The effects of implementation of the Surviving Sepsis Campaign in the Netherlands

作者：Tromp M^*; Tjan D H T; van Zanten A R H; Gielen Wijffels S E M; Goekoop G J D; van den Boogaard M; Wallenborg C M; Biemond Moeniralam H S; Pickkers P

来源：Netherlands Journal of Medicine, 2011, 69(6): 292-298.

• Compliance
• implementation
• management bundle
• resuscitation bundle
• Surviving Sepsis Campaign

To reduce unintentional and avoidable adverse events in patients in hospitals in the Netherlands, a patient safety agency (VMS) programme was launched in 2008. Among the VMS topics, the programme 'optimal therapy in severe sepsis', according to the international Surviving Sepsis Campaign (SSC), aims to improve early diagnosis and treatment of sepsis to reduce sepsis mortality by 15% before the end of 2012. We analysed compliance data submitted to the international SSC database from the Netherlands and compared these data with published international SSC results.
Data of 863 patients, representing 6% of the international data (n=14,209), were used for analysis. In the Netherlands, the resuscitation bundle compliance improved significantly from 7% at baseline to 27% after two years (p=0.002). Internationally, the resuscitation bundle compliance increased significantly from 11 to 31% (p<0.001). In contrast with the international results (18% baseline, 36% after two years), the compliance with the management bundle did not improve (24% baseline, 25% after two years). At baseline, hospital mortality was significantly higher compared with internationally (52 vs 37%; p=0.03) and decreased significantly from 52% at baseline to 35% after two years (p=0.049).
In the Netherlands, the decrease in mortality was significantly more pronounced after implementation of the SSC (p<0.001). In the Netherlands, following implementation of the SCC guidelines, compliance with the resuscitation bundle increased significantly, while compliance with the management bundle remained unaffected. This was associated with a significant improvement in hospital survival. In view of the VMS programme and goals, further implementation of the SSC is warranted.

• 出版日期2011-6