Assessing and Improving Sepsis Bundle Compliance Among Emergency Medicine and Internal Medicine Residents and Outcomes Associated With Septic Shock Through an Educational Intervention

Abstract Objective To assess whether a structured educational intervention for Emergency Medicine and Internal Medicine residents improved sepsis-bundle compliance and patient outcomes. Methods: A quasi-experimental before-and-after study at King Hamad University Hospital compared 150 patients before and 150 after face-to-face and online teaching on sepsis recognition and management. Outcomes included lactate measurement, blood cultures before antibiotics, intravenous fluids and antibiotics within 1 hour, complete four-component bundle compliance, mortality, supportive therapies, and hospital length of stay. Results: Compliance improved for lactate measurement (57.3% to 71.3%), blood cultures before antibiotics (49.3% to 68.7%), intravenous fluids within 1 hour (49.3% to 66.7%), antibiotics within 1 hour (61.3% to 74.0%), and all four components (20.7% to 42.0%). Mortality decreased from 56.0% to 24.0%, and median hospital stay from 12.5 to 5.0 days. Post-intervention status remained independently associated with lower mortality (adjusted OR 0.25, 95% CI 0.14–0.43; p < 0.001). Conclusion: Structured resident education was associated with improved sepsis-bundle compliance and better overall clinical outcomes, although the mortality reduction in the septic-shock subgroup was not statistically significant.