Compliance with Updated Sepsis Bundles to Meet New Sepsis Core Measure in a Tertiary Care Hospital

Abstract

Background The updated Surviving Sepsis Campaign care bundles are associated with improved outcomes in patients with sepsis, yet adherence to the bundles remains inconsistent. The Centers for Medicare & Medicaid Services has adopted similar care bundles as a core measure that went into effect with October 1, 2015 discharges. Objective The aim of this study was to assess bundle compliance, length of stay (LOS), and in-hospital mortality before and after introduction of the new sepsis core measure. Methods A retrospective cohort study was conducted in 158 patients with a diagnosis of severe sepsis or septic shock from April 2015 to February 2016. The before group ( n = 48) consisted of sequential patients discharged from April 1, 2015 to September 30, 2015 (prior to core measure implementation), and the after group ( n = 110) consisted of sequential patients discharged from October 1, 2015 to February 29, 2016 (after core measure implementation). Results Significant improvement was seen in the after group compared to the before group for bundle compliance with the 3-hour (66.4% vs 31.3%; p < 0.01) and 6-hour (75.5% vs 41.7%; p < 0.01) components and the overall core measure (51.8% vs 16.7%; p < 0.01). In-hospital mortality was lower in the after group compared to the before group (14.5% vs 27.1%; p = 0.05), but this difference was not statistically significant. There was no significant difference in LOS. Conclusions The study found a significant increase in compliance with the sepsis care bundles since the implementation of this core measure. Increased adherence to the care bundles may improve in-hospital survival.