Definition

rhAPC has been shown to decrease mortality in severely septic patients in clinical trials. There are a number of clinical criteria applied to patients to determine eligibility best captured in a standardized ICU policy for administration.

Compliance with this bundle element is defined as the percent of patients with severe sepsis or septic shock for whom rhAPC was administerred in accordance with a standardized ICU policy within 24 hours following the time of presentation.

Note: It is possible that the standardized ICU policy that governs rhAPC administration concludes that the drug should not be given in a particular case. The structure of the data collection tools assigns credit for this indicator in that case, as long as there is annotation in the chart concluding that rhAPC was not indicated by protocol.

Numerator: The number of patients with severe sepsis or septic shock for whom rhAPC was administered in accordance with a standardized ICU policy within 24 hours following the time of presentation

Denominator: The total number of patients presenting with severe sepsis and septic shock

Exclusion: Non-severe sepsis

Goal

Increase administration of rhAPC in accordance with a standardized ICU policy to 100 percent of indicated severe sepsis cases.

Data Collection Plan

Data is collected for this measure on each individual patient using the Individual Chart Measurement Tool.  This can be done concurrently or retrospectively as detailed here.

Once all the Individual Chart Measurement Tools have been collected for the month, the Monthly Measurement Worksheet integrates the data by combining the results of all the Individual Chart Measurement Tools.

At the end of each section on the Monthly Measurement Worksheet you will find a line designated “Numerator” and a line designated “Denominator,” which are ready for input into the pre-configured Improvement Tracker for the measure.

Sample Graph

Use IHI's Improvement Tracker to enter, save, and graph your team's data.