Factors Associated with Compliance with Sepsis Bundle Care in the Intensive Care Unit

Background: The aim of this study was to determine which factors are associated with compliance with sepsis bundle care in the intensive care unit.Patients and Methods: Forty-five patients with severe sepsis admitted to the medical intensive care units of Kaohsiung Chang Gung Memorial Hospital from December 2009 through December 2010 were enrolled. We analyzed the factors, including patient, organizational, and process factors, that were most likely associated with compliance with the sepsis bundle.Results: The total compliance rate with the 6-hour resuscitation bundle was 17.8%, and that with the 24-hour management bundle was 11.1%. When comparing patient groups with compliance or non-compliance with the sepsis bundle (either 6-hour or 24-hour), there was no statistically significant difference among factors, such as using the sepsis code and intubation-to-ICU time. However, admission source, admission time, resident at admission, nurse-to-bed ratio, and number of dysfunctional organs were associated with compliance with detailed bundle elements.Conclusions: The factors that are associated with compliance with sepsis bundle elements in the intensive care unit include admission source, admission time, resident at admission, nurse-to-bed ratio, and number of dysfunctional organs. We should be aware of these factors, to improve compliance with sepsis bundle elements.