Evaluating Sepsis Bundle Compliance as a Predictor for Patient Outcomes at a Community Hospital: A Retrospective Study.
John R Lawrence, Ben Seiyon Lee, Adetokunbo I Fadahunsi and 1 others
PMID 38470467WHAT IT FOUND
At a community hospital with high sepsis bundle compliance, SEP-1 compliance was not associated with mortality, hospital length of stay, or ICU length of stay.
Shock and infection source were linked to outcomes instead.
Key findings
01SEP-1 bundle compliance was not associated with mortality, hospital length of stay, or ICU length of stay.
02Shock was associated with higher odds of death (OR 4.85, 95% CI 2.50-9.64), while genitourinary infection was associated with lower odds of death (OR 0.24, 95% CI 0.08-0.64).
03The most common reasons for SEP-1 non-compliance were antibiotic administration (33 cases, 27.5%), crystalloid fluid administration (23 cases, 19.2%), and initial lactate measurement (22 cases, 18.3%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single community hospital with only 2 years of data, so it may not apply to other hospitals. The hospital exceeded national and state benchmarks for SEP-1 compliance, so results may not generalise to sites with lower compliance. SEP-1 scoring treats the bundle as all-or-nothing, so the study cannot show which individual elements matter. The analysis may not have had enough power to detect a true association between compliance and outcomes. Sepsis present on admission differed between compliant and non-compliant groups and was associated with shorter length of stay, so confounding is possible.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that early antibiotics are unnecessary because SEP-1 compliance did not predict outcomes. This was a single community hospital with high compliance, and the all-or-nothing bundle score cannot show which individual elements matter.