Early treatment of patients with probable sepsis Infections and Infestations
Conditions
Interventions
Real-time automated monitoring of the electronic medical record to identify suspected sepsis patients without completion of sepsis bundle measures within 1-hour of the completion deadline and generate
Sponsors
CRICO
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adult patients aged 18 years old and over 2. Who triggered a sepsis best practice advisory that was subsequently acknowledged by a treating clinician as "yes, sepsis possible"
Exclusion criteria
Exclusion criteria: 1. Transfer from an outside hospital 2. Sepsis best practice advisory triggered while the patient is in an intensive care unit 3. Sepsis best practice advisory triggered while the patient is in a perioperative care area
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Overall 3-hour bundle ordering compliance, defined as orders for all 3-hour bundle measures monitored by the study platform completed within the bundle time limits - i.e., orders for antibiotics, blood cultures, and lactate measurement measured from the electronic medical record at the end of the study period | — |
Secondary
| Measure | Time frame |
|---|---|
| The following secondary outcomes were measured from the electronic medical record at the end of the study follow-up period (T0 + 28 days): 1. Antibiotic ordering compliance, defined as orders for antibiotics placed within 3 hours of time-zero 2. Blood culture ordering compliance, defined as orders for blood cultures placed within 3 hours of time-zero 3. Initial blood lactate level ordering compliance, defined as orders for initial blood lactate level within 3 hours of time-zero 4. Repeat blood lactate level ordering compliance, defined as orders for repeat blood lactate level placed within 6 hours of time-zero and within 3 hours of initial lactate measurement, among patients with initial lactate > 2.0mmol/L 5. Overall 3-hour bundle care delivery compliance, defined as the implementation of all 3-hour bundle measures monitored by the study platform completed within the bundle time limits - i.e., administration of antibiotics, collection of blood cultures prior to antibiotic administration, and lactate measurement. 6. Antibiotic delivery compliance, defined as administration of antibiotics within 3 hours of time-zero 7. Blood cultures delivery compliance, defined collection of blood cultures within 3 hours of time-zero and prior to antibiotic administration 8. Initial lactate delivery compliance, defined measurement of initial lactate within 3 hours of time-zero 9. Repeat lactate delivery compliance, defined as the measurement of a repeat lactate within 6 hours of time-zero and within 3 hours of initial lactate measurement, among patients with an initial lactate > 2.0mmol/L 10. Mortality by Day 28 11. Early mechanical ventilation, defined as the receipt of mechanical ventilation or death within 72 hours of time-zero 12. Early intensive care unit (ICU) admission, defined as ICU admission or death within 72 hours of time-zero 13. Mechanical ventilation during hospitalization, defined as receipt of mechanical ventilation or death within 28 days of time-zero 14. ICU admis | — |
Countries
United States of America
Outcome results
None listed