Causal Association of Physician-in-Triage with Improved Pediatric Sepsis Care: A Single-Center, Emergency Department Experience.
Causal Association of Physician-in-Triage with Improved Pediatric Sepsis Care: A Single-Center, Emergency Department Experience.
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通过改善儿科脓毒症护理的贸易医师因果协会：单中心的急诊科经验。
DOI：
10.1097/pq9.0000000000000651
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发表时间：
2023-05
影响因子：
1.1
通讯作者：
中科院分区：
文献类型：
--
作者：
Approximately 75,000 children are hospitalized for sepsis yearly in the United States, with 5%–20% mortality estimates. Outcomes are closely related to the timeliness of sepsis recognition and antibiotic administration. A multidisciplinary sepsis task force formed in the Spring of 2020 aimed to assess and improve pediatric sepsis care in the pediatric emergency department (ED). The electronic medical record identified pediatric sepsis patients from September 2015 to July 2021. Data for time to sepsis recognition and antibiotic delivery were analyzed using statistical process control charts (X̄-S charts). We identified special cause variation, and Bradford-Hill Criteria guided multidisciplinary discussions to identify the most probable cause. In the fall of 2018, the average time from ED arrival to blood culture orders decreased by 1.1 hours, and the time from arrival to antibiotic administration decreased by 1.5 hours. After qualitative review, the task force hypothesized that initiation of attending-level pediatric physician-in-triage (P-PIT) as a part of ED triage was temporally associated with the observed improved sepsis care. P-PIT reduced the average time to the first provider exam by 14 minutes and introduced a process for physician evaluation before ED room assignment. Timely assessment by an attending-level physician improves time to sepsis recognition and antibiotic delivery in children who present to the ED with sepsis. Implementing a P-PIT program with early attending-level physician evaluation is a potential strategy for other institutions.
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影响因子：
2.9
作者：
Jeyaraman, Maya M.;Alder, Rachel N.;Copstein, Leslie;Al-Yousif, Nameer;Suss, Roger;Zarychanski, Ryan;Doupe, Malcolm B.;Berthelot, Simon;Mireault, Jean;Tardif, Patrick;Askin, Nicole;Buchel, Tamara;Rabbani, Rasheda;Beaudry, Thomas;Hartwell, Melissa;Shimmin, Carolyn;Edwards, Jeanette;Halas, Gayle;Sevcik, William;Tricco, Andrea C.;Chochinov, Alecs;Rowe, Brian H.;Abou-Setta, Ahmed M.
通讯作者：
Abou-Setta, Ahmed M.
影响因子：
2.3
作者：
Fedak KM;Bernal A;Capshaw ZA;Gross S
通讯作者：
Gross S
影响因子：
--
作者：
Carroll, Alison R;Johnson, David P
通讯作者：
Johnson, David P
DOI：
10.1097/pcc.0000000000000225
发表时间：
2014-11
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Balamuth F;Weiss SL;Neuman MI;Scott H;Brady PW;Paul R;Farris RW;McClead R;Hayes K;Gaieski D;Hall M;Shah SS;Alpern ER
通讯作者：
Alpern ER
影响因子：
6.2
作者：
Bourgeois, Florence T.;Shannon, Michael W.;Stack, Anne M.
通讯作者：
Stack, Anne M.