Impact of pharmacist involvement on hospital sepsis response teams

Data describing the impact of pharmacists on early sepsis management performed by multidisciplinary sepsis response teams are limited to the emergency department and lack contemporaneous comparator groups. Objectives of the study reported here included determining if pharmacist presence on a sepsis response team improves sepsis bundle compliance and outcomes of hospitalized patients.

This was a single-center, retrospective cohort study of hospitalized adult patients diagnosed with severe sepsis or septic shock seen by a sepsis response team between July 2019 and July 2022. Patients were divided into 2 groups based on the presence (pharmacist present [PhP]) or absence (no pharmacist present [NPh]) of a pharmacist as a member of the sepsis response team. The primary endpoint was 1-hour bundle compliance, as defined by the Surviving Sepsis Campaign, with time zero defined as the time an alert was paged to the responding team. Secondary endpoints included rates of compliance with the Centers for Medicare and Medicaid Services 3- and 6-hour severe sepsis and septic shock (SEP-1) bundles, time to individual bundle component completion, hospital length of stay (LOS), and in-hospital mortality.

In total, 167 responses were included (91 in the PhP group and 76 in the NPh group). A pharmacist's presence resulted in improved 1-hour bundle compliance (60.4% vs 44.7%, P = 0.045), an increased rate of antibiotic administration within 1 hour of an sepsis alert page (84.6% vs 59.2%, P < 0.001), and a lower median time to antibiotic administration (51 minutes vs 108 minutes, P < 0.01). Rates of 3- and 6-hour bundle compliance, hospital LOS, and mortality were similar between the PhP and NPh groups.

Pharmacist involvement in a sepsis response team is associated with improved completion of the 1-hour bundle, specifically the early administration of broad-spectrum antibiotics. Early identification of sepsis and alerting a multidisciplinary team remain barriers to optimizing treatment.