Outcomes of Implementation of the Ramathibodi Sepsis System for Patients with Sepsis by Multidisciplinary Team
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Abstract
Objective: To compare the length of time sepsis patients received the first empiric antibiotic therapy before and after the implementation of the Ramathibodi Sepsis System (RSS), and to compare the length of time before patients receiving the appropriate antibiotic treatment according to sensitivity test, in-hospital mortality, 28-day mortality, and the length of hospital stay. Methods: The research was a quasi-experimental study measuring the outcomes before and after the implementation of the RSS in patients with sepsis at Ramathibodi Hospital between January 29, 2021 and April 30, 2022. The RSS is the collaboration of multidisciplinary team to provide holistic care. It consists of 1) establishing a standardized diagnostic approach to facilitate the timely diagnosis of sepsis, 2) establishing the list of antibiotics filled in an automated dispensing machine located near patient ward to facilitate the checking of drug orders and dispensing of medication, and 3) the examination of test on microbial sensitivity to antibiotics prescribed to the patients to ensure treatment appropriate to pathogens. There were 137 eligible patients including 50 patients before the implementation of the RSS (control group) and 87 after the RSS implementation (intervention group). The study compared the lengths of the time each group prescribed with empiric antibiotics for the first time before and after the RSS implementation. Results: Time to first empiric antibiotic administration in the intervention group was 42 (IQR 21.5, 57.5) minutes, which was significantly lower than that in the control group. Time to appropriate antibiotic administration according to results of sensitivity test in the intervention group was 48 (IQR 0.9, 84.0) hours, which was significantly lower than that in the control group. In-hospital mortality, 28-day mortality, and the length of hospital stay decreased when compared to those in the control group despite no statistical significance. Conclusion: Implementation of the RSS for taking care sepsis patients significantly reduced the time to first empiric antibiotic administration, and the time to appropriate antibiotic administration according to results of sensitivity test. This may lead to a decline in in-hospital mortality, 28-day mortality, and the length of hospital stay of the intervention group when compared to those in the control group despite no statistical significance.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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