An Electronic Warning System Helps Reduce the Time to Diagnosis of Sepsis

Overview

Journal Rev Bras Ter Intensiva

Specialties Critical Care
General Medicine

Date 2018 Dec 21

PMID 30570029

Citations 7

Authors

Glauco Adrieno Westphal

Aline Braz Pereira

Silvia Maria Fachin

Geonice Sperotto

Mauricio Goncalves

Lucimeri Albino

Rodolfo Bittencourt

Vanessa de Rossi Franzini

Alvaro Koenig

Affiliations

Soon will be listed here.

Abstract

Objective: To describe the improvements of an early warning system for the identification of septic patients on the time to diagnosis, antibiotic delivery, and mortality.

Methods: This was an observational cohort study that describes the successive improvements made over a period of 10 years using an early warning system to detect sepsis, including systematic active manual surveillance, electronic alerts via a telephonist, and alerts sent directly to the mobile devices of nurses. For all periods, after an alert was triggered, early treatment was instituted according to the institutional sepsis guidelines.

Results: In total, 637 patients with sepsis were detected over the study period. The median triage-to-diagnosis time was reduced from 19:20 (9:10 - 38:15) hours to 12:40 (2:50 - 23:45) hours when the manual surveillance method was used (p = 0.14), to 2:10 (1:25 - 2:20) hours when the alert was sent automatically to the hospital telephone service (p = 0.014), and to 1:00 (0:30 - 1:10) hour when the alert was sent directly to the nurse's mobile phone (p = 0.016). The diagnosis-to-antibiotic time was reduced to 1:00 (0:55 - 1:30) hours when the alert was sent to the telephonist and to 0:45 (0:30 - 1:00) minutes when the alert was sent directly to the nurse's mobile phone (p = 0.02), with the maintenance of similar values over the following years. There was no difference in the time of treatment between survivors and non-survivors.

Conclusion: Electronic systems help reduce the triage-to-diagnosis time and diagnosis-to-antibiotic time in patients with sepsis.

Citing Articles

Impact of an electronic alert system for pediatric sepsis screening a tertiary hospital experience.

Alturki A, Al-Eyadhy A, Alfayez A, Bendahmash A, Aljofan F, Alanzi F Sci Rep. 2022; 12(1):12436.

PMID: 35859000 PMC: 9300636. DOI: 10.1038/s41598-022-16632-2.

The Ramathibodi early warning score as a sepsis screening tool does not reduce the timing of antibiotic administration.

Suttapanit K, Dangprasert K, Sanguanwit P, Supatanakij P Int J Emerg Med. 2022; 15(1):18.

PMID: 35538415 PMC: 9087922. DOI: 10.1186/s12245-022-00420-w.

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Adult Inpatients: Scoping Review.

Ackermann K, Baker J, Green M, Fullick M, Varinli H, Westbrook J J Med Internet Res. 2022; 24(2):e31083.

PMID: 35195528 PMC: 8908200. DOI: 10.2196/31083.

The Surviving Sepsis Campaign: research priorities for the administration, epidemiology, scoring and identification of sepsis.

Nunnally M, Ferrer R, Martin G, Martin-Loeches I, Machado F, De Backer D Intensive Care Med Exp. 2021; 9(1):34.

PMID: 34212256 PMC: 8249046. DOI: 10.1186/s40635-021-00400-z.

Sepsis Alerts in Emergency Departments: A Systematic Review of Accuracy and Quality Measure Impact.

Hwang M, Bond W, Powell E West J Emerg Med. 2020; 21(5):1201-1210.

PMID: 32970576 PMC: 7514413. DOI: 10.5811/westjem.2020.5.46010.

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