ArticleJournal of the Intensive Care Society2019
Analysis of a new best-practice advisory on time to initiation of antibiotics in surgical intensive care unit patients with septic shock.
Article in Journal of the Intensive Care Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 26 citations in OpenAlex.
- Enhancing Comorbidity Management in Patients With Hemorrhagic Stroke via an Electronic Health Record-Linked Best Practice Alert: A Pre/Post Study.Journal of the American Heart Association · 2025Trial
- Quality improvement project to reduce medicare 1-day write-offs due to inappropriate admission orders.BMC health services research · 2024Trial
- Review
- Linezolid-Associated Lactic Acidosis Triggering a Sepsis Alert: A Case Report.Clinical case reports · 2025Article
- Evaluating a Sepsis Screening Tool in the Outpatient Setting.Clinical journal of oncology nursing · 2025Article
- Resident-Driven Clinical Decision Support Governance to Improve the Utility of Clinical Decision Support.Applied clinical informatics · 2024Article
- Pharmacist Involvement in Sepsis Response and Time to Antibiotics: A Systematic Review.Journal of the American College of Clinical Pharmacy : JACCP · 2023Article
- Use of electronic health record best practice alerts to improve adherence to American Urological Association vesicoureteral reflux guidelines.Pediatric surgery international · 2022Article
- Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Adult Inpatients: Scoping Review.Journal of medical Internet research · 2022Article
- Effect of Best Practice Advisories on Sedation Protocol Compliance and Drug-Related Hazardous Condition Mitigation Among Critical Care Patients.Critical care medicine · 2020Observational
- Decreasing ICU and Hospital Length of Stay through a Standardized Respiratory Therapist-driven Electronic Clinical Care Pathway for Status Asthmaticus.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly administration of antibiotics in septic shock is associated with decreased mortality. Promptly identifying sepsis and eliciting a response are necessary to reduce time to antibiotic administration.
methodsA best-practice advisory was introduced in the surgical intensive care unit to identify patients with septic shock and promote timely action. The best-practice advisory is triggered by blood culture orders and vasopressor administration within 24 h. The nurse or provider who triggers the alert may send an automatic notification to the intensive care unit resident, clinical pharmacist, and charge nurse, prompting bedside response and closer evaluation. Patients who met best-practice advisory criteria in the surgical intensive care unit from May 2016 through March 2017 were included. Outcomes included changes in antibiotics within 24 h, response to best-practice advisory, and time-to-antibiotics. Time-to-antibiotics was compared between a retrospective pre-intervention period and a six-month prospective post-intervention period defined by launch of the new best-practice advisory in September 2016. Data were analyzed by chi square, Mann-Whitney U, and Kruskal-Wallis.
resultsDuring the first six months of best-practice advisory implementation, 191 alerts were triggered by 97 unique patients. Alert notification was transmitted in 79 best-practice advisories (41%), with pharmacist bedside response in 53 (67%). New antibiotics were started within 24 h following 83 best-practice advisories (43%). There was a trend toward decreased time-to-antibiotics following implementation of the best-practice advisory (7.4 vs. 4.2 h,
conclusionsA new best-practice advisory has been effective at eliciting a rapid response and reducing the time-to-antibiotics in surgical intensive care unit patients with septic shock. Team notification and pharmacist response are associated with decreased time-to-antibiotics.
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