The Epidemiology of Sepsis

Prescott, Hallie C.

doi:10.1007/978-3-319-73506-1_2

Cited by 4 publications

(1 citation statement)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is estimated that there are 123,000 cases in England each year and 46,000 deaths. [1] Similar high levels of sepsis have been reported internationally [2–3] and sepsis is recognised by WHO as a global health priority. [4] Many countries have nationwide sepsis action plans and in England there are targets for hospitals to rapidly diagnose and treat patients with sepsis.…”

Section: Introductionmentioning

confidence: 65%

Evaluating a digital sepsis alert in a London multi-site hospital network: a natural experiment using electronic health record data

Honeyford¹,

Cooke

Kinderlerer

et al. 2019

Preprint

View full text Add to dashboard Cite

ObjectiveTo determine the impact of a digital sepsis alert on patient outcomes in a UK multi-site hospital network.MethodsA natural experiment utlising the phased introduction of a digital sepsis alert into a multi-site hospital network. Sepsis alerts were either visible to clinicans (the ‘intervention’ group) or running silently and not visible (the control group). Inverse probability of treatment weighted multivariable logistic regression was used to estimate the effect of the intervention on patient outcomes.Outcomes: In-hospital 30-day mortality (all inpatients), prolonged hospital stay (≥7 days) and timely antibiotics (≤60 minutes of the alert) for patients who alerted in the Emergency Department.ResultsThe introduction of the alert was associated with lower odds of death (OR:0.76; 95%CI:(0.70, 0.84) n=21,183); lower odds of prolonged hospital stay ≥7 days (OR:0.93; 95%CI:(0.88, 0.99) n=9988); and in patients who required antibiotics, an increased odds of receiving timely antibiotics (OR:1.71; 95%CI:(1.57,1.87) n=4622).DiscussionCurrent evidence that digital sepsis alerts are effective is mixed. In this large UK study a digital sepsis alert has been shown to be associated with improved outcomes, including timely antibiotics, which may suggest a causal pathway. It is not known whether the presence of alerting is responsible for improved outcomes, or whether the alert acted as a useful driver for quality improvement initiatives.ConclusionsThese findings strongly suggest that the the introduction of a network-wide digital sepsis alert is associated with improvements in patient outcomes, demonstrating that digital based interventions can be successfully introduced and readily evaluated.FundingImperial NIHR Biomedical Research Centre: NIHR-BRC-P68711.

show abstract

Section: Introductionmentioning

confidence: 65%

Evaluating a digital sepsis alert in a London multi-site hospital network: a natural experiment using electronic health record data

Honeyford¹,

Cooke

Kinderlerer

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

Evaluating a digital sepsis alert in a London multisite hospital network: a natural experiment using electronic health record data

Honeyford

Cooke

Kinderlerer

et al. 2019

Journal of the American Medical Informatics Association

View full text Add to dashboard Cite

Objective The study sought to determine the impact of a digital sepsis alert on patient outcomes in a UK multisite hospital network. Materials and Methods A natural experiment utilizing the phased introduction (without randomization) of a digital sepsis alert into a multisite hospital network. Sepsis alerts were either visible to clinicians (patients in the intervention group) or running silently and not visible (the control group). Inverse probability of treatment-weighted multivariable logistic regression was used to estimate the effect of the intervention on individual patient outcomes. Outcomes In-hospital 30-day mortality (all inpatients), prolonged hospital stay (≥7 days) and timely antibiotics (≤60 minutes of the alert) for patients who alerted in the emergency department. Results The introduction of the alert was associated with lower odds of death (odds ratio, 0.76; 95% confidence interval [CI], 0.70-0.84; n = 21 183), lower odds of prolonged hospital stay ≥7 days (OR, 0.93; 95% CI, 0.88-0.99; n = 9988), and in patients who required antibiotics, an increased odds of receiving timely antibiotics (OR, 1.71; 95% CI, 1.57-1.87; n = 4622). Discussion Current evidence that digital sepsis alerts are effective is mixed. In this large UK study, a digital sepsis alert has been shown to be associated with improved outcomes, including timely antibiotics. It is not known whether the presence of alerting is responsible for improved outcomes or whether the alert acted as a useful driver for quality improvement initiatives. Conclusions These findings strongly suggest that the introduction of a network-wide digital sepsis alert is associated with improvements in patient outcomes, demonstrating that digital based interventions can be successfully introduced and readily evaluated.

show abstract

Views and Uses of Sepsis Digital Alerts in National Health Service Trusts in England: Qualitative Study With Health Care Professionals

Lazzarino,

Borek,

Honeyford

et al. 2024

JMIR Hum Factors

View full text Add to dashboard Cite

Background: Sepsis is a common cause of serious illness and death. Sepsis management remains challenging and sub-optimal. To support rapid sepsis diagnosis and treatment, screening tools have been embedded into hospital digital systems to appear as digital alerts. The implementation of digital alerts to improve management of sepsis/deterioration is a complex intervention which has to fit with team workflow and the views and practices of hospital staff. Despite the importance of human decision making and behaviour in optimal implementation, there are limited qualitative studies that explore the views and experiences of healthcare professionals regarding digital alerts as sepsis/deterioration computerised clinician decision support systems.Objective: To explore the views and experiences of healthcare professionals on the use of sepsis/deterioration computerised clinician decision support systems and to identify barriers and facilitators to their implementation and use in NHS hospitals.Methods: A qualitative, multi-site study with unstructured observations and semi-structured interviews with healthcare professionals from emergency departments, outreach teams and intensive/acute units in three NHS hospital Trusts in England. Data from both interviews and observations were analysed together inductively using thematic analysis.Results: Twenty-two healthcare professionals were interviewed, and twelve observation sessions were undertaken. Four themes were identified in relation to sepsis digital alerts: 1) Support decision-making as nested in electronic health records. Participants viewed them as useful tools in decision-making but emphasised that they did not substitute their knowledge and experience; 2) Remind to take action according to the context. Participants expressed that they served as reminders for different clinical actions depending on the hospital unit and the job role; 3) Improve the alerts and their introduction. Participants felt the alerts could be improved by being more accessible, more accurate, and that they should be integrated across the whole healthcare system; 4) Contextual factors affecting views and use of alerts in the Trusts. Digital alerts are more optimally used in general hospital units with a lower senior decision maker/patient ratio and by healthcare professionals with experience of a similar technology. Better use of the alerts was associated with quality improvement initiatives and continuous sepsis training. Trust's features, such as the Views and uses of sepsis / deterioration digital alerts in NHS Trusts in England: a qualitative study with healthcare professionals

show abstract

The Epidemiology of Sepsis

Cited by 4 publications

References 65 publications

Evaluating a digital sepsis alert in a London multi-site hospital network: a natural experiment using electronic health record data

Evaluating a digital sepsis alert in a London multi-site hospital network: a natural experiment using electronic health record data

Evaluating a digital sepsis alert in a London multisite hospital network: a natural experiment using electronic health record data

Views and Uses of Sepsis Digital Alerts in National Health Service Trusts in England: Qualitative Study With Health Care Professionals

Contact Info

Product

Resources

About