ED Tracking Sheet Implementation
- Conditions
- SepsisSystemic Inflammatory Response SyndromeSevere Sepsis
- Interventions
- Procedure: ED Sepsis Tracking Sheet
- Registration Number
- NCT05213923
- Lead Sponsor
- Dartmouth-Hitchcock Medical Center
- Brief Summary
The purpose of this study is to assess whether implementation of an ED Sepsis Tracking Sheet effects the percentage of goal-directed sepsis criteria met in a tertiary care academic Emergency Department.
- Detailed Description
Sepsis remains a common cause of morbidity and mortality in the hospital setting. Accurate diagnosis and timely initiation of therapy are important drivers of patient-centered outcomes in sepsis management. Compliance with the core measures listed in the surviving sepsis campaign guidelines has been variable.
An ED-specific Sepsis Tracking Sheet (STS) - a tool for implementing and documenting critical actions in sepsis management - was created at our institution by a team of physicians, nurses, and ED pharmacists. Dedicated ED pharmacists were instructed to fill this sheet within one hour of the sepsis-specific best practice advisory (BPA) being activated in the ED. Core measures associated with the one hour and three hour sepsis bundles were tracked and outcomes were compared pre- and post-implementation of the STS.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 194
- Over 18 years old
- Initially evaluated in the DHMC Lebanon Emergency Department
- Activated sepsis BPA upon initial presentation (triage history consistent with infection combined with 2 or more SIRS criteria? Are these the criteria that trigger our sepsis BPA?)
- Patients who are transferred to the DHMC Lebanon Emergency Department from another facility
- Patients with absent data regarding one or more of the goal-directed sepsis criteria
- Patients who did not initially meet criteria to trigger the sepsis BPA, but developed sepsis later in their hospital course
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Post-intervention ED Sepsis Tracking Sheet Patients presenting to the Emergency Department meeting severe sepsis criteria following implementation of an ED Sepsis Tracking Sheet
- Primary Outcome Measures
Name Time Method Percentage of goal-directed sepsis criteria met Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks Goal-directed sepsis criteria involve the following: 1) Was an initial lactate obtained? 2) Were two sets of blood cultures sent? 3) Were antibiotics given within one hour of identification of severe sepsis? 4) Was the patient given an initial IV fluid bolus? 5) Was a repeat lactate sent if the initial lactate was elevated? These five criteria will be assessed as "met" or "not met" for each patient. The total of "met" and "not met" criteria will be aggregated across patients. The percentage of goal-directed sepsis criteria met will be calculated as "met" criteria divided by the sum of "met" plus "not met" criteria.
- Secondary Outcome Measures
Name Time Method Length of hospital stay Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks Time of ED presentation to the time of in-hospital death or hospital discharge, measured in days.
In-hospital mortality Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks Death attributed to any cause occurring at any time between the patient's ED presentation and hospital discharge.
Trial Locations
- Locations (1)
Dartmouth-Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States