Impact of Sepsis Management Guideline Implementation in Emergency Departments: A Systematic Review of Process Measures and Clinical Outcomes
Abstract
Sepsis is a life-threatening condition associated with significant morbidity and mortality worldwide. The emergency department (ED) plays a crucial role in the early recognition and management of sepsis, as delays in treatment are strongly associated with worse outcomes. Although sepsis management guidelines and care bundles have been widely implemented to standardize and accelerate care, their impact on patient outcomes remains variably reported. This systematic review evaluated the effect of implementing sepsis management guidelines in EDs on both process indicators and clinical outcomes. A systematic search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library using a combination of controlled vocabulary and free-text terms related to sepsis, emergency care, and guideline implementation, yielding 4,309 records; after removal of duplicates and screening, eight studies met the inclusion criteria. Data extraction was performed using a standardized form capturing study characteristics, interventions, and outcomes, and risk of bias was assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. The included studies comprised diverse designs, including before-and-after studies, retrospective cohort studies, observational studies, and one quasi-experimental trial. Overall, implementation of sepsis guidelines consistently improved process measures, including reduced time to antibiotic administration, increased lactate…
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