Implementation of a real-time computerized sepsis alert in nonintensive care unit patients*
Abstract
Objective Early therapy of sepsis involving fluid resuscitation and antibiotic administration has been shown to improve patient outcomes. A proactive tool to identify patients at risk for developing sepsis may decrease time to interventions and improve patient outcomes. The objective of this study was to evaluate whether the implementation of an automated sepsis screening and alert system facilitated early appropriate interventions. Design Prospective, observational, pilot study. Setting Six medicine wards in Barnes-Jewish Hospital, a 1250-bed academic medical center. Patients Patients identified by the sepsis screen while admitted to a medicine ward were included in the study. A total of 300 consecutive patients were identified comprising the nonintervention group (n=200) and the intervention group (n=100). Interventions A real-time sepsis alert was implemented for the intervention group, which notified the charge nurse on the patient's hospital ward by text page. Measurements and main results Within 12 hrs of the sepsis alert, interventions by the treating physicians were assessed, including new or escalated antibiotics, intravenous fluid administration, oxygen therapy, vasopressors, and diagnostic tests. After exclusion of patients without commitment to aggressive management, 181 patients in the nonintervention group and 89 patients in the intervention group were analyzed. Within 12 hrs of the sepsis alert, 70.8% of patients in the intervention group had received≥1 interve…
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Many models have been developed to improve timely identification of sepsis, but their lack of adoption has led to an implementation gap in early warning systems for sepsis.
“Many models have been developed to improve timely identification of sepsis,4,5,6,7,8,9 but their lack of adoption has led to an implementation gap in early warning systems for sepsis.10,11”
From External validation of a widely implemented proprietary sepsis prediction model in hospitalized patients (2021) · cites this paper as [4]
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- Authors
- Sawyer, A. M., Deal, E. N., Labelle, A. J., Witt, C., Thiel, S. W., Heard, K., Reichley, R. M., Micek, S. T., & Kollef, M. H.
- Affiliations
- Barnes-Jewish Hospital (US)
- Venue
- Critical Care Medicine
- Published
- 2011-03
- Volume
- 39
- Issue
- 3
- Pages
- 469-473
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2034769820
- Cited by
- 169
- References
- 0
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 10 · 2021: 13 · 2020: 11 · 2019: 16 · 2018: 13 · 2017: 22 · 2016: 19 · 2015: 16 · 2014: 11 · 2013: 5 · 2012: 9
- FWCI
- 3.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- sepsis, sepsis alerts, automated clinical decision support, sepsis screening, antibiotic escalation, fluid resuscitation
- MeSH terms
- Academic Medical Centers, Anti-Bacterial Agents, Cross Infection, Diagnosis, Computer-Assisted, Female, Fluid Therapy, Hospital Bed Capacity, 500 and over, Humans, Male, Middle Aged, Oxygen Inhalation Therapy, Pilot Projects, Prospective Studies, Sepsis, Early Diagnosis, Clinical Alarms
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