"Beat the Shock Clock": An Interprofessional Team Improves Pediatric Septic Shock Care

被引：10

作者：

Tuuri, Rachel E. ^{[1
]}

Gehrig, Madeline G. ^{[1
]}

Busch, Carrie E. ^{[1
]}

Ebeling, Myla ^{[1
]}

Morella, Kristen ^{[1
]}

Hunt, Lisa ^{[1
]}

Russell, W. Scott ^{[1
]}

机构：

[1] Med Univ S Carolina, Childrens Hosp, Charleston, SC 29425 USA

来源：

CLINICAL PEDIATRICS | 2016年 / 55卷 / 07期

关键词：

quality improvement; interprofessional relations and communications; multidisciplinary relations and communications; pediatric emergency medicine; severe sepsis; septic shock; electronic health records; LIFE-SUPPORT GUIDELINES; PROVIDER ORDER ENTRY; SEVERE SEPSIS; EMERGENCY-DEPARTMENT; AMERICAN-COLLEGE; HEMODYNAMIC SUPPORT; SURVIVING SEPSIS; HEALTH-CARE; MANAGEMENT; CHILDREN;

D O I：

10.1177/0009922815601984

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Ideal care for septic shock (SS) is difficult. This interprofessional quality improvement intervention in a mid-volume pediatric emergency department aimed to reduce time to vascular access, fluid resuscitation, and antibiotics for SS. Intensive education, a care pathway, and an order set were applied. Outcome measures for patients with criteria for SS before and after intervention were compared. There were 43 patients pre-intervention (January 2009 to June 2011) and 63 post-intervention (June 2012 to June 2013). Median time to vascular access decreased from 37 minutes pre-intervention to 24 minutes post-intervention (p = 0.05). Median time to first fluid bolus decreased from 35 to 26 minutes (p = 0.08). Percentage of boluses delivered rapidly by pressure method increased from 21% to 74% (p < 0.0001). Median time to antibiotics decreased from 92 to 55 minutes (p = 0.02). In conclusion, a multimodal, interprofessional quality improvement intervention in a mid-sized pediatric emergency department improved the time to critical interventions for SS.

引用

页码：626 / 638

页数：13

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