Prise en charge des sepsis graves aux Urgences Adultes de l’hôpital Pellegrin : état des lieux et mise en place d’un protocole (évaluation des pratiques professionnelles)

Abstract : Objectives : to evaluate professional practices regarding provision of care for patients suffering from severe sepsis at the Accident and Emergency Department of the major University Hospital (CHU, Hôpital Pellegrin), Bordeaux. Patients and methods : all patients over the age of 15 years and 3 months admitted to the Adult Emergency Department of the hospital between 1st January 2016 and 31st December 2016 were included. The diagnostic and therapeutic care provided was measured against the current recommendations of ‘Surviving Sepsis Campaign 3’, within the framework of an evaluation of professional practices. Results : out of the 54, 827 admissions to the Emergency Department in 2016, 162 patients were included. Blood culture tests were carried out on 75.3% of patients, and in 61.7% of cases, samples were taken from suspected infectious sites. Vascular volume expansion was administered in 56.8% of cases. Antibiotic treatment was prescribed in 92.5% of cases. 32.5% of patients were referred by the ‘Admissions Administration Nurse’ (IOA) to the ‘Vital Emergency Reception Ward’ (SAUV). The mortality rate was 23.45%. Professional practices complied with the recommendations in 41.2% of cases, with regard to blood culture testing, vascular volume expansion, blood lactate levels and antibiotic treatment, as well as the resuscitator’s opinion. Conclusion : the provision of care for severe sepsis represents a major public health concern and it is necessary to improve diagnostic and therapeutic care from the very point of arrival in the Emergency Department. The main areas for improvement are the training of ‘Admissions Administration Nurses’ (IOAs) in the detection of sepsis in all patients with suspected infection on admission, through systematic use of the qSOFA score, medical team information updating by means of a protocol and an e-learning self-study system. The impact of these measures will be assessed through an electronic questionnaire, relating specifically to sepsis.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01524825
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Submitted on : Thursday, May 18, 2017 - 7:04:47 PM
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Chloé Carruesco. Prise en charge des sepsis graves aux Urgences Adultes de l’hôpital Pellegrin : état des lieux et mise en place d’un protocole (évaluation des pratiques professionnelles). Médecine humaine et pathologie. 2017. ⟨dumas-01524825⟩

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