DOI: 10.5176/2315-4330_WNC17.32
Authors: SK Fok
Abstract:
Introduction and objectives Sepsis is a very common cause of hospital admission both locally and worldwide. Satisfactory management of sepsis includes prompt sepsis diagnosis, timely administration of antibiotics, source control, timely availability of investigation results, and intensive care for severe sepsis and septic shock , which involve not a single step, but the collaboration and coordination of multiple specialties in a hospital. In 2014, a retrospective audit titled “Time Frame from Prescribing to Administration of the First Dose of Intravenous Antibiotics for Inpatients in 2014” was carried out by the HKEC Q&S Office. This audit looked at the time from antibiotics prescription to administration and explored the factors affecting it, as well as the time from the order of blood tests to venesection. The results showed that in 64.7{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} of patients, antibiotics were given within 3 hours after prescription, and in 30.9{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} the time of blood culture ordering to sampling was ≤ 1 hour. Since then the delivery logistics in the phlebotomy service were improved. The limitations of this audit were that it was retrospective in nature, and only patients from the Department of Medicine were reviewed. Severity of disease was variable and the sample was generally not a very sick group of patients, hence urgency of antibiotics in relation to disease severity was not known. Other aspects including laboratory turnaround time (TAT), Medication Administration Record (MAR) arrival to pharmacy, timeliness of radiological tests were not studied. It was thus proposed that a second review be carried out to focus on sicker patients suffering from sepsis or septic shock, and to measure whether the administration time of the first dose of antibiotics could meet the Surviving Sepsis Campaign (SSC) Guideline of the three-hour standard, and hence the present audit was carried out to follow these recommendations to study only patients with sepsis, severe sepsis and septic shock.
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