Sepsis-based critical care teaching program: the SETUP Project

Introduction

Sepsis is a very frequent, severe multisystemic disease with a myriad of signs and symptoms that can mimic several critical illnesses. Only the optimal treatment of sepsis-associated conditions is able to reduce the high morbidity and mortality associated with such a complex disease. Evidence-based medicine concepts have been developed to manage those conditions, improving patient care. Particularly regarding sepsis, there is a gap between evidence-based literature and clinical application. Moreover, different intensive care units (ICUs) may have heterogeneous facilities with unequal health care providers. Therefore, we have been developing a tool able to diagnose current sepsis ICU management and to translate evidence-based concepts into bedside practice.

Objectives

To use sepsis as a model to highlight the optimal clinical practice that may influence outcome based on known pathophysiological mechanisms and life-saving interventions in critical care medicine. Also, to implement a tool capable to find major drawbacks in critical care management.

Methods

Initially, evidence-based interventions were reviewed in order to choose six inexpensive interventions, which could be taught to most physicians and easily applied in ICUs, even those with minimal resources. First, the MEDLINE database was systematically reviewed, addressing established evidence-based interventions and preparing guidelines and protocols to conditions that reduce sepsis-induced organ dysfunctions, and thereby morbidity and mortality. Second, evaluative questionnaires before and after the proposed interventions are characterizing individualized ICU current standards of care and how they will be impacted by the SETUP Project. Third, adherence to the proposed protocols will be evaluated. Finally, patient outcome evaluation will demonstrate the overall impact of the SETUP Project.