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Implementation and Evaluation of a Multidisciplinary Sepsis Management Model
in an Emergency Department

N. Kuntorn, S. Wangsrikhun, and C. Yothayai 2
2
1
Faculty of Medicine, Chiang Mai University, Thailand, and Faculty of Nursing, Chiang Mai University,
1 2
Thailand

Background: Multidisciplinary teamwork is crucial for optimum sepsis management due to the nature
of multiple management processes and time pressure. This implementation research is the second
phase of the study. A Multidisciplinary Sepsis Management Model in an Emergency Department was
developed and explored for feasibility in the first phase. The developed model consists of the
management in three processes, including sepsis screening, diagnosis, and treatment, and
assignment of involved personnel and their roles.

Objective: The second phase aimed to examine the model’s effectiveness on door-to-antibiotic time,
the occurrence of septic shock, and sepsis patients’ mortality rate.

Methods: The National Health and Medical Research Council’s Guide to the Development,
Implementation and Evaluation of Clinical Practice Guidelines (1999) was applied as the study
framework. There were 3 steps used in the study, including dissemination, implementation, and
evaluation of the model. The samples were 40 multidisciplinary personnel involved in sepsis
management, including 5 emergency physicians, 22 emergency nurses, 5 medical technicians, and
5 pharmacists. Door-to-antibiotic time, occurrence of septic shock, and mortality were collected
from the medical records of sepsis patients who visited the emergency department 2 weeks before
(60 patients) and 2 weeks during (65 patients) the model implementation.

Oral Presentation Abstracts
Results: The percentage of patients receiving antibiotics within 60 minutes increased from 65.00%
before model implementation to 92.31% during the model implementation. Before implementing the
model, the occurrence of septic shock among sepsis patients was 36.67% and decreased to 12.31%
during model implementation. The mortality rate before implementing the model was 3.33%, while
none died during implementation.

Conclusion: The study findings confirmed the effectiveness of the Multidisciplinary Sepsis
Management Model in decreasing door-to-antibiotic time, occurrence of septic shock, and mortality
rate.

Keywords: sepsis, septic shock, mortality, emergency department, door-to-antibiotic time

_____________________________________________________________________________________________________
Correspondence: Suparat Wangsrikhun, Faculty of Nursing, Chiang Mai University, Thailand
E-mail: suparat.w@cmu.ac.th

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