ED Tracking Sheet Implementation
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 194
- 试验地点
- 2
- 主要终点
- Percentage of goal-directed sepsis criteria met
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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?)
排除标准
- •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
结局指标
主要结局
Percentage of goal-directed sepsis criteria met
时间窗: 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.
次要结局
- Length of hospital stay(Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks)
- In-hospital mortality(Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks)
研究者
Harman S. Gill
Principal Investigator, Assistant Professor of Emergency Medicine and Medicine
Dartmouth-Hitchcock Medical Center