ArticleApplied clinical informatics2018
Impact of Electronic Physician Order-Set on Antibiotic Ordering Time in Septic Patients in the Emergency Department.
Article in Applied clinical informatics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Evaluating the Impact of Source-specific Order Sets for Sepsis on Empiric Antibiotic Selection in the Emergency Department.Open forum infectious diseases · 2024Trial
- Decreased racial disparities in sepsis mortality after an order set-driven initiative: An analysis of 8151 patients.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- A five-year quasi-experimental study to evaluate the impact of empiric antibiotic order sets on antibiotic use metrics among hospitalized adult patients.Infection control and hospital epidemiology · 2024Article
- Order Set Usage is Associated With Lower Hospital Mortality in Patients With Sepsis.Critical care explorations · 2023Article
- Antimicrobial stewardship using electronic prescribing systems in hospital settings: a scoping review of interventions and outcome measures.JAC-antimicrobial resistance · 2022Article
- Quality initiative to improve emergency department sepsis bundle compliance through utilisation of an electronic health record tool.BMJ open quality · 2022Article
- The Impact of Changes to an Electronic Admission Order Set on Prescribing and Clinical Outcomes in the Intensive Care Unit.Applied clinical informatics · 2020Article
- Sustained Improvement in Inflammatory Bowel Disease Quality Measures Using an Electronic Health Record Intervention.Applied clinical informatics · 2019Article
- Comparison of Antibiotic Dosing Before and After Implementation of an Electronic Order Set.Applied clinical informatics · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality.
objectiveThis article determines if the use of an electronic physician order-set decreases time to antibiotic ordering for patients with sepsis in the emergency department (ED).
methodsA retrospective chart review was performed on adult patients who presented to the ED of four community hospitals from May to July 2016. Patients with severe sepsis and/or septic shock were included. Primary outcome was the difference in time to antibiotic ordering in patients whose physicians utilized the order-set versus those whose physicians did not. Secondary outcomes included differences in time to antibiotic administration, time to lactate test, hospital length of stay, and posthospitalization disposition. The institution's Quality Improvement Committee approved the project.
resultsForty-five of 123 patients (36.6%) with sepsis had physicians who used the order-set. Order-set utilization reduced the mean time to ordering antibiotics by 20 minutes (99 minutes, 95% confidence interval [CI]: 69-128 vs. 119 minutes, 95% CI: 91-147), but this finding was not statistically significant. Mean time to antibiotic administration (145 minutes, 95% CI: 108-181 vs. 182 minutes, 95% CI: 125-239) and median time to lactate tests (12 minutes, 95% CI: 0-20 vs. 19 minutes, 95% CI: 8-34), although in the direction of the hypotheses, were not significantly different.
conclusionUtilization of the order-set was associated with a potentially clinically significant, but not statistically significant, reduced time to antibiotic ordering in patients with sepsis. Electronic order-sets are a promising tool to assist hospitals with meeting the Centers for Medicare and Medicaid Services core measure.
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