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Compliance of medicine residents with 6-hour sepsis bundle at a tertiary care center
Infectious Diseases Journal of Pakistan
  • Ashique Ali, Aga Khan University
  • Hassan Ashraf Zia, Aga Khan University
  • Bushra Jamil, Aga Khan University
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Objective: To determine the frequency of medicine residents’ compliance with 6-hour sepsis bundle in patients with severe sepsis at the Aga Khan University Hospital
Methods: Cross-sectional study, conducted at the emergency room and medical wards of a tertiary care university hospital. The study was conducted from April to October, 2009. Sixty seven patients with severe sepsis and 67 medicine residents (postgraduate years 3 and 4) meeting the inclusion criteria were enrolled in the study after informed consent. A checklist was used to document whether all tasks of 6-hour sepsis bundle were undertaken and completed within 6 hours of making a diagnosis of severe sepsis.
Results: Overall residents’ compliance with 6-hour sepsis bundle was 11.9%. Out of the 67 patients of severe sepsis, serum lactate was measured in 14 (20.9%) patient, blood culture before antibiotics was obtained in 38(56.7%) patients; 53(79.1%) patients received antibiotics within 3 hour of presentation to the emergency room and 1 hour of their diagnosis of severe sepsis in the ward. Initial fluid resuscitation was completed in 65(97%) patients. If the mean arterial pressure (MAP) remained less than 65mmHg despite adequate initial fluid resuscitation, vasopressors of choice were initiated in 55 (82.1%) cases. Central venous pressure of =8 mmHg was achieved in 53(79%) patients after adequate fluid resuscitation. Blood transfusion to target hemoglobin (Hb) of 7-9g/dl was given to 59(88.1%) patients.
Conclusion: Hospital mortality from severe sepsis can be reduced by enhancing compliance with evidence-based interventions through adoption of simple strategies which are relevant to our local problems and needs.

Citation Information
Ashique Ali, Hassan Ashraf Zia and Bushra Jamil. "Compliance of medicine residents with 6-hour sepsis bundle at a tertiary care center" Infectious Diseases Journal of Pakistan Vol. 22 Iss. 4 (2013) p. 633 - 637
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