OBJECTIVE Sepsis causes morbidity and mortality in pediatric patients, but timely antibiotic administration can improve sepsis outcomes. The pharmacy department can affect the time from order to delivery of antibiotics. By evaluating the pharmacy process, this study aimed to decrease the time from antibiotic order to delivery to within 45 minutes. METHODS All antibiotic orders placed following a positive sepsis screen for acute care patients at a freestanding children's hospital from April 1, 2019, to December 31, 2019, were reviewed. Lean Six Sigma methodology including process mapping was used to identify and implement improvements, including educational interventions for providers. Outcome measures included time from antibiotic order placement to delivery and to administration. Additional assessment of process measures included evaluation of order priority, PowerPlan (an internally created order set) use, and delivery method. RESULTS Ninety-eight antibiotic orders for 85 patients were evaluated. In an individual chart of antibiotic delivery time, a trend towards faster delivery time was observed after interventions. Stat orders (40.5 minutes [IQR, 19.5–48]) were delivered more quickly than routine orders (51 minutes [IQR, 45–65]; p < 0.001). Orders using the PowerPlan (20.5 minutes [IQR, 18.5–38]) were delivered more quickly than those that did not (47 minutes [IQR, 34–64]; p < 0.01). Shorter time to administration was observed with pneumatic tube delivery (41 minutes [IQR, 20–50]) than with direct delivery to a health care provider (51 minutes [IQR, 31–83]; p < 0.05) or to the automated dispensing cabinet's refrigerator (47 minutes [IQR, 41–62]; p < 0.0001). CONCLUSIONS Multifactorial coordinated interventions within the pharmacy department improve medication delivery time for pediatric sepsis antibiotic orders.
The Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes (IPSO) collaborative is a multi-center quality improvement (QI) learning collaborative of 61 U.S. children’s hospitals that seeks to improve sepsis outcomes through collaborative learning and reliable implementation of evidence-based interventions in pediatric emergency departments, intensive care units, general care units, and hematology/oncology units. Specifically, IPSO’s goals are to decrease sepsis-attributable mortality and prevent hospital-onset sepsis among children. The following 10 abstracts represent a select group of projects undertaken by IPSO participating hospitals that were presented at one of three collaborative events in 2020 and 2021. IPSO’s Research Workgroup reviewed all submitted abstracts and selected the top 10 for inclusion in this Supplement
The Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes (IPSO) collaborative is a multi-center quality improvement (QI) learning collaborative of 61 U.S. children’s hospitals that seeks to improve sepsis outcomes through collaborative learning and reliable implementation of evidence-based interventions in pediatric emergency departments, intensive care units, general care units, and hematology/oncology units. Specifically, IPSO’s goals are to decrease sepsis-attributable mortality and prevent hospital-onset sepsis among children. The following 10 abstracts represent a select group of projects undertaken by IPSO participating hospitals that were presented at one of three collaborative events in 2020 and 2021. IPSO’s Research Workgroup reviewed all submitted abstracts and selected the top 10 for inclusion in this Supplement
The Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes (IPSO) collaborative is a multi-center quality improvement (QI) learning collaborative of 61 U.S. children’s hospitals that seeks to improve sepsis outcomes through collaborative learning and reliable implementation of evidence-based interventions in pediatric emergency departments, intensive care units, general care units, and hematology/oncology units. Specifically, IPSO’s goals are to decrease sepsis-attributable mortality and prevent hospital-onset sepsis among children. The following 10 abstracts represent a select group of projects undertaken by IPSO participating hospitals that were presented at one of three collaborative events in 2020 and 2021. IPSO’s Research Workgroup reviewed all submitted abstracts and selected the top 10 for inclusion in this Supplement
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