The sepsis alert developed at Barnes-Jewish Hospital was shown to increase early therapeutic and diagnostic interventions among nonintensive care unit patients at risk for sepsis.

Patients with PA and AB VAP may experience favorable survival when treated with AAA, despite greater severity of illness and a greater incidence of multidrug-resistant infection. Large randomized trials are needed to further explore this therapy.

The initial management of patients with septic shock appears to be critical in terms of determining outcome; a standardized systematic approach for the management of patients with severe infections appears to consistently improve the delivery of recommended therapies and, as a result, may improve patient outcomes. With minimal-to-no risk or acquisition costs, severe sepsis bundle implementation should become the standard of care for the management of septic shock. A multifaceted approach may aid in the success of implementation of sepsis bundles in teaching and nonteaching institutions. Bundle implementation should change clinical practice by including surveillance, feedback reporting, and staff education to organize the target interventions into packages that must be implemented in strict compliance, for every patient, to ensure uniformity and provide practical applicability. Quality improvement via utilization of protocols can be achieved, regardless of institution size or academic status, and should continue to be promoted in the intensive care unit setting.