Factors Associated With Implementation of Early Goal-Directed Therapy in Septic Patients

Background:Sepsis is a systemic inflammatory response that cause by infection and it is a continuously process. Sepsis common occur in critically ill patients. Surviving sepsis campaign guidelines in 2012 and 2008 have highlighted the importance of “initial resuscitation- six golden hours”, which is the time point sepsis care bundle shall start. Before/ after sepsis care bundle stared, we will compare the length of stayed in ICU, the days of hospitalization and mortality rate in patients with severe sepsis or septic shock.

Purpose:  This study aims to explore the implementation of early goal directed against sepsis patient prognostic factors of
treatment analysis.

Methods:  The design of study was retrospective cohort study. We enrolled participants in the forty-two beds Medical &
surgical intensive care unit of northern Taiwan. The inclusion criteria were the adult patients who admitted to the ICU
from 2012 to 2014, and diagnosis of sepsis. The exclusion criteria were non-sepsis patients. The study tool is checklist of
EGDT. Statistics analysis Statist using descriptive statistics presented participants basic information, t-test and chi-
square test conducted observations, the outcomes by the logistic regression and survival analysis.

Results:  This study recruited 838 patients of severe sepsis patients, including the implementation of early goal-directed
therapy for the 687 patients implementation rate of 82%, which reached a total of 581 cases, 84.6% achievement rate.
The impact of sepsis patients outcomes of disease severity, types of fluid and goal-directed therapy completion rates.

Conclusion:  Achieved goal-directed therapy, the recovery of the initial intravenous infusion type and severity of illness
related factors affecting the prognosis of patients with sepsis, it is recommended to enhance the implementation of health
care compliance monitor of early goal-directed therapy. This study provides intensive medical care in performing clinical
reference basis.This study provides critical care staffs to perform clinical reference basis.

Implication:Nurses play a critical role in the process of EGDT recognition, diagnosis, and treatment of sepsis. The SSC guidelines
provide updated evidence-based practice recommendations that help to promote best practices for patient care. Critical care nurses’
knowledge of the new guideline recommendations can help to ensure that patients with sepsis receive therapies that are based on the latest scientific evidence.