Implementing a quick Sequential (Sepsis-Related) Organ Failure Assessment sepsis screening tool: an interrupted times series study

Loading...
Thumbnail Image
File version

Accepted Manuscript (AM)

Author(s)
Alberto, L
Aitken, LM
Walker, RM
Pálizas, F
Marshall, AP
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2020
Size
File type(s)
Location
License
Abstract

OBJECTIVE: The aim of this study was to evaluate the outcomes of implementing a sepsis screening (SS) tool based on the quick Sequential [Sepsis-Related] Organ Failure Assessment (qSOFA) and the presence of confirmed/suspected infection. The implementation of the 6-hour (6-h) bundle was also evaluated. DESIGN: Interrupted times series with prospective data collection. SETTING: Five hospital wards in a developing nation, Argentina. PARTICIPANTS: 1151 patients (≥18 years) recruited within 24-48 hours of hospital admission. INTERVENTION: The qSOFA-based SS tool and the 6-h bundle. MAIN OUTCOME MEASURES: The primary outcome was the timing of implementation of the first 6-h bundle element. Secondary outcomes were related to the adherence to the screening procedures. RESULTS: Of 1151 patients, 145 (12.6%) met the qSOFA-based SS tool criteria, among them intervention (39/64) patients received the first 6-h bundle element earlier (median 8 hours; 95% CI: 0.1-16) than baseline (48/81) patients (median 22 hours; 95% CI: 3-41); these times, however, did not differ significantly (p = 0.525). Overall, 47 (4.1%) patients had sepsis; intervention patients (18/25) received the first 6-h bundle element sooner (median 5 hours; 95% CI: 4-6) than baseline patients (15/22) did (median 12 hours; 95% CI: 0-33), however times were not significantly different (p = 0.470). While intervention patients were screened regularly, only one-third of patients that required sepsis alerts had them activated. CONCLUSION: The implementation of the qSOFA-based SS tool resulted in early, but not significantly improved, provision of 6-h bundle care. Screening procedures were regularly conducted, but sepsis alerts rarely activated. Further research is needed to better understand implementation of sepsis care in developing settings.

Journal Title

International Journal for Quality in Health Care

Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement

© 2020 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in International Journal for Quality in Health Care following peer review. The definitive publisher-authenticated version Implementing a quick Sequential (Sepsis-Related) Organ Failure Assessment sepsis screening tool: an interrupted times series study, International Journal for Quality in Health Care, 2020 is available online at: https://doi.org/10.1093/intqhc/mzaa059.

Item Access Status
Note

This publication was entered as an advanced online version.

Access the data
Related item(s)
Subject

Biomedical and clinical sciences

Psychology

Applied economics

Health services and systems

Policy and administration

6-h bundle

developing nation

hospital ward

implementation

qSOFA

Persistent link to this record
Citation

Alberto, L; Aitken, LM; Walker, R; Pálizas, F; Marshall, AP, Implementing a quick Sequential (Sepsis-Related) Organ Failure Assessment sepsis screening tool: an interrupted times series study, International Journal for Quality in Health Care, 2020

Collections