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An electronic warning system helps reduce the time to diagnosis of sepsis
OBJECTIVE: To describe the improvements of an early warning system for the identification of septic patients on the time to diagnosis, antibiotic delivery, and mortality. METHODS: This was an observational cohort study that describes the successive improvements made over a period of 10 years using a...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Associação de Medicina Intensiva Brasileira -
AMIB
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334482/ https://www.ncbi.nlm.nih.gov/pubmed/30570029 http://dx.doi.org/10.5935/0103-507X.20180059 |
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author | Westphal, Glauco Adrieno Pereira, Aline Braz Fachin, Silvia Maria Sperotto, Geonice Gonçalves, Maurício Albino, Lucimeri Bittencourt, Rodolfo Franzini, Vanessa de Rossi Koenig, Álvaro |
author_facet | Westphal, Glauco Adrieno Pereira, Aline Braz Fachin, Silvia Maria Sperotto, Geonice Gonçalves, Maurício Albino, Lucimeri Bittencourt, Rodolfo Franzini, Vanessa de Rossi Koenig, Álvaro |
author_sort | Westphal, Glauco Adrieno |
collection | PubMed |
description | OBJECTIVE: To describe the improvements of an early warning system for the identification of septic patients on the time to diagnosis, antibiotic delivery, and mortality. METHODS: This was an observational cohort study that describes the successive improvements made over a period of 10 years using an early warning system to detect sepsis, including systematic active manual surveillance, electronic alerts via a telephonist, and alerts sent directly to the mobile devices of nurses. For all periods, after an alert was triggered, early treatment was instituted according to the institutional sepsis guidelines. RESULTS: In total, 637 patients with sepsis were detected over the study period. The median triage-to-diagnosis time was reduced from 19:20 (9:10 - 38:15) hours to 12:40 (2:50 - 23:45) hours when the manual surveillance method was used (p = 0.14), to 2:10 (1:25 - 2:20) hours when the alert was sent automatically to the hospital telephone service (p = 0.014), and to 1:00 (0:30 - 1:10) hour when the alert was sent directly to the nurse's mobile phone (p = 0.016). The diagnosis-to-antibiotic time was reduced to 1:00 (0:55 - 1:30) hours when the alert was sent to the telephonist and to 0:45 (0:30 - 1:00) minutes when the alert was sent directly to the nurse's mobile phone (p = 0.02), with the maintenance of similar values over the following years. There was no difference in the time of treatment between survivors and non-survivors. CONCLUSION: Electronic systems help reduce the triage-to-diagnosis time and diagnosis-to-antibiotic time in patients with sepsis. |
format | Online Article Text |
id | pubmed-6334482 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Associação de Medicina Intensiva Brasileira -
AMIB |
record_format | MEDLINE/PubMed |
spelling | pubmed-63344822019-01-24 An electronic warning system helps reduce the time to diagnosis of sepsis Westphal, Glauco Adrieno Pereira, Aline Braz Fachin, Silvia Maria Sperotto, Geonice Gonçalves, Maurício Albino, Lucimeri Bittencourt, Rodolfo Franzini, Vanessa de Rossi Koenig, Álvaro Rev Bras Ter Intensiva Original Article OBJECTIVE: To describe the improvements of an early warning system for the identification of septic patients on the time to diagnosis, antibiotic delivery, and mortality. METHODS: This was an observational cohort study that describes the successive improvements made over a period of 10 years using an early warning system to detect sepsis, including systematic active manual surveillance, electronic alerts via a telephonist, and alerts sent directly to the mobile devices of nurses. For all periods, after an alert was triggered, early treatment was instituted according to the institutional sepsis guidelines. RESULTS: In total, 637 patients with sepsis were detected over the study period. The median triage-to-diagnosis time was reduced from 19:20 (9:10 - 38:15) hours to 12:40 (2:50 - 23:45) hours when the manual surveillance method was used (p = 0.14), to 2:10 (1:25 - 2:20) hours when the alert was sent automatically to the hospital telephone service (p = 0.014), and to 1:00 (0:30 - 1:10) hour when the alert was sent directly to the nurse's mobile phone (p = 0.016). The diagnosis-to-antibiotic time was reduced to 1:00 (0:55 - 1:30) hours when the alert was sent to the telephonist and to 0:45 (0:30 - 1:00) minutes when the alert was sent directly to the nurse's mobile phone (p = 0.02), with the maintenance of similar values over the following years. There was no difference in the time of treatment between survivors and non-survivors. CONCLUSION: Electronic systems help reduce the triage-to-diagnosis time and diagnosis-to-antibiotic time in patients with sepsis. Associação de Medicina Intensiva Brasileira - AMIB 2018 /pmc/articles/PMC6334482/ /pubmed/30570029 http://dx.doi.org/10.5935/0103-507X.20180059 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Westphal, Glauco Adrieno Pereira, Aline Braz Fachin, Silvia Maria Sperotto, Geonice Gonçalves, Maurício Albino, Lucimeri Bittencourt, Rodolfo Franzini, Vanessa de Rossi Koenig, Álvaro An electronic warning system helps reduce the time to diagnosis of sepsis |
title | An electronic warning system helps reduce the time to diagnosis of
sepsis |
title_full | An electronic warning system helps reduce the time to diagnosis of
sepsis |
title_fullStr | An electronic warning system helps reduce the time to diagnosis of
sepsis |
title_full_unstemmed | An electronic warning system helps reduce the time to diagnosis of
sepsis |
title_short | An electronic warning system helps reduce the time to diagnosis of
sepsis |
title_sort | electronic warning system helps reduce the time to diagnosis of
sepsis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334482/ https://www.ncbi.nlm.nih.gov/pubmed/30570029 http://dx.doi.org/10.5935/0103-507X.20180059 |
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