Implementation of a sepsis code for septic patients at a community hospital: A practice improvement initiative
Introduction
Sepsis is a major cause of hospitalization with a high mortality rate. Early recognition and management of sepsis have shown to improve mortality outcomes. A proactive alert system to improve the response of the interdisciplinary team may decrease the time to intervention and improve patient outcomes.
Objective
Our study evaluated the impact of an early alert system, “CODE SEPSIS,” on adherence to the sepsis management bundle and time to intervention among patients at risk for sepsis.
Method
Patients presenting to the Emergency Department (ED) and meeting two or more criteria on sepsis screening were intended to trigger an overhead alert known as CODE SEPSIS, which was activated based on physician decision. Data were retrospectively collected over a three-month period for all hospitalized adult patients (over 18 years of age) with confirmed sepsis. Our data analysis evaluated the time from ED presentation to diagnostic and treatment interventions. A data collection tool was designed to record information.
Results
Thirty-six sepsis patients were identified, among which 18 patients were classified as CODE SEPSIS and 18 patients were classified as non-CODE SEPSIS. We found that the CODE SEPSIS group showed greater improvement than the non-CODE SEPSIS group in the time from ED presentation to intravenous catheter insertion from 37.3 minutes to 31.5 minutes (15.6%), fluid administration from 41 minutes to 39 minutes (4.9%), microbiological workup from 91 minutes to 33 minutes (63.7%) , lactate level from 69 minutes to 66 minutes (4.3%), prescribing antimicrobial therapy from 92 minutes to 44 minutes (52%), and administration of antimicrobial therapy from 88 to 46 minutes (47.7%). Patients in the non-CODE SEPSIS group showed a one-day decrease in length of hospital stay.
Conclusion
The CODE SEPSIS developed at Alwakra Hospital promoted early and standardized management among patients at risk for sepsis, which may lead to improved patient outcomes.
