Influence of full-time intensivist and the nurse-to-patient ratio on the implementation of severe sepsis bundles in Korean intensive care units

Objective: To assess compliance of Intensive Care Units (ICUs) of Bangladesh to the components of resuscitation & management bundles of Surviving Sepsis Campaign (SSC). Secondary objective was to assess the impact of compliance on mortality and to determine how its compliance & mortality compared with other Asian and Western countries. Design: Prospective Cohort study. Setting: 14 ICUs of Bangladesh. Participants: 65 adult patients with severe sepsis admitted into these ICUs in July 2009. The organizational characteristics of the participating centers, the patients baseline characteristics, the achievement of target within the resuscitation & management bundle & outcome data were recorded. Outcome: Compliance with the Surviving Sepsis Campaigns resuscitation (6 hrs) & management (24 hrs) bundles. Results: Hospital mortality in ICU patients of Bangladesh suffering from severe sepsis was 49·2%. It was significantly higher than countries reported. Compliance to entire components of both resuscitation & management bundles were reported to be zero in ICUs of Bangladesh. Compliance of individual components of the bundles did not predict improved survival. Conclusion: In ICUs of Bangladesh, high mortality of severe sepsis and failure of compliance of SSC bundle guidelines to have positive impact on survival were presumably attributed to delayed diagnosis, poor adherence to & delayed application of SSC guidelines on sepsis bundles. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14359 Bangladesh Crit Care J March 2013; 1: 8-17

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The Implementation of Sepsis Bundles on the Outcome of Patients with Severe Sepsis or Septic Shock in Intensive Care Units

International Journal of Gerontology ◽

10.1016/j.ijge.2013.01.016 ◽

2014 ◽

Vol 8 (2) ◽

pp. 60-65 ◽

Cited By ~ 2

Author(s):

Shu-Lien Chou ◽

Khee-Siang Chan ◽

Kuo-Chen Cheng ◽

Willy Chou ◽

Hui-Mei Hung ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Intensive Care Units ◽

Sepsis Bundles

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Severe Sepsis in Elderly Patients Undergoing Gastrointestinal Surgery—a Prospective Multicenter Follow-up Study of Finnish Intensive Care Units

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-016-3076-4 ◽

2016 ◽

Vol 20 (5) ◽

pp. 1028-1033 ◽

Cited By ~ 5

Author(s):

Mika Ukkonen ◽

◽

Sari Karlsson ◽

Johanna Laukkarinen ◽

Tuomo Rantanen ◽

...

Keyword(s):

Severe Sepsis ◽

Intensive Care ◽

Elderly Patients ◽

Intensive Care Units ◽

Gastrointestinal Surgery ◽

Follow Up Study

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Epidemiology of severe sepsis occurring in the first 24 hrs in intensive care units in England, Wales, and Northern Ireland

Critical Care Medicine ◽

10.1097/01.ccm.0000085141.75513.2b ◽

2003 ◽

Vol 31 (9) ◽

pp. 2332-2338 ◽

Cited By ~ 265

Author(s):

Andrew Padkin ◽

Caroline Goldfrad ◽

Anthony R. Brady ◽

Duncan Young ◽

Nick Black ◽

...

Keyword(s):

Severe Sepsis ◽

Intensive Care ◽

Northern Ireland ◽

Intensive Care Units

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An Efficiency Evaluation of Protocols for Tight Glycemic Control in Intensive Care Units

American Journal of Critical Care ◽

10.4037/ajcc2007.16.6.589 ◽

2007 ◽

Vol 16 (6) ◽

pp. 589-598 ◽

Cited By ~ 36

Author(s):

Mark A. Malesker ◽

Pamela A. Foral ◽

Ann C. McPhillips ◽

Keith J. Christensen ◽

Julie A. Chang ◽

...

Keyword(s):

Intensive Care ◽

Blood Glucose ◽

Glycemic Control ◽

Intensive Care Units ◽

Tight Glycemic Control ◽

Third Party ◽

Full Time ◽

Motion Data ◽

Time Motion ◽

The Impact

Background The efficiency of protocols for tight glycemic control is uncertain despite their adoption in hospitals. Objectives To evaluate the efficiency of protocols for tight glycemic control used in intensive care units. Methods Three separate studies were performed: (1) a third-party observer used a stopwatch to do a time-motion analysis of patients being treated with a protocol for tight glycemic control in 3 intensive care units, (2) charts were retrospectively reviewed to determine the frequency of deviations from the protocol, and (3) a survey assessing satisfaction with and knowledge of the protocol was administered to full-time nurses. Results Time-motion data were collected for 454 blood glucose determinations from 38 patients cared for by 47 nurses. Mean elapsed times from blood glucose result to therapeutic action were 2.24 (SD, 1.67) minutes for hypoglycemia and 10.65 (SD, 3.24) minutes for hyperglycemia. Mean elapsed time to initiate an insulin infusion was 32.56 (SD, 12.83) minutes. Chart review revealed 734 deviations from the protocol in 75 patients; 57% (n = 418) were deviations from scheduled times for blood glucose measurements. The mean number of deviations was approximately 9 per patient. Of 60 nurses who responded to the workload survey, 42 (70%) indicated that the protocol increased their workload; frequency of blood glucose determinations was the most common reason. Conclusions Nurses spend substantial time administering protocols for tight glycemic control, and considerable numbers of deviations occur during that process. Further educational efforts and ongoing assessment of the impact of such protocols are needed.

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The prevalence and characteristics of rapid response systems in hospitals with pediatric intensive care units in Japan and barriers to their use

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzaa040 ◽

2020 ◽

Vol 32 (5) ◽

pp. 325-331

Author(s):

Taiki Haga ◽

Hiroshi Kurosawa ◽

Junji Maruyama ◽

Katsuko Sakamoto ◽

Ryo Ikebe ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Pediatric Intensive Care ◽

The United States ◽

Rapid Response ◽

Full Time ◽

Pediatric Intensive Care Units ◽

Rapid Response Systems ◽

Significant Difference ◽

Response Systems

Abstract Objective The use of pediatric rapid response systems (RRSs) to improve the safety of hospitalized children has spread in various western countries including the United States and the United Kingdom. We aimed to determine the prevalence and characteristics of pediatric RRSs and barriers to use in Japan, where epidemiological information is limited. Design A cross-sectional online survey. Setting All 34 hospitals in Japan with pediatric intensive care units (PICUs) in 2019. Participants One PICU physician per hospital responded to the questionnaire as a delegate. Main outcome measures Prevalence of pediatric RRSs in Japan and barriers to their use. Results The survey response rate was 100%. Pediatric RRSs had been introduced in 14 (41.2%) institutions, and response teams comprised a median of 6 core members. Most response teams employed no full-time members and largely comprised members from multiple disciplines and departments who served in addition to their main duties. Of 20 institutions without pediatric RRSs, 11 (55%) hoped to introduce them, 14 (70%) had insufficient knowledge concerning them and 11 (55%) considered that their introduction might be difficult. The main barrier to adopting RRSs was a perceived personnel and/or funding shortage. There was no significant difference in hospital beds (mean, 472 vs. 524, P = 0.86) and PICU beds (mean, 10 vs. 8, P = 0.34) between institutions with/without pediatric RRSs. Conclusions Fewer than half of Japanese institutions with PICUs had pediatric RRSs. Operating methods for and obstructions to RRSs were diverse. Our findings may help to popularize pediatric RRSs.

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