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Author Narayanan, Navaneeth ♦ Gross, A. Kendall ♦ Pintens, Megan ♦ Fee, Christopher ♦ MacDougall, Conan
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Management & auxiliary services ♦ General management ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Bacterial Infections and Mycoses ♦ Diseases ♦ Chemical Actions and Uses ♦ Chemicals and Drugs ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Physical Phenomena ♦ Mathematical Concepts ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Services Administration ♦ Health Care
Subject Keyword Discipline Emergency ♦ Discipline Medicine ♦ Clinical Protocols ♦ Electronic Health Records ♦ Emergency Service, Hospital ♦ Outcome And Process Assessment (health Care) ♦ Sepsis ♦ Therapy ♦ Aged ♦ Algorithms ♦ Anti-bacterial Agents ♦ Therapeutic Use ♦ Female ♦ Hospital Mortality ♦ Humans ♦ Length Of Stay ♦ Statistics & Numerical Data ♦ Male ♦ Mortality ♦ Time Factors ♦ Journal Article ♦ Observational Study
Abstract BACKGROUND: Severe sepsis and septic shock are a major health concern worldwide. The objective of this study is to determine if Severe Sepsis Best Practice Alert (SS-BPA) implementation was associated with improved processes of care and clinical outcomes among patients with severe sepsis or septic shock presenting to the emergency department (ED). METHODS: This is a single-center, before-and-after observational study. The intervention group (n = 103) consisted of adult patients presenting to the ED with severe sepsis or septic shock during a 7-month period after implementation of the SS-BPA. The control group (n = 111) consisted of patients meeting the same criteria over a prior 7-month period. The SS-BPA primarily acts by automated, real-time, algorithm-based detection of severe sepsis or septic shock via the electronic medical record system. The primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), time to antibiotic administration, and proportion of patients who received antibiotics within the target 60 minutes. RESULTS: Time to antibiotics was significantly reduced in the SS-BPA cohort (29 vs 61.5 minutes, P < .001). In addition, there was a higher proportion of patients who received antibiotics within 60 minutes (76.7 vs 48.6%; P < .001). On multivariable analysis, in-hospital mortality was not significantly reduced in the intervention group (odds ratio, 0.64; 95% confidence interval, 0.26-1.57). Multivariable analysis of LOS indicated a significant reduction among patients in the SS-BPA cohort (geometric mean ratio, 0.66; 95% confidence interval, 0.53-0.82). CONCLUSION: Implementation of the SS-BPA for severe sepsis or septic shock among ED patients is associated with significantly improved timeliness of antibiotic administration and reduced hospital LOS.
Description Author Affiliation: Narayanan N ( Department of Clinical Pharmacy, University of California, San Francisco School of Pharmacy, San Francisco, CA 94143. Electronic address: navan12@pharmacy.rutgers.edu.); Gross AK ( Department of Pharmaceutical Services, University of California, San Francisco Medical Center, San Francisco, CA 94143.); Pintens M ( Department of Pharmaceutical Services, University of California, San Francisco Medical Center, San Francisco, CA 94143.); Fee C ( Department of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco, CA 94143.); MacDougall C ( Department of Clinical Pharmacy, University of California, San Francisco School of Pharmacy, San Francisco, CA 94143.)
ISSN 07356757
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2016-02-01
Publisher Place United States
e-ISSN 15328171
Journal The American Journal of Emergency Medicine
Volume Number 34
Issue Number 2


Source: WHO-Global Index Medicus