Effect of Automated Real-Time Feedback on Early-Sepsis Care: A Pragmatic Clinical Trial*
Main findingResult — go to the resultDifference 8.5% 95% CI 3.9–13.1%Authors' conclusion
Real-time monitoring and paging alerts significantly increased orders for and delivery of guideline-adherent care for suspected sepsis patients at risk of 3-hour bundle nonadherence.
Study context
- Population
- Adult ED or inpatients meeting objective sepsis criteria with clinician-acknowledged electronic medical record (EMR) sepsis advisory, at risk of bundle nonadherenceof 3,269 enrolled
- Participants
- 1,377 participants
- Exposure
- Real-time automated EMR monitoring with reminder pages vs no pages
- Interventionn = 670
- Controln = 707reference
- Outcome
- Orders for all 3-hour bundle elements within guideline time limits
Methodological detailsprospective, allocation alternated every 7 days, single quaternary hospital, Quaternary hospital, December 1, 2020 to November 30, 2021
- Prospective
- Allocation alternated every 7 days
- Single quaternary hospital
- Quaternary hospital, December 1, 2020 to November 30, 2021
Main finding
As reported in the abstract
Difference
8.5%
95% CI 3.9–13.1%
P = 0.0003
Events by group
Intervention vs Control
difference 8.5% (95% CI 3.9–13.1%); P = 0.0003
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Intervention | Control | Difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Guideline-adherent delivery of all 3-hour bundle elements | 22.7% | 17.1% | 5.6% (1.4–9.8%) | P = 0.0095 | |
| −50510Difference (linear scale) |
28-day mortality
- Mortality similar between groups
- 8.4% vs 8.3%
Antibiotic discontinuation within 48 hours
- Early antibiotic discontinuation similar between groups
- 35.1% vs 33.4%
Pan-culture negativity (no pathogen recovery from any culture within 7 days of time-zero)
- Pan-culture negativity similar between groups
- 69.0% vs 68.2%
Original publication
Effect of Automated Real-Time Feedback on Early-Sepsis Care: A Pragmatic Clinical Trial*. Crit Care Med. Published 13 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →