Drotrecogin Alfa (Activated) has been shown to decrease mortality in severely septic patients in some 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 Drotrecogin Alfa (Activated) was administered 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 Drotrecogin Alfa (Activated) administration concludes that the drug should not be given in a particular case. In that case, as long as there is annotation in the chart concluding that Drotrecogin Alfa was not indicated by protocol, simply assign credit for following the policy.

Numerator: The number of patients with severe sepsis or septic shock for whom Drotrecogin Alfa (Activated) 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

Increase administration of Drotrecogin Alfa (Activated) in accordance with a standardized ICU policy to 100 percent of indicated severe sepsis cases.

Data may be collected concurrently — that is, once a patient is placed on the hospital’s severe sepsis protocol, data can be abstracted from the patient chart in real time — or retrospectively using a chart review, a method generally recommended for more experienced improvement teams.