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785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance

BACKGROUND: Sepsis—a life-threatening organ dysfunction caused by a dysregulated host response to infection—is a major public health burden and is considered a leading cause of preventable death. Although sepsis care guidelines have been established by the Surviving Sepsis Campaign, improved complia...

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Autores principales: Balankura, Tonnam, Odom, Ashley
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811204/
http://dx.doi.org/10.1093/ofid/ofz360.853
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author Balankura, Tonnam
Odom, Ashley
author_facet Balankura, Tonnam
Odom, Ashley
author_sort Balankura, Tonnam
collection PubMed
description BACKGROUND: Sepsis—a life-threatening organ dysfunction caused by a dysregulated host response to infection—is a major public health burden and is considered a leading cause of preventable death. Although sepsis care guidelines have been established by the Surviving Sepsis Campaign, improved compliance monitoring and analytics are required for sustainable improvement in clinical processes and patient outcomes. Using the Optum Pan-Therapeutic (PanTher) electronic medical record database, we developed granular process measures and a data analytics toolkit to measure compliance with sepsis care guidelines and provide insight into areas for improvement. METHODS: We identified 15,421 episodes of adult patients in January-June, 2017 with sufficient evidence of suspected sepsis. Episodes qualified if they: (1) met at least two of the quick Sequential Organ Failure Assessment (qSOFA) clinical criteria, (2) had a blood culture order initiated, and (3) had a serum lactate order. For these 15,421 episodes, we obtained the timestamps of antibiotics order and administration, blood culture order and collection, and when at least two of the qSOFA criteria were first met. Based on Surviving Sepsis Campaign care protocols for suspected Sepsis, we measured compliance for the timeliness of antibiotics administration and blood culture collection using a threshold of 3 hours after when the qSOFA criteria were first met. RESULTS: Compliance of the antibiotics administration and blood culture collection measures were found in 7,647/10,343 (74%) episodes and 1,219/1,530 (80%) episodes, respectively. The median times from when the qSOFA criteria were first met to antibiotics administration and blood culture collection were 77 minutes and 5 minutes, respectively. CONCLUSION: We have developed new process measures and a data analytics toolkit to monitor compliance rates and identify episodes where sepsis protocols are not followed according to sepsis care guidelines. These noncompliant episodes are opportunities for care providers to identify root causes of noncompliance and proactively work toward improved adherence to sepsis care guidelines. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68112042019-10-29 785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance Balankura, Tonnam Odom, Ashley Open Forum Infect Dis Abstracts BACKGROUND: Sepsis—a life-threatening organ dysfunction caused by a dysregulated host response to infection—is a major public health burden and is considered a leading cause of preventable death. Although sepsis care guidelines have been established by the Surviving Sepsis Campaign, improved compliance monitoring and analytics are required for sustainable improvement in clinical processes and patient outcomes. Using the Optum Pan-Therapeutic (PanTher) electronic medical record database, we developed granular process measures and a data analytics toolkit to measure compliance with sepsis care guidelines and provide insight into areas for improvement. METHODS: We identified 15,421 episodes of adult patients in January-June, 2017 with sufficient evidence of suspected sepsis. Episodes qualified if they: (1) met at least two of the quick Sequential Organ Failure Assessment (qSOFA) clinical criteria, (2) had a blood culture order initiated, and (3) had a serum lactate order. For these 15,421 episodes, we obtained the timestamps of antibiotics order and administration, blood culture order and collection, and when at least two of the qSOFA criteria were first met. Based on Surviving Sepsis Campaign care protocols for suspected Sepsis, we measured compliance for the timeliness of antibiotics administration and blood culture collection using a threshold of 3 hours after when the qSOFA criteria were first met. RESULTS: Compliance of the antibiotics administration and blood culture collection measures were found in 7,647/10,343 (74%) episodes and 1,219/1,530 (80%) episodes, respectively. The median times from when the qSOFA criteria were first met to antibiotics administration and blood culture collection were 77 minutes and 5 minutes, respectively. CONCLUSION: We have developed new process measures and a data analytics toolkit to monitor compliance rates and identify episodes where sepsis protocols are not followed according to sepsis care guidelines. These noncompliant episodes are opportunities for care providers to identify root causes of noncompliance and proactively work toward improved adherence to sepsis care guidelines. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6811204/ http://dx.doi.org/10.1093/ofid/ofz360.853 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Balankura, Tonnam
Odom, Ashley
785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance
title 785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance
title_full 785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance
title_fullStr 785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance
title_full_unstemmed 785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance
title_short 785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance
title_sort 785. identifying opportunities to improve adherence to sepsis care guidelines compliance
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811204/
http://dx.doi.org/10.1093/ofid/ofz360.853
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