Use of Sequential Organ Failure Assessment Among Intensive Care Unit Patients with Septic Shock

Abstract

Purpose: Sepsis is a significant cause of mortality in modern intensive care units (ICUs). At Sharp Grossmont Hospital (SGH), sepsis cases increased the patient mortality rate in comparison to other Sharp facilities. Currently, no tools are utilized to identify septic patients at SGH. The study aimed to find out the impact of early consultation of advanced illness management (AIM) and goals of care conversations (GOCC) on reducing the length of stay (LOS) among septic shock patients.

Methodology: Descriptive data were attained based on Electronic Medical Records (EMR) of 39 septic shock patients form which ICU nurses utilize to calculate Sequential Organ Failure Assessment (SOFA) on admission and daily for 2 days. 

Findings: The education increased the ICU staff's awareness of the high occurrence of septic shock among ICU patients. After the deployment of SOFA scores among 39 patients of septic shock, the average LOS was 3 days, compared to more than 5 days before implementing SOFA scores. Post-implementation, 33 % of patients received early AIM or GOCC intervention, with 84% of them receiving intervention from the first day of admission. These percentages are compared to pre-implementation, when early AIM or GOCC intervention was provided to 36.4 % of patients, with 41.3 % of them receiving AIM or GOCC from the first day of admission.

Recommendations: In this study, the leader of change must be aware of standardized Arterial Blood Gas (ABG) orders for SOFA scores and measure the compliance of ICU nurses in documenting SOFA scores. Moreover, raise awareness among healthcare professionals about the high occurrence of septic shock mortality among ICU patients.