Evidence map›Paper›PMID 38978714›Full record

ArticleJAMIA open2024

Barriers and facilitators to effective electronic health record-based sepsis screening in the pediatric intensive care unit.

Stacey M Sears, Anisha K Coughlin, Kathryn Nelson, Terri Stillwell, Erin F Carlton, Heidi R Flori

Abstract read
In one paragraph

Article in JAMIA open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Stacey M SearsDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States.ORCID https://orcid.org/0000-0002-0944-6194
Anisha K CoughlinDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States.
Kathryn NelsonUniversity of Michigan School of Nursing, Ann Arbor, MI 48109, United States.
Terri StillwellDepartment of Pediatrics, Division of Infectious Disease, University of Michigan Health System, Ann Arbor, MI 48109, United States.
Erin F CarltonDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States.
Heidi R FloriDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The Pediatric Surviving Sepsis Campaign supports the implementation of automated tools for early sepsis recognition. In 2019 the C.S. Mott Children's Hospital Pediatric Intensive Care Unit deployed an electronic medical record (EMR)-based screening for early recognition and treatment of sepsis. Materials and Methods: We analyzed all automated primary sepsis alerts, secondary screens, and bedside huddles from November 2019 to January 2020 (Cohort 1) and from November 2020 to January 2021 (Cohort 2) to identify barriers and facilitators for the use of this tool. We distributed surveys to frontline providers to gather feedback on end-user experience. Results: In Cohort 1, 895 primary alerts were triggered, yielding 503 completed secondary screens and 40 bedside huddles. In Cohort 2, 925 primary alerts were triggered, yielding 532 completed secondary screens and 12 bedside huddles. Surveys assessing end-user experience identified the following facilitators: (1) 73% of nurses endorsed the bedside huddle as value added; (2) 74% of medical providers agreed the bedside huddle increased the likelihood of interventions. The greatest barriers to successful implementation included the (1) overall large number of primary alerts from the automated tool and (2) rate of false alerts, many due to routine respiratory therapy interventions. Discussion: Our data suggests that the successful implementation of EMR-based sepsis screening tools requires countermeasures focusing on 3 key drivers for change: education, technology, and patient safety. Conclusion: While both medical providers and bedside nurses found merit in our EMR-based sepsis early recognition system, continued refinement is necessary to avoid sepsis alert fatigue.

Indexed as

EMRend-user experiencepediatric intensive care unitquality improvementsepsis screening tool

Identifiers

PMID38978714
PMCPMC11229986

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.