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.
Keywords
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Article Info
Publication History
Published online: January 23, 2018
Accepted:
January 21,
2018
Received in revised form:
January 10,
2018
Received:
May 19,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
