Pharmacist impact on sepsis bundle compliance through participation on an emergency department sepsis alert team

Yarbrough, Nicholas; Bloxam, Meghan; Priano, James; Lynch, Patricia; Hunt, Lauren N; Elfman, Jennifer

doi:10.1016/j.ajem.2018.08.009

Cited by 13 publications

(14 citation statements)

References 9 publications

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“…An additional study was identified from the review of bibliographies of these previously retained studies for a total of 10 studies included in this systematic review (Figure 1). 12‐21 These 10 studies include 1772 patients with sepsis or septic shock, were conducted during 2006‐2019, and published during the time period of 2008‐2022.…”

Section: Resultsmentioning

confidence: 99%

“…Pharmacists were specifically identified as key participants in all included studies per the inclusion criteria of the systematic review. Eight studies specifically noted a pharmacist responding to the bedside and interacting with other members of the health care team to consult and facilitate antibiotic order placement and verification, 13‐19,21 one study described pharmacists “huddling” with providers when notified of a sepsis notification, 20 and one study described pharmacists calling the nursing unit if no antibiotics were placed after 15 min of a sepsis alert and facilitating antibiotic ordering if needed, including a protocol which allowed for the pharmacist to select antibiotics if the provider was engaged in other aspects of care 12 . Six studies compared a sepsis bundle response or sepsis quality improvement initiative which included a pharmacist in some capacity, with the comparator group representing prior or concurrent care of sepsis patients without the bundle or quality improvement initiative (eg, historical control) 12‐14,16,17,19 .…”

Section: Resultsmentioning

confidence: 99%

Section: Studies Includedmentioning

confidence: 99%

“…An overview of included studies is presented in Table 1. Six studies were retrospective, observational cohorts, 12,14,15,[17][18][19] three studies were prospective, observational cohorts, 13,16,21 and a single study was a randomized, controlled, quality improvement initiative. 20 All of the studies occurred in hospitalized, adult patients.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Atkins

Bastin

Morgan

et al. 2022

J Am Coll Clin Pharm

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Introduction Sepsis is a life‐threatening medical emergency and a leading cause of morbidity and mortality worldwide. Reductions in time to antibiotics in patients presenting with sepsis or septic shock are associated with reduced mortality, and Surviving Sepsis Campaign guidelines recommend antibiotics within 1 h of recognition. Pharmacists are well‐equipped to help navigate the therapeutic and operational challenges associated with achieving this goal. Objectives To assess the association of pharmacist involvement in sepsis response with time to antibiotics in hospitalized patients with sepsis and septic shock. Methods A systematic review of the following databases was conducted: PubMed/MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Studies must have included a designated role of an individual pharmacist in the management of sepsis or septic shock and not be considered an operational change. The primary outcome of interest was time to antibiotic administration, with secondary outcomes including intensive care unit (ICU) and hospital length of stay as well as in‐hospital mortality. Results We identified 10 studies including 1772 patients with sepsis or septic shock that evaluated a sepsis response in which a pharmacist was included. Studies included patients in the ICU, emergency department, and hospital ward setting. Seven studies demonstrated a significant reduction in time to antibiotics, with two other studies supporting this conclusion in extrapolation or sensitivity analysis. There was not a consistent reduction in ICU or hospital length of stay nor in‐hospital mortality between those interventions involving a pharmacist compared with their defined control groups. Conclusion Pharmacist involvement in sepsis response, often as part of a multiprofessional team‐based approach to sepsis care, is associated with a reduced time to antibiotic administration for hospitalized patients with sepsis or septic shock.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Studies Includedmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Atkins

Bastin

Morgan

et al. 2022

J Am Coll Clin Pharm

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“…Some studies found improved selection and decreased time to antibiotic administration with the addition of an ED pharmacist. [3][4][5][6][7] Despite this, ED pharmacists are not present in all hospitals, with a 2015 national survey reporting the presence of an ED pharmacist in 68.7% of respondents at 187 facilities. Even facilities with ED pharmacists often have limited hours of coverage, with at least 8 hours of coverage in 49.4% of facilities with an ED pharmacist and no weekend coverage at 34.8% of these facilities.…”

mentioning

confidence: 99%

Incorporation of Clinical Staff Pharmacists in the Emergency Department Sepsis Response at a Single Institution

Hixson¹

2022

Federal Practitioner

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Background: Sepsis is a medical emergency in which timely, appropriate antibiotic therapy improves patient outcomes. While the addition of emergency department (ED) pharmacists has been found to optimize timely antimicrobial therapy in patients with sepsis, the role of clinical staff pharmacists (CSPs) in the sepsis response has not been studied. Methods: We implemented a process of incorporating CSPs in sepsis antimicrobial management in the ED. To evaluate the accuracy of antimicrobial selection by CSPs with a sepsis antibiotic algorithm and vancomycin dosing nomogram, a retrospective cohort study was conducted on patients with sepsis presenting to the ED from December 3, 2018 through March 31, 2020. Results: Of the 157 sepsis alerts included in this study, CSPs correctly used the antibiotic selection algorithm in 154 (98%) instances and the vancomycin dosing nomogram in 147 (94%) instances. Conclusions: A process incorporating CSPs into the ED sepsis response resulted in high rates of accuracy for antibiotic selection and vancomycin dosing.

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Impact of a sepsis tracking sheet and emergency department pharmacists on sepsis compliance measures: a prospective emergency department analysis

et al. 2023

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Pharmacist impact on sepsis bundle compliance through participation on an emergency department sepsis alert team

Cited by 13 publications

References 9 publications

Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Incorporation of Clinical Staff Pharmacists in the Emergency Department Sepsis Response at a Single Institution

Impact of a sepsis tracking sheet and emergency department pharmacists on sepsis compliance measures: a prospective emergency department analysis

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