Early identification of sepsis in hospital inpatients by ward nurses increases 30-day survival.

Autor: Torsvik M; Faculty of Health Science, Nord University, Høgskoleveien 27, N-7600, Levanger, Norway. malvin.torsvik@nord.no., Gustad LT; Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Kirkegata 2 A, N-7600, Levanger, Norway.; Department of Neuroscience, NTNU, Norwegian University of Science and Technology, Edvard Griegs gate 9, N-7030, Trondheim, Norway., Mehl A; Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Kirkegata 2 A, N-7600, Levanger, Norway.; Mid-Norway Sepsis Research Group, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.; Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Prinsesse Kristinas gate 1, N-7030, Trondheim, Norway., Bangstad IL; Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Kirkegata 2 A, N-7600, Levanger, Norway., Vinje LJ; Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Kirkegata 2 A, N-7600, Levanger, Norway., Damås JK; Mid-Norway Sepsis Research Group, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.; Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Prinsesse Kristinas gate 1, N-7030, Trondheim, Norway.; Department of Infectious Diseases, St Olavs Hospital, Trondheim University Hospital, Olav Kyrres gate 17, N-7030, Trondheim, Norway., Solligård E; Mid-Norway Sepsis Research Group, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.; Clinic of Anesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Olav Kyrres gate 17, N-7030, Trondheim, Norway.; Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Olav Kyrres gate 17, N-7030, Trondheim, Norway.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2016 Aug 05; Vol. 20 (1), pp. 244. Date of Electronic Publication: 2016 Aug 05.
DOI: 10.1186/s13054-016-1423-1
Abstrakt: Background: Systemic inflammatory response syndrome (SIRS) and sepsis are now frequently identified by observations of vital signs and detection of organ failure during triage in the emergency room. However, there is less focus on the effect on patient outcome with better observation and treatment at the ward level.
Methods: This was a before-and-after intervention study in one emergency and community hospital within the Mid-Norway Sepsis Study catchment area. All patients with confirmed bloodstream infection have been prospectively registered continuously since 1994. Severity of sepsis, observation frequency of vital signs, treatment data, length of stay (LOS) in high dependency and intensive care units, and mortality were retrospectively registered from the patients' medical journals.
Results: The post-intervention group (n = 409) were observed better and had higher odds of surviving 30 days (OR 2.7, 95 % CI 1.6, 4.6), lower probability of developing severe organ failure (0.7, 95 % CI 0.4, 0.9), and on average, 3.7 days (95 % CI 1.5, 5.9 days) shorter LOS than the pre-intervention group (n = 472).
Conclusions: In a cohort with stable mortality rates, early sepsis recognition by ward nurses may have reduced progression of disease and improved survival for patients in hospital with sepsis.
Databáze: MEDLINE
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