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A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Sepsis Recognition by Electronic Health Record Screening in the Pediatric ICU
Molly Zimmerman1, Eryn Brown, Myra Schmaderer
1Author Affiliations: College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA (Ms Zimmerman, Brown, Dr Schmaderer, and Dr Struwe).
Insights
Improving sepsis recognition in pediatric intensive care units (PICUs) is crucial. An electronic health record (EHR) sepsis screen using vital signs and lab data demonstrated improved detection rates.
Area of Science:
- Pediatric critical care medicine
- Health informatics
- Clinical decision support systems
Background:
- Early sepsis recognition and intervention in children reduce hospital stay and mortality.
- Pediatric intensive care unit (PICU) stakeholders sought to enhance sepsis recognition per Improving Pediatric Sepsis Outcomes Collaborative guidelines.
Purpose of the Study:
- To determine optimal screening variables for an electronic health record (EHR)-embedded sepsis tool.
- To improve sepsis recognition within the PICU setting.
Main Methods:
- Retrospective analysis of three EHR sepsis screen versions.
- Tested triggers based on vital signs and/or laboratory results.
Main Results:
- The sepsis screen combining vital signs and laboratory findings yielded the best performance.
- Achieved a sensitivity of 83.3% and a specificity of 76%.
Conclusions:
- EHR-embedded sepsis screening tools monitoring documented variables can effectively identify potential sepsis.
- These tools help mitigate over-triggering, improving clinical workflow.
Background:
Early recognition and intervention of sepsis in the pediatric population have been shown to decrease hospital length of stay and mortality rates. Stakeholders within a pediatric intensive care unit (PICU) identified a need to improve sepsis recognition in compliance with the Improving Pediatric Sepsis Outcomes Collaborative recommendations.
Purpose:
The purpose of this study was to identify appropriate screening variables in an electronic health record (EHR)-embedded sepsis screening tool to improve sepsis recognition in the PICU setting.
Methods:
A retrospective data analysis was conducted to test 3 versions of an EHR sepsis screen including triggers based on vital signs and/or laboratory results.
Results:
Of the 3 tested versions, the sepsis screen version that triggered based on both vital signs and laboratory findings showed the most promising results with a sensitivity of 83.3% and a specificity of 76%.
Conclusions:
EHR-embedded sepsis screens that monitor documented variables can identify potential sepsis while avoiding over-triggers.
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