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Improving Timely Recognition and Treatment of Sepsis in the Pediatric ICU

Rhea Vidrine, Matthew Zackoff, Zachary Paff

    Joint Commission Journal on Quality and Patient Safety
    |March 24, 2020
    PubMed

    Insights

    Implementing sepsis huddles and clinical decision support (CDS) alerts in the pediatric ICU improved sepsis recognition and significantly reduced time to antibiotics. This intervention is key for better pediatric sepsis management.

    Area of Science:

    • Pediatric critical care medicine
    • Infectious disease management
    • Health informatics

    Background:

    • Sepsis is a major global cause of death in children.
    • Sepsis bundles and clinical decision support (CDS) tools enhance sepsis recognition and treatment.

    Purpose of the Study:

    • To evaluate the impact of multidisciplinary sepsis huddles and automated CDS alerts on pediatric sepsis identification.
    • To assess improvements in sepsis recognition and adherence to evidence-based therapies in a pediatric intensive care unit (PICU).

    Main Methods:

    • Intervention focused on multidisciplinary sepsis huddles triggered by an automated CDS tool in the PICU.
    • Primary outcome: days between delayed sepsis recognition. Secondary outcomes: timely antibiotics, fluid bolus, and lactate measurement.
    • Median time to antibiotics was also tracked.

    Main Results:

    • Days between delayed sepsis recognition improved from 1 episode every 9 days to 1 episode every 28 days.
    • Percentage of patients receiving antibiotics within 1 hour increased from 33.9% to 45.5%.
    • Median time to antibiotics significantly decreased from 1.53 hours to 1.05 hours post-implementation (p=0.03).

    Conclusions:

    • Multidisciplinary sepsis huddles combined with automated CDS alerts enhance pediatric sepsis management.
    • The intervention led to improved sepsis recognition and a significant reduction in time to antibiotic administration.
    Abstract

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