Clinical decision support tools useful for identifying sepsis risk.

Area of Science:

• Medical Informatics
• Clinical Sepsis Management
• Healthcare Quality Improvement

Background:

• Sepsis remains a leading cause of mortality, necessitating early detection and intervention.
• Clinical Decision Support Tools (CDSTs) are increasingly used to aid in sepsis identification.
• Comparing the efficacy of different CDSTs is crucial for optimizing patient care pathways.

Purpose of the Study:

• To evaluate the effectiveness of POC Advisor (POCA) and Modified Early Warning System (MEWS) in identifying inpatient sepsis risk.
• To compare the impact of POCA and MEWS alert mechanisms on time to sepsis treatment.
• To assess the role of CDSTs in influencing sepsis management and patient outcomes.

Main Methods:

• Retrospective analysis of adult inpatient data from two academic medical centers (2020).
• Inclusion criteria: sepsis-related ICD-10 codes, antibiotic administration, sepsis labs.
• Statistical analysis included Fisher's exact test and Wilcoxon Rank Sum test to compare groups and mortality.

Main Results:

• 143 sepsis events identified among 744 patients; 83% received treatment pre-alert.
• POC Advisor (POCA) alert group demonstrated reduced response times compared to MEWS.
• MEWS group experienced longer time to treatment; some sepsis events were missed by both systems.

Conclusions:

• CDSTs contribute to sepsis management, but clinical judgment and nursing assessment are paramount.
• High alert volumes from CDSTs may lead to alarm fatigue.
• A collaborative approach integrating CDSTs with clinical expertise is essential for prompt sepsis treatment and mortality reduction.