Clinical trial NCT05213923: ED Tracking Sheet Implementation
Official title: ED Tracking Sheet Implementation
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Sepsis
Severe Sepsis
Systemic Inflammatory Response Syndrome
Keywords: CMS Compliance
ED Pharmacist
Lead sponsor: Dartmouth-Hitchcock Medical Center
Sponsor class: OTHER
First posted: 2022-01-28
Enrollment: 194
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to assess whether implementation of an ED Sepsis Tracking Sheet effects the percentage of goal-directed sepsis criteria met in a tertiary care academic Emergency Department.

Detailed description: Sepsis remains a common cause of morbidity and mortality in the hospital setting. Accurate diagnosis and timely initiation of therapy are important drivers of patient-centered outcomes in sepsis management. Compliance with the core measures listed in the surviving sepsis campaign guidelines has been variable.

An ED-specific Sepsis Tracking Sheet (STS) - a tool for implementing and documenting critical actions in sepsis management - was created at our institution by a team of physicians, nurses, and ED pharmacists. Dedicated ED pharmacists were instructed to fill this sheet within one hour of the sepsis-specific best practice advisory (BPA) being activated in the ED. Core measures associated with the one hour and three hour sepsis bundles were tracked and outcomes were compared pre- and post-implementation of the STS.

Eligibility criteria: Inclusion Criteria:

* Over 18 years old
* Initially evaluated in the DHMC Lebanon Emergency Department
* Activated sepsis BPA upon initial presentation (triage history consistent with infection combined with 2 or more SIRS criteria? Are these the criteria that trigger our sepsis BPA?)

Exclusion Criteria:

* Patients who are transferred to the DHMC Lebanon Emergency Department from another facility
* Patients with absent data regarding one or more of the goal-directed sepsis criteria
* Patients who did not initially meet criteria to trigger the sepsis BPA, but developed sepsis later in their hospital course

Primary outcomes:
measure: Percentage of goal-directed sepsis criteria met
timeFrame: Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks
Secondary outcomes:
measure: Length of hospital stay
timeFrame: Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks
measure: In-hospital mortality
timeFrame: Time of ED presentation to the time of in-hospital death or hospital discharge, approximately 2 weeks
Other outcomes:
Locations:
city: Lebanon
country: United States
facility: Dartmouth-Hitchcock Medical Center
state: New Hampshire
Study officials:
affiliation: Dartmouth-Hitchcock Medical Center
name: Harman Gill, MD
role: PRINCIPAL_INVESTIGATOR
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