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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2017

Open Access 01-12-2017 | Research

The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock

Authors: Yaseen M. Arabi, Hasan M. Al-Dorzi, Ahmed Alamry, Ra’ed Hijazi, Sami Alsolamy, Majid Al Salamah, Hani M. Tamim, Saad Al-Qahtani, Abdulaziz Al-Dawood, Abdellatif M. Marini, Fatimah H. Al Ehnidi, Shihab Mundekkadan, Amal Matroud, Mohamed S. Mohamed, Saadi Taher

Published in: Annals of Intensive Care | Issue 1/2017

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Abstract

Background

Compliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department.

Methods

This was a pre–post two-phased implementation study that consisted of a pre-intervention phase (January 01, 2011–September 24, 2012), intervention phase I (multifaceted intervention including e-alert, from September 25, 2012–March 03, 2013) and intervention phase II when SRT was added (March 04, 2013–October 30, 2013) in a 900-bed tertiary-care academic hospital. We recorded baseline characteristics and processes of care in adult patients presenting with sepsis or septic shock. The primary outcome measures were hospital mortality. Secondary outcomes were the need for mechanical ventilation and length of stay in the intensive unit and in the hospital.

Results

After implementing the multifaceted intervention including e-alert and SRT, cases were identified with less severe clinical and laboratory abnormalities and the processes of care improved. When adjusted to propensity score, the interventions were associated with reduction in hospital mortality [for intervention phase II compared to pre-intervention: adjusted odds ratio (aOR) 0.71, 95% CI 0.58–0.85, p = 0.003], reduction in the need for mechanical ventilation (aOR 0.45, 95% CI 0.37–0.55, p < 0.0001) and reduction in ICU LOS and hospital LOS for all patients as well as ICU LOS for survivors.

Conclusions

Implementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and LOS.
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Metadata
Title
The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock
Authors
Yaseen M. Arabi
Hasan M. Al-Dorzi
Ahmed Alamry
Ra’ed Hijazi
Sami Alsolamy
Majid Al Salamah
Hani M. Tamim
Saad Al-Qahtani
Abdulaziz Al-Dawood
Abdellatif M. Marini
Fatimah H. Al Ehnidi
Shihab Mundekkadan
Amal Matroud
Mohamed S. Mohamed
Saadi Taher
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2017
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-017-0280-7

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