Emergency department sepsis screening tool decreases time to antibiotics in patients with sepsis

Shah, Tanvi; Sterk, Ethan; Rech, Megan A.

doi:10.1016/j.ajem.2018.01.060

Cited by 25 publications

(27 citation statements)

References 17 publications

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“…Previous research, mainly in emergency departments, has found that providing nurses with training and education, paired with appropriate tools can improve sepsis care (Tromp et al 2010;Bruce et al 2015;Drahnak et al 2016;McCaffery et al 2016;Torsvik at al. 2016;Shah et al 2018).…”

Section: Discussionmentioning

confidence: 99%

Sepsis knowledge, skills and attitudes among ward-based nurses

Edwards

Jones

2021

Br J Nurs

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Background: Nurses are in a prime position to identify sepsis early by screening patients for sepsis, a skill that should be embedded into their daily practice. However, compliance with the sepsis bundle remains low. Aims: To explore the effects of sepsis training on knowledge, skills and attitude among ward-based nurses. Methods: Registered nurses from 16 acute surgical and medical wards were invited to anonymously complete a questionnaire. Findings: Response rate was 39% (98/250). Nurses with sepsis training had better knowledge of the National Early Warning Score 2 for sepsis screening, and the systemic inflammatory response syndrome (SIRS) criteria, demonstrated a more positive attitude towards sepsis screening and management, were more confident in screening patients for sepsis and more likely to have screened a patient for sepsis. Conclusions: Sepsis training improves nurses' attitudes, knowledge and confidence with regards to sepsis screening and management, resulting in adherence to evidence-based care, and should become mandatory for all clinical staff.

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Section: Discussionmentioning

confidence: 99%

Sepsis knowledge, skills and attitudes among ward-based nurses

Edwards

Jones

2021

Br J Nurs

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“…This study demonstrated that the majority of antibiotics were prescribed to patients who did not meet established criteria (SIRS/qSOFA) for sepsis. There is a prominent research emphasis dedicated to identifying sepsis in the ED with a focus on targeting early initiation of antibiotics 25 . In septic shock, delays in antibiotic administration in the ED have been associated with increased mortality, 26–28 increasing the pressure on clinicians to make early decisions when prescribing antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Appropriateness of antibiotic prescribing in the Emergency Department

Denny

Gartside

Alcorn

et al. 2018

Journal of Antimicrobial Chemotherapy

108

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BackgroundAntibiotics are some of the most commonly prescribed drugs in the Emergency Department (ED) and yet data describing the overall appropriateness of antibiotic prescribing in the ED is scarce.ObjectivesTo describe the appropriateness of antibiotic prescribing in the ED.MethodsA retrospective, observational study of current practice. All patients who presented to the ED during the study period and were prescribed at least one antibiotic were included. Specialists from Infectious Disease, Microbiology and Emergency Medicine and a Senior Pharmacist assessed antibiotic appropriateness against evidence-based guidelines.ResultsA total of 1019 (13.6%) of patient presentations involved the prescription of at least one antibiotic. Of these, 640 (62.8%) antibiotic prescriptions were assessed as appropriate, 333 (32.7%) were assessed as inappropriate and 46 (4.5%) were deemed to be not assessable. Adults were more likely to receive an inappropriate antibiotic prescription than children (36.9% versus 22.9%; difference 14.1%, 95% CI 7.2%–21.0%). Patients who met quick Sepsis-related Organ Failure Assessment (qSOFA) criteria were more likely to be prescribed inappropriate antibiotics (56.7% versus 36.1%; difference 20.5%, 95% CI, 2.4%–38.7%). There was no difference in the incidence of appropriate antibiotic prescribing based on patient gender, disposition (admitted/discharged), reason for antibiotic administration (treatment/prophylaxis) or time of shift (day/night). ConclusionsInappropriate administration of antibiotics can lead to unnecessary adverse events, treatment failure and antimicrobial resistance. With over one in three antibiotic prescriptions in the ED being assessed as inappropriate, there is a pressing need to develop initiatives to improve antibiotic prescribing to prevent antibiotic-associated patient and community harms.

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“…In the present study, blood cultures were collected within 3 hours from triage for the majority of bacteraemic patients (84.1%), and in the subgroup of sepsis or septic shock (84.9%), a percentage that is comparable to previous studies with septic patients in the ED or Intensive Care Unit. 18,19 According to Surviving Sepsis Campaign guidelines, blood cultures should be obtained rapidly after recognition of sepsis and prior to the initiation of antibiotic treatment. 4 Presence of fever was associated with a more rapid collection of blood cultures, once more underlining the difficulty of emergency physicians to adequately identify infection, in the absence of fever.…”

Section: Discussionmentioning

confidence: 99%

Predictors for delayed antibiotic administration among bacteraemic patients in the Emergency Department: Differences between medical and surgical interns

Papadimitriou‐Olivgeris

Perdikis²,

Cois³

et al. 2020

Eur J Clin Investigation

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Despite advances in medicine, bloodstream infections (BSIs) are still associated with increased morbidity and mortality, with estimated 157 000 deaths annually in Europe (among 1 200 000 BSIs) and 72 000 to 85 000 in United States of America (among 536 000 to 628 000 BSIs). 1-3 Appropriateness and timely administration of antibiotic treatment is associated with improved outcomes among bacteraemic patients. 3-5

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Emergency department sepsis screening tool decreases time to antibiotics in patients with sepsis

Cited by 25 publications

References 17 publications

Sepsis knowledge, skills and attitudes among ward-based nurses

Sepsis knowledge, skills and attitudes among ward-based nurses

Appropriateness of antibiotic prescribing in the Emergency Department

Predictors for delayed antibiotic administration among bacteraemic patients in the Emergency Department: Differences between medical and surgical interns

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