BMJ  2008;336:440-443 (23 February), doi:10.1136/bmj.39454.634502.80

Practice

Quality Improvement Report

Improving early management of bloodstream infection: a quality improvement project

Jane Minton, consultant in infectious diseases1, James Clayton, specialist registrar in medical microbiology2, Jonathan Sandoe, consultant microbiologist2, Hugh Mc Gann, consultant in infectious diseases1, Mark Wilcox, professor of medical microbiology2

1 Infection and Travel Medicine, St James’s University Hospital, Leeds LS9 7TF, 2 Department of Microbiology, Old Medical School, Leeds General Infirmary, Leeds LS1 3EX

Correspondence to: J Minton jane.minton@leedsth.nhs.uk

The first 150 words of the full text of this article appear below.


Problem Bloodstream infection is a common but serious illness with high mortality and morbidity, which is seen in many clinical specialties. Errors such as delay in diagnosis and lack of effective treatment often occur.
Design Initial observational study followed by prospective study before and after intervention in a high risk clinical area.
Setting 1400 bed teaching hospital in the United Kingdom where the initial management of all inpatients with bloodstream infections was surveyed over six weeks. This showed 55 major errors in 46 (30%) of 157 episodes of bloodstream infection. Most (44) were in general areas of the hospital without a specific protocol for managing sepsis. 29 of the 55 errors were caused by delay in giving effective antibiotics to critically ill patients. In 19 cases, effective antibiotics were still not given despite advice from infection services based on blood culture results. A diagnosis of bloodstream infection had not been . . . [Full text of this article]



Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Articles

Early treatment strategies in sepsis
Mohammed A Butt, A K Coulson, J H Hull, and T B L Ho
BMJ 2008 336: 521. [Extract] [Full Text] [PDF]

Bacteraemia service model of infection care
Gavin D Barlow and Patrick Lillie
BMJ 2008 336: 521. [Extract] [Full Text] [PDF]

Prognosis and politics
Fiona Godlee
BMJ 2008 336: 0. [Extract] [Full Text]

This article has been cited by other articles:

  • Lillie, P., Moss, P., Thaker, H., Parsonage, M., Adams, K., Meigh, J., Meigh, R., Mawer, S., Dibb, W., Wilson, J., Musaad, S., O'Brien, P., Barlow, G. (2008). Development, impact and outcomes of the Hull Bacteraemia Service. QJM 101: 889-898 [Abstract] [Full text]  
  • Butt, M. A, Coulson, A K, Hull, J H, Ho, T B L (2008). Early treatment strategies in sepsis. BMJ 336: 521-521 [Full text]  
  • Barlow, G. D, Lillie, P. (2008). Bacteraemia service model of infection care. BMJ 336: 521-521 [Full text]  

Rapid Responses:

Read all Rapid Responses

The bacteraemia service model of infection care
Gavin D Barlow, et al.
bmj.com, 25 Feb 2008 [Full text]
Early treatment strategies in sepsis
Mohammed A Butt, et al.
bmj.com, 26 Feb 2008 [Full text]
A quality improvement?
Martin J Sheppard
bmj.com, 3 Mar 2008 [Full text]
Early Management of Sepsis
Daniel G Boden
bmj.com, 7 Mar 2008 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ