Implementation of a Sepsis Chart and Its Effects on Mortality Rate in Indonesian Primary Referral Hospitals

Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorDr Cipto Mangunkusumo General Hospital

About this trial

The goal of this observational study is to evaluate the effectiveness of implementing Koran Sepsis, or sepsis chart, a paper-based order set designed to guide the implementation of the One-hour Sepsis Bundle, in improving adherence to early sepsis management and reducing 7-day mortality among adult patients with sepsis presenting to the Emergency Department. The main questions it aims to answer are:

1. Does implementation of a sepsis chart improve adherence to the One-hour Sepsis Bundle among adult patients with sepsis? 2. Does implementation of a sepsis chart reduce 7-day mortality among adult patients with sepsis?

Researchers will compare the period before and after implementation of Koran Sepsis to determine whether its implementation improves adherence to the One-hour Sepsis Bundle and reduces 7-day mortality.

Participants will:

* Receive standard clinical care for sepsis, with management documented during the first hour after sepsis is suspected or diagnosed. * Receive care guided by sepsis chart after its implementation at the participating hospital. * Have clinical data collected from their medical records, including adherence to the One-hour Sepsis Bundle and time to administration of broad-spectrum antibiotics. * Be followed for seven days to determine their mortality outcome.

The study will include adult patients aged ≥18 years diagnosed with sepsis according to the Sepsis-3 definition who present to the Emergency Department and are admitted to one of two participating hospitals: Cipto Mangunkusumo and Fatmawati General Hospital.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adult patients aged ≥18 years.

Patients diagnosed with sepsis according to the Sepsis-3 definition, using the lactate-modified qSOFA score as a reference.

Patients presenting to the Emergency Department.

Patients who are subsequently admitted to one of the participating hospitals: Cipto Mangunkusumo and Fatmawati General Hospital.

Disqualifiers

Incomplete clinical or outcome data required for the study analysis.

Trial population

Patients above ≥18 years diagnosed with sepsis in the emergency department in Cipto Mangunkusumo and Fatmawati General Hospital.

Trial design

Design model

Other

Time perspective

Prospective

Treatments tested in this trial

  • Sepsis chart (koran sepsis)

    Other intervention

    Implementation of the sepsis one-hour bundle using a paper-based chart containing instructions for the recommended bundle components.

  • Usual care

    Other intervention

    Standard sepsis management according to existing hospital practice without implementation of the study-specific sepsis one-hour bundle order set.

Treatment groups

304 Participants
are divided into 1 treatment group
Group A: Sepsis patients2 interventions

Trial outcomes

Primary outcomes

1

All-cause mortality

All death attributed to any reason during study follow-up

Time frame
7 days

Secondary outcomes

1

Time to serum lactate measurement

Time to serum lactate measurement to identify adherence to the sepsis one-hour bundle, as documented using the paper-based order set containing instructions for the sepsis one-hour bundle.

Time frame
Within 1 hour after sepsis diagnosis
2

Time to Administration of Broad-Spectrum Antibiotics

Time from sepsis diagnosis to administration of broad-spectrum antibiotics, based on documentation of patient management in the electronic health record (EHR) and sepsis record.

Time frame
Within 24 hours after study inclusion
3

Time to blood culture collection

Time to blood culture collection to identify adherence to the sepsis one-hour bundle, as documented using the paper-based order set containing instructions for the sepsis one-hour bundle.

Time frame
Within 1 hour after sepsis diagnosis
4

Time to administration of 30 mL/kg crystalloid fluid

Time to fluid administration to identify adherence to the sepsis one-hour bundle, as documented using the paper-based order set containing instructions for the sepsis one-hour bundle.

Time frame
Within 1 hour after sepsis diagnosis

Other outcomes

Sponsors and contacts

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