Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;12(3):469-478.
doi: 10.1055/s-0041-1730027. Epub 2021 May 26.

Evaluation of a Sepsis Alert in the Pediatric Acute Care Setting

Karen DiValerio Gibbs  1 , Yan Shi  2 , Nicole Sanders  2 , Anthony Bodnar  2 , Terri Brown  2 , Mona D Shah  3 , Lauren M Hess  2   4
Affiliations

Evaluation of a Sepsis Alert in the Pediatric Acute Care Setting

Karen DiValerio Gibbs et al. Appl Clin Inform. 2021 May.

Abstract

Background: Severe sepsis can cause significant morbidity and mortality in pediatric patients. Early recognition and treatment are vital to improving patient outcomes.

Objective: The study aimed to evaluate the impact of a best practice alert in improving recognition of sepsis and timely treatment to improve mortality in the pediatric acute care setting.

Methods: A multidisciplinary team adapted a sepsis alert from the emergency room setting to facilitate identification of sepsis in acute care pediatric inpatient areas. The sepsis alert included clinical decision support to aid in timely treatment, prompting the use of intravenous fluid boluses, and antibiotic administration. We compared sepsis-attributable mortality, time to fluid and antibiotic administration, proportion of patients who required transfer to a higher level of care, and antibiotic days for the year prior to the sepsis alert (2017) to the postimplementation phase (2019).

Results: We had 79 cases of severe sepsis in 2017 and 154 cases in 2019. Of these, we found an absolute reduction in both 3-day sepsis-attributable mortality (2.53 vs. 0%) and 30-day mortality (3.8 vs. 1.3%) when comparing the pre- and postintervention groups. Though our analysis was underpowered due to small sample size, we also identified reductions in median time to fluid and antibiotic administration, proportion of patients who were transferred to the intensive care unit, and no observable increase in antibiotic days.

Conclusion: Electronic sepsis alerts may assist in improving recognition of sepsis and support timely antibiotic and fluid administration in pediatric acute care settings.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Sepsis scoring. LDA, lines, drains, and airways documentation to indicate presence of a central line.
Fig. 2
Fig. 2
Sepsis alert for patient care assistants.
Fig. 3
Fig. 3
Sepsis alert for nurses.
Fig. 4
Fig. 4
Sepsis alert for physicians and advanced practice providers.
Fig. 5
Fig. 5
Severe sepsis and sepsis attributable mortality for pediatric patients in acute care at time zero from 2017 to 2019.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Balamuth F, Weiss S L, Neuman M I. Pediatric severe sepsis in U.S. children's hospitals. Pediatr Crit Care Med. 2014;15(09):798–805. - PMC - PubMed
    1. Scott H F, Balamuth F, Paul R M. Sepsis bundles and mortality among pediatric patients. JAMA. 2018;320(21):2271. - PMC - PubMed
    1. Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network . Weiss S L, Fitzgerald J C, Pappachan J. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med. 2015;191(10):1147–1157. - PMC - PubMed
    1. Cruz A T, Williams E A, Graf J M. Test characteristics of an automated age- and temperature-adjusted tachycardia alert in pediatric septic shock. Pediatr Emerg Care. 2012;28(09):889–894. - PubMed
    1. Lloyd J K, Ahrens E A, Clark D, Dachenhaus T, Nuss K E. Automating a manual sepsis screening tool in a pediatric emergency department. Appl Clin Inform. 2018;9(04):803–808. - PMC - PubMed

Substances