Improving Sepsis Outcomes for Acutely Ill Adults Using Interdisciplinary Order Sets Article

Full Text via DOI: 10.1097/NUR.0b013e318221f2aa PMID: 21654373 Web of Science: 000291423800006
International Collaboration

Cited authors

  • Winterbottom, Fiona; Seoane, Leonardo; Sundell, Erik; Niazi, Jawad; Nash, Teresa


  • Purpose/Objective:; The objective of the study was to measure outcomes following implementation of standardized order sets for managing patients with severe sepsis/septic shock.; Background/Rationale:; Sepsis is a severe illness, affecting approximately 750 000 people in the United States, with mortality rates of 28% to 50%, and costing $17 billion each year.; Project Description:; An interdisciplinary team was created to improve early recognition and process of care in patients with severe sepsis/septic shock. Education was rolled out over 6 months, and sepsis "bundle" order sets were implemented.; Setting and Sample:; Adult patients (N = 674) with a diagnosis of severe sepsis or septic shock who were admitted to an emergency department or critical care unit at a 563-bed tertiary care teaching facility from May 2008 through October 2010 were included in data analysis.; Methods:; A plan, do, study, act methodology was used. Outcomes following project implementation were measured prospectively including appropriate recognition of patients with a diagnosis of sepsis, hospital site where the order set was initiated, and attainment of treatment goals within 6 hours of onset of severe sepsis/septic shock.; Findings:; When order set usage was analyzed, the use of order sets was significantly associated with meeting "6-hour goals" successfully (chi(2)(1) [n = 662] = 36.16, P < .001); order set usage explained 24% of the variation in meeting goals, R(2) = 0.24, F(1,661) = 38.51, P < .0001.; Conclusions:; Order sets improved management of septic patients through effective change in delivery systems to support evidence-based medical care.; Implications for Practice:; Administrative support, team collaboration, and standardized order sets can lead to improved process of care.

Publication date

  • 2011

Published in

International Standard Serial Number (ISSN)

  • 0887-6274

Start page

  • 180

End page

  • 185


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