Clinical Audit Evaluation of Septic Shock Management in Medical Unit, Ayub Teaching Hospital A Retrospective Analysis and Comparison with Updated NICE Guidelines

Clinical Audit

Abstract

Background: Septic shock is a critical condition requiring prompt and effective management to improve patient outcomes. This clinical audit evaluates the adherence to updated NICE guidelines for septic shock management in the Medical Unit at Ayub Teaching Hospital.

Aims & Objectives: Evaluate the proportion of septic shock patients among all admissions. Assess adherence to updated NICE guidelines for septic shock management. Analyze demographic Distribution of septic shock patients. Review management practices including oxygen administration, blood cultures, fluid resuscitation, serum lactate measurement, broad-spectrum antibiotics, and norepinephrine support. Evaluate patient outcomes (recovery vs. mortality).

Methods: A retrospective analysis was conducted from Jan 10, 2023, to March 10, 2023, involving 34 septic shock patients out of 450 total admissions. Data were collected on demographics, management practices, and patient outcomes. Adherence to key components of the NICE guidelines, including oxygen administration, blood cultures, fluid resuscitation, serum lactate measurement, broad -spectrum antibiotic use, and norepinephrine support, was assessed.

Results: Of the 34 patients, 59% were female, and 88% were over 50 years old. The most common cause of sepsis was urosepsis (44%). Adherence to guidelines varied: oxygen administration (65%), blood cultures before antibiotics (53%), fluid resuscitation (50%), norepinephrine support (45%), serum lactate measurement (56%), broad-spectrum antibiotics (50%), and urine output monitoring (62%). The overall mortality rate was 59%.

Conclusion: Significant deviations from NICE guidelines were observed, particularly in timely antibiotic administration, fluid resuscitation, and norepinephrine support. These deficiencies likely contributed to the high mortality rate. Recommendations include staff train ing, protocol improvements, and continuous audits to enhance guideline adherence and patient outcomes.

Keywords : Septic shock management, NICE guidelines, adherence, mortality