Early Sepsis Response System Does Not Correlate with Pediatric Early Warning Score in Sepsis Recognition

Area of Science:

• Pediatric critical care medicine
• Clinical informatics
• Health systems research

Background:

• Sepsis is a major cause of death in children globally, necessitating early detection.
• Electronic medical record (EMR)-based early recognition systems are recommended for pediatric care.
• Existing pediatric early warning scores (PEWS) help identify at-risk children but may not be optimal for sepsis.

Purpose of the Study:

• To develop and evaluate a novel sepsis early response warning system integrated into the EMR.
• To compare the effectiveness of this new system against the generic PEWS in identifying pediatric sepsis.
• To assess the feasibility of implementing such a sepsis alert system in a children's hospital.

Main Methods:

• A novel sepsis early warning system was implemented in the EMR of a tertiary pediatric hospital.
• A best practice alert (BPA) triggered for patients meeting sepsis criteria.
• Data from December 2018 to May 2020 were analyzed, comparing BPA sepsis identification with PEWS scores.

Main Results:

• The BPA triggered for 736 pediatric patients across different hospital units.
• The sepsis criteria identified 71% of these patients (524/736) as having sepsis.
• The existing PEWS identified only 13% (66/524) of sepsis patients identified by the BPA.

Conclusions:

• Implementing a sepsis-specific trigger tool within the EMR is feasible.
• The novel best practice alert system effectively identifies children with early sepsis.
• This sepsis alert system can be integrated into electronic medical records for improved detection.