Implementation of sepsis management guideline in a community-based teaching hospital - can education be potentially beneficial for septic patients?

Nguyen, Huan Mark; Schiavoni, A.; Scott, Ken; Tanios, Maged

doi:10.1111/j.1742-1241.2012.02939.x

Cited by 15 publications

(14 citation statements)

References 20 publications

(32 reference statements)

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“…Previous studies have demonstrated that the implementation of the EGDT protocol and SSC education program in developed countries is associated with improved outcomes, including shorter length of stay in the ICU and hospital, and even decreased mortality [10,[17][18][19] . However, the impact of these interventions on ED visits for septicemia was unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, numerous clinical trials have been conducted to provide other evidence-based clinical practice protocols, such as the Surviving Sepsis Campaign (SSC) guidelines, to be delivered in education programs or different protocols control to improve patient outcomes [12][13][14][15][16] . These protocols or education programs aim to change physician behavior and guarantee that critically ill patients receive effective treatment [17][18][19][20] . The Joint Taiwan Critical Care Medicine Committee has in fact launched a nationwide education program after the publication of the SSC [21] .…”

Section: Introductionmentioning

confidence: 99%

“…Multiple studies have indicated that both the EGDT protocol and SSC education program are associated with survival [10,[12][13][14][15][16][17][18][19][20] . Particularly, research in Asia has shown that implementation of EGDT and SSC were associated with improvements in outcome and survival rates.…”

Section: Introductionmentioning

confidence: 99%

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Segmented regression analysis of emergency departments patient visits from Septicemia in Taiwan

Tzeng

Chien

et al. 2018

Health Policy and Technology

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a b s t r a c tBackground: The protocol for early goal-directed therapy (EGDT) is effective for improving both the costs and outcomes of septicemia treatment, including a significant reduction in case fatality. However, this complicated protocol may have a downside. Furthermore, the Joint Taiwan Critical Care Medicine Committee has launched a nationwide educational program after the publication of the Surviving Sepsis Campaign (SSC) to improve the overall survival rate from septicemia in the emergency care system of Taiwan.Objectives: To assess the impact of the EGDT protocol and SSC education programs on island-wide septicemia-related emergency department (ED) visits.Methods: Segmented regression techniques were utilized to assess the differences in annual rates and changes in septicemia-related ED visits between 1998 and 2012. We considered annual incidence of two medical comorbidities as potential confounders: metastatic malignant neoplasms and malignant neoplasms of the lymphatic and hematopoietic tissues. Results:The EGDT protocol was associated with decreased septicemia-related ED visits in 2002 (level change; p < 0.001), while the SSC education program led to a slight increase in septicemia-related ED visits in 2007 (slope change; p < 0.001). For the EGDT protocol, the number of patient visits decreased by 32.9% after the protocol was implemented in 2002 compared with the expected number without the intervention. For the SSC education program, the number of patient visits increased by 20.2% (compared with the predicted number) in 2007 after the education program was implemented. Conclusions:The EGDT protocol and SSC education program were associated with significant immediate changes and lagged intervention effects on island-wide septicemia-related ED visits.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Segmented regression analysis of emergency departments patient visits from Septicemia in Taiwan

Tzeng

Chien

et al. 2018

Health Policy and Technology

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“…There were various reasons as to why a misdiagnosis could occur including errors by physicians. For example, physicians in non-endemic areas were usually unfamiliar with schistosomiasis (Nguyen et al 2012), and hence, misdiagnosis might occur (Huang and Manderson 2005). Therefore, it was very necessary for physicians to conform to guidelines to diagnose patients with advanced schistosomiasis japonica.…”

Section: Discussionmentioning

confidence: 99%

Guideline adherence for the treatment of advanced schistosomiasis japonica in Hubei, China

2014

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This study compared physicians’ practices on three treatment procedures and hospitalization days with guideline recommendations to assess guideline adherence in the treatment of advanced schistosomiasis japonica. Descriptive statistics were used to estimate patients’ characteristics and rate of guideline adherence. And chi-square tests were used to assess influences of severity of the disease on guideline adherence. The study found no one (0/173) adhered to adequate diagnosis, treatment regimens, and discharge criteria of guidelines completely. And 2.23 % of patients in group 1 and 4.23 % in group 2 were totally conforming to adequate diagnosis. 91.91 % of patients were conforming to adequate treatment regimens among which group 1 and group 2 were 90.32 and 92.25 %, respectively. And one (2.23 %) patient in group 1 and zero (0 %) in group 2 were conforming to discharge criteria of guidelines, and most of the patients left hospital without symptom checks (151/173), liver function and biochemical tests (169/173), and complication checks (91/173). Among 173 inpatients, rate of adequate hospitalization days was 36.42 % (63/173). And chi-square test suggested no significant difference (P > 0.05) on guideline adherence in two groups, which implied both of critical and general patients’ treatments should be stressed to comply with guidelines. There existed a large gap between guidelines and practices of the treatment of advanced schistosomiasis japonica.

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“…Multiple studies show a decreased mortality with correct implementation goal-directed therapy for severe sepsis(Puskarich et al, 2009;Levy et al, 2010;Patel et al, 2010;Westpahl et al, 2011;Nguyen et al, 2012; …”

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confidence: 99%

Are adequate fluid challenges prescribed for severe sepsis?

Courtney

Gopinath

Toward

et al. 2014

International Journal of Health Care Quality Assurance

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Implementation of sepsis management guideline in a community-based teaching hospital - can education be potentially beneficial for septic patients?

Cited by 15 publications

References 20 publications

Segmented regression analysis of emergency departments patient visits from Septicemia in Taiwan

Segmented regression analysis of emergency departments patient visits from Septicemia in Taiwan

Guideline adherence for the treatment of advanced schistosomiasis japonica in Hubei, China

Are adequate fluid challenges prescribed for severe sepsis?

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