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All Journal Alami Journal (Alauddin Islamic Medical) Journal UMI Medical Journal jpki Fakumi Medical Journal Malahayati International Journal of Nursing and Health Science
Sri Wahyuni Gayatri
Fakultas Kedokteran Universitas Muslim Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Sepsis protocol adherence and emergency department overcrowding: An observational study Nisa Arifani; Leli Mulyati; Priyo Sasmito; Treesia Sujana; Sri Wahyuni Gayatri; Novia Dwi Astuti; Nurfanida Librianty; Sukirman Lie; Elina Deviana; Farly Ihsan
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 2 (2025): Volume 8 Number 2
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i2.870

Abstract

Background: Emergency Department (ED) overcrowding is a persistent global challenge that affects the quality and timeliness of patient care, particularly for sepsis management. Despite established guidelines such as the hour-1 sepsis bundle and national sepsis guideline, adherence remains inconsistent. Purpose: To analyze the relationship between sepsis protocol compliance and emergency unit crowding. Method: A retrospective observational cohort study was conducted, analyzing adult sepsis and septic shock patients triaged as Priority 1. Data on patient demographics, sepsis severity scores, ED occupancy rates, and adherence to sepsis protocols using the Hour-1 sepsis bundle and the National Sepsis Guideline were collected. Statistical analysis was performed using Fisher’s Exact Test to examine associations between ED overcrowding and compliance with sepsis protocols, with a significance threshold of p<0.05. Results: This study included 38 cases with a mean age of 56.6 years and the majority (52.6%) of patients were female. Most cases were diagnosed with septic shock (55.3%) and the average occupancy rate of the emergency department was 80.8%. Serum lactate measurements were performed in 68.4% of cases, blood culture sampling in 21.1%, and broad-spectrum antibiotics were given in 94.7%. Full compliance with both sepsis protocols was only 5.3%. Compliance with fluid resuscitation was high at 97.4%, while compliance with blood culture sampling was low at 5.3% and 7.9%. No significant association was found between protocol compliance and ED crowding (p > 0.05). Conclusion: There was no significant correlation between ED crowding and adherence to sepsis protocols. Strategic and clinical policy interventions are needed to improve adherence to sepsis management guidelines. Suggestion: Future research should investigate additional barriers to sepsis care, such as financial constraints, physician decision-making processes, and variations in adherence across healthcare settings to develop more comprehensive strategies to improve sepsis outcomes worldwide.
Co-Authors A Kartini Eka Yanti Abadi Aman Abd. Rahman Achmad Harun Muchsin Achmad Harun Muchsin Agung Dirgantara Ahmad Nabani Alamanda Irwan Alfian Fadli Andi Farid Abdullah Andi Husni Esa Darussalam Andi Kartini Eka Yanti Andi Retno Afifah Andi Siti Fahirah Arsal Andi Sitti Fahirah Andi Tenri Sanna Andi Tenri Sanna Andi Tenri Sanna Arifuddin Anna Sari Dewi Anna Sari Dewi Arina F Arifin Arina Fathiyyah Armanto Makmun Armanto Makmun Arni Isnaini Arni Isnaini Arfah Arum Dwi Haerunnisa Aryanti Bamachry Aryanti Bamahry Asrini Safitri Asrini Safitri Asrini Safitri Asrini Savitri Asrini Syafitri Ayu Ulfiah Dahliah Desy Rizka Wulandari Dian Amelia Abdi Djauhariah Arifuddin Dwi Anggita Dwi Astuti , Novia Elina Deviana Eny Arlini Wello Fadil Mula Putra Fahmi Satrio Hidayat Farly Ihsan Febie Irsandy Fendy Dwimartyono Fendy Dwimartyono Fitriah Handayani, Prema Hapsari Hermiaty Nasruddin Hijriah Syafitri Indah Lestari Indah Lestari Indah Lestari Daeng Kanang Inna Mutmainna Musa Inna Mutmainnah Musa Irna Diyana Kartika Irna Diyana Kartika Irna Diyana Kartika Irna Diyana Kartika Leli Mulyati Lisa Yuniaty M. Hamsah M. Hamsah M.Abrar Naufal Hidayatullah ZA M.Farizan Atjo Masita Fujiko Masita Fujiko M.Said Moch. Erwin Rachman Mochammad Erwin Rachman Mona Nulanda Muhammad Mursyid Muhammad Shendy Abiyyu Badi Mutiara Amalia Nasrudin Andi Mappaware Nevi Sulvita Karsa Nisa Arifani Nur Fatimah Sirajuddin Nur Isra Nurelly N Waspodo Nurfanida Librianty Nurhikmawati Nurmadilla, Nesyana Nurul Aziza Andi M Priyo Sasmito Priyo Sasmito Rachmat Faisal Syamsu Rachmat Faisal Syamsu Rachmat Faisal Syamsu Radiana Syamsu Rafiqah Ramdania Ridwan Rahmawati Rahmawati Rahmawati Rahmi Utami Rasfayanah Rasfayanah Rasfayanah, Rasfayanah Rezky Pratiwi Rezky Putri Indarwati Abdullah Rezky Putri Indarwati Abdullah Riski Astriani Putri Roza Linda Salahuddin Andi Palloge Santriani Hadi Shofiyah Latief Shulhana Mokhtar Sigit Dwi Pramono Siti Anisah Azzahra Rasmin Sri Julyani Sri Vitayani Sri Wahyu Sri Wahyu Sri Wahyu Sukirman Lie Sultan Buraena Syamsu Rijal Treesia Sujana Vellya Dwi Damayanti Wiriansya, Edward Pandu Yani Sodiqah Yusriani Mangarengi Yusriani Mangarengi Zulfahmidah Zulfahmidah Zulfahmidah Zulfi Indriani Zulfitriani Murfat Zulfitriani Murfat Zulfiyah Surdam