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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2012

Open Access 01-12-2012 | Research article

Hospital staff education on severe sepsis/septic shock and hospital mortality: an original hypothesis

Authors: Maurizia Capuzzo, Marco Rambaldi, Giovanni Pinelli, Manuela Campesato, Antonia Pigna, Marco Zanello, Maria Barbagallo, Massimo Girardis, Elena Toschi

Published in: BMC Anesthesiology | Issue 1/2012

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Abstract

Background

Signs of serious clinical events overlap with those of sepsis. We hypothesised that any education on severe sepsis/septic shock may affect the outcome of all hospital patients. We designed this study to assess the trend of the mortality rate of adults admitted to hospital for at least one night in relationship with a hospital staff educational program dedicated to severe sepsis/septic shock.

Methods

This study was performed in six Italian hospitals in the same region. Multidisciplinary Sepsis Teams members were selected by each hospital management among senior staff. The education included the following steps: i) the Teams were taught about adult learning, problem based learning, and Surviving Sepsis guidelines, and provided with educational material (literature, electronic presentations, scenarios of clinical cases for training and booklets); ii) they started delivering courses and seminars each to their own hospital staff in the last quarter of 2007.
To analyse mortality, we selected adult patients, admitted for at least one night to the wards or units present in all the study hospitals and responsible for 80% of hospital deaths. We fitted a Poisson model with monthly hospital mortality rates from December 2003 to August 2009 as dependent variable. The effect of the educational program on hospital mortality was measured as two dummy variables identifying a first (November 2007 to December 2008) and a second (January to August 2009) education period. The analysis was adjusted for a linear time trend, seasonality and monthly average values of age, Charlson score, length of stay in hospital and urgent/non-urgent admission.

Results

The hospital staff educated reached 30.6% at the end of June 2009. In comparison with the pre-education period, the Relative Risk of death of the patient population considered was 0.93 (95% confidence interval [CI] 0.87-0.99; p 0.025) for in-patients in the first, and 0.89 (95% CI 0.81-0.98; p 0.012) for those in the second period after education.

Conclusion

Our hypothesis that a program educating hospital staff to early detection and treatment of severe sepsis/septic shock may affect the outcome of all hospital patients is original, but it has to be corroborated by other experiences.
Appendix
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Metadata
Title
Hospital staff education on severe sepsis/septic shock and hospital mortality: an original hypothesis
Authors
Maurizia Capuzzo
Marco Rambaldi
Giovanni Pinelli
Manuela Campesato
Antonia Pigna
Marco Zanello
Maria Barbagallo
Massimo Girardis
Elena Toschi
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2012
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/1471-2253-12-28

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