Compliance with maternal sepsis guidelines in a tertiary hospital in the Netherlands

Sepsis is a common cause of maternal mortality and morbidity. Early detection and rapid management are essential. In this study, we evaluate the compliance with the implemented maternity-specific Early Warning Score (EWS), Rapid Response Team (RRT) protocol and the Surviving Sepsis Campaign (SSC) Ho...

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Published in:	Hospital practice (1995) Vol. 52; no. 1-2; pp. 29 - 33
Main Authors:	de Vries, Baukje S, Verschueren, Kim J C, Jansen, Sophie, Bekker, Vincent, Veenhof, Marieke B, van den Akker, Thomas
Format:	Journal Article
Language:	English
Published:	England 01-02-2024
Subjects:	Adult Anti-Bacterial Agents - therapeutic use Early Warning Score Female Guideline Adherence - statistics & numerical data Humans Netherlands Practice Guidelines as Topic Pregnancy Pregnancy Complications, Infectious - diagnosis Pregnancy Complications, Infectious - drug therapy Pregnancy Complications, Infectious - therapy Retrospective Studies Sepsis - diagnosis Sepsis - therapy Tertiary Care Centers - organization & administration Netherlands surviving sepsis campaign Maternal sepsis sepsis prevention rapid response team early warning score sepsis management
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Summary:	Sepsis is a common cause of maternal mortality and morbidity. Early detection and rapid management are essential. In this study, we evaluate the compliance with the implemented maternity-specific Early Warning Score (EWS), Rapid Response Team (RRT) protocol and the Surviving Sepsis Campaign (SSC) Hour-1 Bundle in a tertiary hospital in the Netherlands. We performed a retrospective patient chart review from July 2019 to June 2020 at the Leiden University Medical Centre. We included women who received therapeutic antibiotics and were admitted for at least 24 hours. We included 240 women: ten were admitted twice and one woman three times, comprising 252 admissions. A clinical diagnosis of sepsis was made in 22 women. The EWS was used in 29% ( = 73/252) of admissions. Recommendations on the follow-up of the EWS were carried out in 53% ( = 46/87). Compliance with the RRT protocol was highest for assessment by a medical doctor within 30 minutes ( = 98/117, 84%) and lowest for RRT involvement ( = 7/23, 30%). In women with sepsis, compliance with the SSC Bundle was highest for acquiring blood cultures ( = 19/22, 85%), while only 64% ( = 14/22) received antibiotics within 60 minutes of the sepsis diagnosis. The adherence to the maternity-specific EWS and the SSC Hour-1 bundle was insufficient, even within this tertiary setting in a high-income country.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2154-8331 2377-1003
DOI:	10.1080/21548331.2024.2320068