quality of care; sepsis management; sepsis programs; sepsis screening; standard of care; Humans; Cross-Sectional Studies; Europe; Practice Guidelines as Topic; Surveys and Questionnaires; Antimicrobial Stewardship; Emergency Service, Hospital/standards; Intensive Care Units/standards; Sepsis/therapy; Sepsis/diagnosis; Quality Improvement; Guideline Adherence/statistics & numerical data; Hospitals/standards; Hospitals/statistics & numerical data; Pulmonary and Respiratory Medicine; Critical Care and Intensive Care Medicine
Abstract :
[en] Rationale: Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. Objectives: To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. Methods: A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. Measurements and Main Results: A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. Conclusions: The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Scheer, Christian S ; Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine Greifswald, Greifswald, Germany
Giamarellos-Bourboulis, Evangelos J ; Fourth Department of Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
Ferrer, Ricard; Intensive Care Department, Vall d'Hebron University Hospital. SODIR Research Group, Vall d'Hebron Research Institute. Medicine Department, Autonomous University of Barcelona, Barcelona, Spain
Idelevich, Evgeny A; Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany ; Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
Annane, Djillali; Service de Réanimation, Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Garches, France ; Université Versailles Saint-Quentin, Versailles, France
Artigas, Antonio; Sabadell University Hospital, Research and Innovation Institute Parc Tauli (I3PT CERCA), CIBER Respiratory Diseases, Autonomous University of Barcelona, Sabadell, Spain
Aslan, Abdullah Tarik; Department of Internal Medicine, Hacettepe University, Ankara, Turkey
Bottari, Gabriella; Pediatric Intensive Care Unit Children Hospital Bambino Gesú, Institute for Health and Research, Rome, Italy
Bouma, Hjalmar R; Department of Internal Medicine, Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Černý, Vladimir; Department of Anesthesia and Intensive Care Medicine, Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic ; Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovakia
Curić Radivojević, Renata; Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb University Hospital Centre, Zagreb, Croatia
Dakou, Konstantina; The Hellenic Institute for the Study of Sepsis, Athens, Greece
Dewitte, Ken; Emergency Department, Antwerp University Hospital, Antwerp, Belgium
Elbahnasawy, Mohamed; Department of Emergency Medicine and Traumatology, Tanta University, Tanta, Egypt
Gründling, Matthias; Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine Greifswald, Greifswald, Germany
Gurjar, Mohan ; Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
Hästbacka, Johanna; Department of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ; Department of Anesthesia and Intensive Care, Tampere University Hospital, Wellbeing Services County of Pirkanmaa and Tampere University, Tampere, Finland
Kyprianou, Miltiadis; Fourth Department of Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
Laribi, Said; Emergency Medicine Department, Tours University, School of Medicine and Tours University Hospital, Centre Hospitalier Universitaire de Tours, Tours, France
Lassen, Annmarie; Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
Lebedinskii, Konstantin; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, North-West State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
Máca, Jan ; Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital Ostrava and University of Ostrava, Ostrava, Czech Republic
Malbrain, Manu L N G ; First Department of Anesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland ; Medical Data Management, Medaman, Geel, Belgium
Monti, Gianpaola; Anestesia e Rianimazione dei Trapianti Dipartimento Chirurgico Polispecialistico ASST, Grande Ospedale Metropolitano Niguarda Milano, Milan, Italy
Ostermann, Marlies ; Department of Critical Care, King's College London, Guy's and St. Thomas' Hospital, London, United Kingdom
Osthoff, Michael; Division of Internal Medicine, University Hospital Basel, Basel, Switzerland ; Departments of Biomedicine and Clinical Research, University of Basel, Basel, Switzerland
Paiva, José-Artur; Intensive Care Medicine Service, Sao Joao Local Health Unit, Faculty of Medicine, University of Porto, Porto, Portugal
Sabbatucci, Michela; Department of Infectious Diseases, Italian National Institute of Health, Rome, Italy
Śmiechowicz, Jakub; Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
Ştefan, Mihai Gabriel; Department of Anesthesiology and Intensive Care, "Prof. Dr. CC Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
Vollmer, Marcus; Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
Vuković, Natalija; Clinic for Anesthesiology, Reanimation and Intensive Care, University Clinical Center Niš, Nis, Serbia
Zaragkoulias, Kyriakos; Department of Laboratory Medicine, Section for Medical Microbiology, Nord-Trøndelag Hospital Trust, Levanger, Norway ; Department of Medical Microbiology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
Reinhart, Konrad; Department of Anesthesiology and Operative Intensive Care Medicine, Charité University Medicine Berlin, Berlin, Germany
Linder, Adam; Division of Infection Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden, and
Filipescu, Daniela; Department of Anesthesiology and Intensive Care, "Prof. Dr. CC Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania ; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
STAMMET, Pascal ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Life Sciences and Medicine (DLSM) > Medical Education ; Centre Hospitalier de Luxembourg > Anaesthesia and Intensive Care > Intensive Care Unit
External co-authors :
yes
Language :
English
Title :
Status of Sepsis Care in European Hospitals: Results from an International Cross-Sectional Survey.
Publication date :
April 2025
Journal title :
American Journal of Respiratory and Critical Care Medicine
Supported by the European Sepsis Alliance and an educational grant from Becton Dickinson SA. Becton Dickinson SA was not involved in the study design or recruitment or in writing, reviewing, or submission of the manuscript. This article represents the views of the named authors only. The authors thank the scientific boards/committees from the European Society of Intensive Care Medicine, European Society of Anaesthesiology and Intensive Care, European Society for Emergency Medicine, European Society of Clinical Microbiology and Infectious Diseases Study Group for Bloodstream Infections, Endocarditis and Sepsis, and Intensive Care Society United Kingdom, who reviewed the study protocol and questionnaire; the endorsing scientific societies, the European Society of Anaesthesiology and Intensive Care, European Society of Clinical Microbiology and Infectious Diseases Study Group for Bloodstream Infections, Endocarditis and Sepsis (from the European Society of Clinical Microbiology and Infectious Diseases), European Society for Emergency Medicine, European Society of Intensive Care Medicine, European Society of Paediatric and Neonatal Intensive Care, European Shock Society, Intensive Care Society United Kingdom, and International Fluid Academy, which supported the dissemination of the survey; all participants, including those who did not consent to being named in the collaborators list; and Simone Mancini from the Global Sepsis Alliance for organizing and coordinating the steering committee meetings.
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