Measuring sustainable practice change of the sepsis guideline in one emergency department: A retrospective health care record audit |
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| Affiliation: | 1. Faculty of Health School of Nursing and Midwifery, University of Technology Sydney, NSW, Australia;2. Faculty of Health, University of Canberra, ACT, Australia;1. Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden;2. Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden;3. PreHospen – Centre for Prehospital Research, University of Borås, Sweden;4. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden;1. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden;2. Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden;3. Gothenburg Emergency Medicine Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden;4. Department of Business, History, and Social Sciences, School of Business, University of South-Eastern Norway;5. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway;6. Centre for Inter-Professional Collaboration within Emergency Care, Linnaeus University, Sweden;7. Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden;1. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia;2. Emergency Department, Canterbury Hospital, Campsie, Sydney, Australia;3. Illawarra Shoalhaven Local Health District, NSW, Australia;4. Illawarra Health and Medical Research Institute, NSW, Australia;1. Emergency Department, Changhua Christian Medical Foundation, Erlin Christian Hospital, 558, Sec. 1, Da-Chen Rd., Erlin, Changhua 52665, Taiwan ROC;2. Department of Administration, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County 35053, Taiwan ROC;3. Department of Information Management, Da-Yeh University, 168 University Road, Dacun, Changhua 51591, Taiwan ROC;4. Department of Nursing, Fooyin University, 151 Jinxue Rd., Daliao Dist., Kaohsiung City 83102, Taiwan ROC;5. Office of the Deputy Superintendent, Changhua Christian Hospital, 135 Nan-Hsiao Street, Changhua 500, Taiwan ROC;1. University of Szeged, Faculty of Medicine, Albert Szent-Györgyi Health Centre, Department of Emergency Medicine, Semmelweis utca 6, 6720 Szeged, Hungary;2. University of Szeged, Faculty of Medicine, Albert Szent-Györgyi Health Centre, Department of Surgery, Semmelweis utca 8, 6720 Szeged, Hungary |
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| Abstract: | Aims and objectivesTo explore the longitudinal impact of the New South Wales Sepsis guideline on time to antibiotics, triage assessment and emergency management before and four years after guideline implementation.BackgroundGlobally, sepsis continues to be a significant cause of mortality and morbidity within hospitals. To reduce avoidable adverse patient outcomes the corner stone has been to improve the early recognition and management of sepsis. The New South Wales government in Australia introduced sepsis guidelines into Emergency Departments. However, the longitudinal impact of the sepsis guideline, has never been conducted.MethodsA 12-month retrospective randomised health care record audit of adult patients with a sepsis diagnosis was conducted 12-months before and four years after implementation of the sepsis guideline.ResultsThis study demonstrated sustained improvement in allocation of urgent triage categories in the follow-up group (n = 43; 53.1%) and a reduction in the median time to antibiotics from 189 min to 102 min (p ≤ 0.001) after the implementation of the sepsis guideline.ConclusionThe study has demonstrated the sepsis guideline has improved a sustained change in early assessment, recognition and management of patients presenting with sepsis in one tertiary referral Emergency Department. |
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| Keywords: | Assessment Clinical Guidelines Emergency Care Emergency Sepsis Audit |
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