Abstract:
ABSTRACT
EVALUATION OF THE IMPACT OF SEPSIS BUNDLES ON SEVERE
SEPSIS MORTALITY
by
Gay Sharon Garton-Lutz
Master of Science in Nursing
California State University, Chico
Fall 2010
In the United States, severe sepsis is common and affects over 750,000 people
each year and more than 250,000 of those will die. With an alarming mortality rate
of between 28% and 50% or higher, the numbers continue to escalate and no one is exempt
from this disease process; severe sepsis knows no boundaries and it affects the
young as well as the old.
One of the most significant interventions regarding severe sepsis is implementing
an early goal-directed therapy plan, a sepsis bundle, within six hours of diagnosis.
These therapies are evidenced-based treatments and when initiated early on, can
reduce progression into multi-system organ failure and mortality.
The purpose of this retrospective study was to review whether implementing
a sepsis bundle within six hours of diagnosis of severe sepsis would reduce mortality
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rates. A retrospective review was done using the guidelines established by the Surviving
Sepsis Campaign, and included 152 adult subjects admitted via the ED at the Northern
Nevada target facility. Seven months of data included 58 pre-bundle patients in
2008 (July 1 thru December 31), and 94 post-bundle patients during the same seven
months in 2009.
This report summarizes the retrospective review of bundle usage with severe
sepsis to determine if mortality rates were reduced at a Northern Nevada community
hospital. Deaths due to severe sepsis were overall reduced from 31% (pre-bundles) to
23% after implementing bundles but no statistical significance was noted overall. However,
a subset of patients with severe sepsis who had respiratory co-morbidities did have
significantly decreased mortality after bundle implementation. Implementation of bundles
with patients who have respiratory co-morbidities is strongly recommended, based
on these findings. The overall decrease in mortality rates of 8% indicates potential for
further research in sepsis bundles. Additional studies might include reviewing sepsis in
its earliest stage using the bundles vs. waiting until severe sepsis occurs.
