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A multifaceted educational intervention improved anti-infectious measures but had no effect on mortality in patients with severe sepsis

التفاصيل البيبلوغرافية
العنوان: A multifaceted educational intervention improved anti-infectious measures but had no effect on mortality in patients with severe sepsis
المؤلفون: Daniel Schwarzkopf, Claudia Tanja Matthaeus-Kraemer, Daniel O. Thomas-Rüddel, Hendrik Rüddel, Bernhard Poidinger, Friedhelm Bach, Herwig Gerlach, Matthias Gründling, Matthias Lindner, Christian Scheer, Philipp Simon, Manfred Weiss, Konrad Reinhart, Frank Bloos, MEDUSA study group
المصدر: Scientific Reports, Vol 12, Iss 1, Pp 1-13 (2022)
بيانات النشر: Nature Portfolio, 2022.
سنة النشر: 2022
المجموعة: LCC:Medicine
LCC:Science
مصطلحات موضوعية: Medicine, Science
الوصف: Abstract Sepsis is a major reason for preventable hospital deaths. A cluster-randomized controlled trial on an educational intervention did not show improvements of sepsis management or outcome. We now aimed to test an improved implementation strategy in a second intervention phase in which new intervention hospitals (former controls) received a multifaceted educational intervention, while controls (former intervention hospitals) only received feedback of quality indicators. Changes in outcomes from the first to the second intervention phase were compared between groups using hierarchical generalized linear models controlling for possible confounders. During the two phases, 19 control hospitals included 4050 patients with sepsis and 21 intervention hospitals included 2526 patients. 28-day mortality did not show significant changes between study phases in both groups. The proportion of patients receiving antimicrobial therapy within one hour increased in intervention hospitals, but not in control hospitals. Taking at least two sets of blood cultures increased significantly in both groups. During phase 2, intervention hospitals showed higher proportion of adequate initial antimicrobial therapy and de-escalation within 5 days. A survey among involved clinicians indicated lacking resources for quality improvement. Therefore, quality improvement programs should include all elements of sepsis guidelines and provide hospitals with sufficient resources for quality improvement. Trial registration: ClinicalTrials.gov, NCT01187134. Registered 23 August 2010, https://www.clinicaltrials.gov/ct2/show/study/NCT01187134 .
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2045-2322
Relation: https://doaj.org/toc/2045-2322
DOI: 10.1038/s41598-022-07915-9
URL الوصول: https://doaj.org/article/42cb178d6ba04332a66a8c13ee18e67f
رقم الأكسشن: edsdoj.42cb178d6ba04332a66a8c13ee18e67f
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:20452322
DOI:10.1038/s41598-022-07915-9