A prospective quality improvement study in the emergency department targeting paediatric sepsis
A prospective quality improvement study in the emergency department targeting paediatric sepsis
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DOI：
10.1136/archdischild-2015-310234
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发表时间：
2016-10-01
影响因子：
5.2
通讯作者：
Duke, Trevor
中科院分区：
文献类型：
--
作者：
Long, Elliot;Babl, Franz E.;Duke, Trevor
目的：儿科急诊科脓毒症质量改进措施与流程改进有关，但对患者结局的影响尚不清楚。我们的目的是评估和改善急诊科脓毒症的过程和跟踪随后的变化，患者outcome.Study设计的前瞻性观察队列研究，在急诊科的皇家儿童医院，墨尔本。参与者是符合败血症诊断预定标准的0-18岁儿童。在脓毒症干预中确定并针对以下管理缺陷：静脉插管时给予抗生素和静脉气体采血，以及快速给予所有液体复苏治疗。结果干预前102例患者入组，干预后113例患者入组。从静脉插管插入到抗生素给药的中位时间从干预前的55分钟（IQR 27-90分钟）减少到干预后的19分钟（IQR 10-32分钟）（p
Objective Quality improvement sepsis initiatives in the paediatric emergency department have been associated with improved processes, but an unclear effect on patient outcome. We aimed to evaluate and improve emergency department sepsis processes and track subsequent changes in patient outcome.Study design A prospective observational cohort study in the emergency department of The Royal Children's Hospital, Melbourne. Participants were children aged 0-18 years of age meeting predefined criteria for the diagnosis of sepsis. The following shortcomings in management were identified and targeted in a sepsis intervention: administration of antibiotics and blood sampling for a venous gas at the time of intravenous cannulation, and rapid administration of all fluid resuscitation therapy. The primary outcome measure was hospital length of stay.Results 102 patients were enrolled pre-intervention, 113 post-intervention. Median time from intravenous cannula insertion to antibiotic administration decreased from 55 min (IQR 27-90 min) pre-intervention to 19 min (IQR 10-32 min) post-intervention (p