The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock
| Autor: | Ra’ed Hijazi, Abdulaziz Al-Dawood, Amal Matroud, Yaseen M. Arabi, Hasan M. Al-Dorzi, Shihab Mundekkadan, Sami Alsolamy, Saadi Taher, Hani Tamim, Abdellatif M. Marini, Fatimah H. Al Ehnidi, Mohamed Salih Aziz Mohamed, Saad Al-Qahtani, Ahmed Alamry, Majid Al Salamah |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Sepsis resuscitation bundle
medicine.medical_specialty Hospital mortality medicine.medical_treatment Critical Care and Intensive Care Medicine law.invention Sepsis 03 medical and health sciences 0302 clinical medicine law Anesthesiology medicine Intensive care unit 030212 general & internal medicine Quality improvement Intensive care medicine Mechanical ventilation business.industry Septic shock Emergency department Research lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine Shock Odds ratio lcsh:RC86-88.9 medicine.disease Patient safety Emergency medicine Propensity score matching Health service administration business |
| Zdroj: | Annals of Intensive Care, Vol 7, Iss 1, Pp 1-10 (2017) Annals of Intensive Care BASE-Bielefeld Academic Search Engine |
| ISSN: | 2110-5820 |
| DOI: | 10.1186/s13613-017-0280-7 |
| Popis: | Background Compliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department. Methods This was a pre–post two-phased implementation study that consisted of a pre-intervention phase (January 01, 2011–September 24, 2012), intervention phase I (multifaceted intervention including e-alert, from September 25, 2012–March 03, 2013) and intervention phase II when SRT was added (March 04, 2013–October 30, 2013) in a 900-bed tertiary-care academic hospital. We recorded baseline characteristics and processes of care in adult patients presenting with sepsis or septic shock. The primary outcome measures were hospital mortality. Secondary outcomes were the need for mechanical ventilation and length of stay in the intensive unit and in the hospital. Results After implementing the multifaceted intervention including e-alert and SRT, cases were identified with less severe clinical and laboratory abnormalities and the processes of care improved. When adjusted to propensity score, the interventions were associated with reduction in hospital mortality [for intervention phase II compared to pre-intervention: adjusted odds ratio (aOR) 0.71, 95% CI 0.58–0.85, p = 0.003], reduction in the need for mechanical ventilation (aOR 0.45, 95% CI 0.37–0.55, p |
| Databáze: | OpenAIRE |
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