for children initiated at triage. Pediatrics 127:e1585–e1592

    Article  PubMed  Google Scholar 

  13. Paul R, Neuman MI, Monuteaux MC, Melendez E (2012) Adherence to PALS sepsis guidelines and hospital length of stay. Pediatrics 130:e273–e280

    Article  PubMed  Google Scholar 

  14. Levy MM, Dellinger RP, Townsend SR et al (2010) The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med 38:367–374

    Article  PubMed  Google Scholar 

  15. Ninis N, Phillips C, Bailey L et al (2005) The role of healthcare delivery in the outcomes of meningococcal disease in children: case-control study of fatal and non-fatal cases. BMJ 330:1475

    Article  PubMed  Google Scholar 

  16. Santhanam I, Kissoon N, Kamath SR, Ranjit S, Ramesh J, Shankar J (2009) GAP between knowledge and skills for the implementation of the ACCM/PALS septic shock guidelines in India: is the bridge too far? Indian J Crit Care Med 13:54–58

    Article  PubMed Central  PubMed  Google Scholar 

  17. Phua J, Koh Y, Du B et al (2011) Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. BMJ 13:342:d3245

    Google Scholar 

  18. Brunkhorst FM, Engel C, Ragaller M et al (2008) Practice and perception – a nationwide survey of therapy habits in sepsis. Crit Care Med 36(27):199–125

    Google Scholar 

  19. Launay E, Gras-Le Guen C, Martinot A et al (2010) Suboptimal care in the initial management of children who died from severe bacterial infection: a population-based confidential inquiry. Pediatr Crit Care Med 11:469–474

    PubMed  Google Scholar 

  20. Inwalds DP, Tasker RC, Peters MJ, Nadel S (2009) Emergency management of children with severe sepsis in the United Kingdom: the results of the Paediatric Intensive Care Society sepsis audit. Arch Dis Child 94:348–353

    Article  Google Scholar 

  21. McIntyre PB, Macintyre CR, Gilmour R et al (2005) A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis. Arch Dis Child 90:391–396

    Article  CAS  PubMed  Google Scholar 

  22. Cabana MD, Rand CS, Powe NR et al (1999) Why don’t physicians follow clinical practice guidelines: A framework for improvement. JAMA 282:1458–1465

    Article  CAS  PubMed  Google Scholar 

  23. Shaneyfelt TM, Centor RM (2009) Reassessment of clinical practice guidelines: go gently into that good night. JAMA 301:868–869

    Article  CAS  PubMed  Google Scholar 

  24. Leone M, Ragonnet B, Alonso S et al (2012) Variable compliance with clinical practice guidelines identified in a 1-day audit at 66 French adult intensive care units. Crit Care Med 40:3189–3195

    Article  PubMed  Google Scholar 

  25. Pollach G, Namboya F (2013) Preventing intensive care admissions for sepsis in tropical Africa (PICASTA): and extension of the international pediatric global sepsis initiative: and African perspective. Pediatr Crit Care Med 14:561–570

    Article  PubMed  Google Scholar 

  26. Kissoon N (2013) Preventing intensive care admissions for sepsis in tropical Africa: PICASTA – food for thought. Pediatr Crit Care Med 14:644–645

    Article  PubMed  Google Scholar 

  27. Barochia AV, Cui X, Vitberg D et al (2010) Bundled care for septic shock: an analysis of clinical trials. Crit Care Med 39:668–678

    Article  Google Scholar 

  28. Nguyen HB, Corbett SW, Steele R et al (2007) Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality. Crit Care Med 35:1105–1112

    Article  PubMed  Google Scholar 

  29. Irimu GW, Gathara D, Zurovac D et al (2012) Performance of health workers in the management of seriously sick children at a Kenyan tertiary hospital: before and after a training intervention. PLoS One 7:e39964

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Schramm GE, Kashyap R, Mullon JJ et al (2011) Septic shock: a multidisciplinary response team and weekly feedback to clinicians improve the process of care and mortality. Crit Care Med 39:252–258

    Article  PubMed  Google Scholar 

  31. Wenger E (2000) Communities of practice and social learning systems. Organization 7:225–246

    Article  Google Scholar 

  32. Shorr AF, Micek ST, Jackson WL et al (2007) Economic implications of an evidence-based sepsis protocol: can we improve outcomes and lower costs? Crit Care Med 35:1257–1262

    Article  PubMed  Google Scholar 

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Kissoon, N. (2014). Sepsis Guideline Implementation: Benefits, Pitfalls and Possible Solutions. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2014. Annual Update in Intensive Care and Emergency Medicine, vol 2014. Springer, Cham. https://doi.org/10.1007/978-3-319-03746-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-03746-2_3

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-03745-5

  • Online ISBN: 978-3-319-03746-2

  • eBook Packages: MedicineMedicine (R0)

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