Emergency department sepsis screening tool decreases time to antibiotics in patients with sepsis. Journal Article

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Authors: Shah, T; Sterk, E; Rech, MA
Article Title: Emergency department sepsis screening tool decreases time to antibiotics in patients with sepsis.
Abstract: Recent literature has highlighted the importance of early identification and treatment of sepsis; however, limited data exists to help recognize sepsis in the emergency department (ED) through use of a screening tool. The purpose of this study was to evaluate the impact of a sepsis screening tool implemented in an academic medical center ED on compliance with the 3-hour sepsis bundle. This was a retrospective cohort study that included a total of 115 patients, of which 58 were in the pre-tool group and 57 were in the post-tool group. There was no difference in 3-hour bundle compliance between groups (36.2% vs. 47.4%, P?=?0.26). There was no difference in the following bundle components: lactate (79.3% vs. 80.7%, P?=?0.85), blood cultures (86.2% vs. 96.5%, P?=?0.09), blood cultures before administering antibiotics (91.4% vs. 100%, P?=?0.57) and adequate fluids administration (44.7% vs. 41.9%, P?=?0.820). A significantly higher number of patients received antibiotics within 3?h in the post-tool group (58.6% vs. 89.5%, P?0.001). Statistically significant secondary outcomes included average time to antibiotics (P?=?0.04), administering antibiotics within an hour (P?>?0.001), and ICU length of stay (P?=?0.03). There was no difference in 30-day mortality, however mortality was numerically lower in the post-tool group (36.2% vs. 26.3%, P?=?0.25). Although implementation of an ED sepsis screening tool did not increase 3-hour bundle compliance, it did increase the proportion of patients receiving timely antimicrobial therapy and demonstrated a trend towards decreased mortality.
Journal Title: The American Journal of Emergency Medicine
ISSN: 1532-8171; 0735-6757
Publisher: Unknown  
Date Published: 2018