Improving Timely Recognition and Treatment of Sepsis in the Pediatric ICU
| Autor: | Maya Dewan, Matthew Zackoff, Stephen Pfeiffer, Erin Buenaventura, Erika Stalets, Zachary Paff, Rhea Vidrine, Cecilia Smith, Meg Satterlee, Brandy Seger, Rashmi D Sahay |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Leadership and Management medicine.drug_class Antibiotics Lactate measurement Intensive Care Units Pediatric Sepsis 03 medical and health sciences 0302 clinical medicine Primary outcome Secondary outcome Humans Medicine 030212 general & internal medicine Child Fluid bolus Retrospective Studies business.industry 030503 health policy & services medicine.disease Anti-Bacterial Agents Median time Emergency medicine 0305 other medical science business |
| Zdroj: | The Joint Commission Journal on Quality and Patient Safety. 46:299-307 |
| ISSN: | 1553-7250 |
| Popis: | Background Sepsis is a leading cause of pediatric mortality worldwide. The implementation of sepsis bundles and clinical decision support (CDS) tools have been useful in improving sepsis recognition and treatment. Methods Interventions targeted the pediatric ICU (PICU) sepsis identification process and focused on implementation of multidisciplinary sepsis huddles prompted by an automated CDS tool. The primary outcome measure was days between delayed sepsis recognition, with secondary outcome measures of the percentages of patients receiving goal-directed evidence-based sepsis therapies, including antibiotics within 1 hour, rapid fluid bolus within 20 minutes, and lactate measurement within 1 hour. The researchers also tracked median time to antibiotics. Results Average days between delayed sepsis recognition improved from one episode every 9 days to one episode every 28 days. The percentage of patients who received antibiotics within 1 hour improved from 33.9% to 45.5%, received a fluid bolus within 20 minutes increased from 54.7% to 61.8%, and had a lactate measured within 1 hour increased from 59.4% to 71.1% post–CDS alert; none were statistically significant. Median time to antibiotics prior to CDS alert implementation was 1.53 hours, with improvement to 1.05 hours postimplementation (p = 0.03). Conclusion Implementation of multidisciplinary sepsis huddles and an automated CDS alert in the PICU led to an improvement in days between delayed sepsis recognition and a significant improvement in time to antibiotics. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|