Evaluation of a Sepsis Alert in the Pediatric Acute Care Setting

Area of Science:

• Pediatric critical care medicine
• Health informatics
• Clinical decision support systems

Background:

• Severe sepsis poses a significant threat to pediatric patients, contributing to substantial morbidity and mortality.
• Early identification and prompt intervention are crucial for improving survival rates and overall patient outcomes.

Purpose of the Study:

• To assess the effectiveness of a best practice alert system in enhancing sepsis recognition and expediting treatment for pediatric patients in acute care.
• To evaluate the impact of the alert on sepsis-attributable mortality and other key clinical indicators.

Main Methods:

• A multidisciplinary team adapted an existing sepsis alert for pediatric inpatient use, incorporating clinical decision support for timely fluid and antibiotic administration.
• A comparative analysis was conducted, examining data from the year before (2017) and after (2019) the alert's implementation.
• Key metrics included sepsis-attributable mortality, time to treatment, transfer rates to higher care levels, and antibiotic utilization.

Main Results:

• The study observed a notable decrease in 3-day sepsis-attributable mortality (2.53% to 0%) and 30-day mortality (3.8% to 1.3%) post-implementation.
• Reductions were also seen in the median time to administer fluids and antibiotics.
• While underpowered, the study indicated no increase in antibiotic days and a lower proportion of patients requiring intensive care unit transfer.

Conclusions:

• Electronic sepsis alerts show promise in improving the recognition of severe sepsis in pediatric acute care settings.
• These alerts can support timely administration of essential treatments like fluids and antibiotics, potentially reducing mortality.
• Further research with larger sample sizes is warranted to confirm these findings and optimize alert system implementation.