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Improving Time to Stat Intravenous Antibiotic Administration: An 8-Year Quality Initiative.

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Timely antibiotic administration for pediatric sepsis improved significantly through quality improvement initiatives. This involved multiple interventions to speed up stat intravenous antibiotic delivery in children.

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Area of Science:

  • Pediatric critical care
  • Quality improvement science
  • Infectious disease management

Background:

  • Pediatric sepsis remains a significant cause of child mortality globally.
  • Prompt antibiotic administration is crucial for improving outcomes in pediatric sepsis.
  • This study details quality improvement efforts at a children's hospital to enhance antibiotic timeliness.

Purpose of the Study:

  • To describe quality improvement (QI) initiatives aimed at improving the timeliness of stat intravenous (IV) antibiotic administration in pediatric sepsis.
  • To report on the sustained impact of these QI efforts over an eight-year period.

Main Methods:

  • Utilized electronic health records to track time from order to administration of stat IV antibiotics (2012-2020).
  • Implemented multiple QI interventions including a dedicated sepsis committee, automated dispensing, standardized order sets, sepsis screening, national collaborative participation, difficult IV access guidelines, and automated nurse notifications.
  • Monitored stat IV antibiotic use relative to emergency department visits and inpatient days as a balancing measure.

Main Results:

  • Achieved a substantial improvement in the administration of stat IV antibiotics within 1 hour of order, increasing from 33% in 2012 to 77% in 2019.
  • Sustained this improved performance through July 2020.
  • Demonstrated consistent and sustained improvement in timely antibiotic administration.

Conclusions:

  • A multipronged quality improvement approach effectively enhanced the timely administration of stat IV antibiotics in pediatric sepsis.
  • Further research is warranted to determine the association between improved antibiotic timeliness and clinical outcomes such as reduced length of stay and enhanced survival rates in pediatric sepsis patients.