City Research Online

Implementing a quick Sequential (Sepsis-Related) Organ Failure Assessment sepsis screening tool: an interrupted times series study

Alberto, L., Aitken, L. M. ORCID: 0000-0001-5722-9090, Walker, R., Palizas, F. and Marshall, A. P. (2020). Implementing a quick Sequential (Sepsis-Related) Organ Failure Assessment sepsis screening tool: an interrupted times series study. International Journal for Quality in Health Care, doi: 10.1093/intqhc/mzaa059

Abstract

Objective
The aim of this study was to evaluate the outcomes of implementing a sepsis screening (SS) tool based on the quick Sequential [Sepsis-Related] Organ Failure Assessment (qSOFA) and the presence of confirmed/suspected infection. The implementation of the 6-hour (6-h) bundle was also evaluated.

Design
Interrupted times series with prospective data collection.

Setting
Five hospital wards in a developing nation, Argentina.

Participants
1151 patients (≥18 years) recruited within 24–48 hours of hospital admission.

Intervention
The qSOFA-based SS tool and the 6-h bundle.

Main outcome measures
The primary outcome was the timing of implementation of the first 6-h bundle element. Secondary outcomes were related to the adherence to the screening procedures.

Results
Of 1151 patients, 145 (12.6%) met the qSOFA-based SS tool criteria, among them intervention (39/64) patients received the first 6-h bundle element earlier (median 8 hours; 95% CI: 0.1–16) than baseline (48/81) patients (median 22 hours; 95% CI: 3–41); these times, however, did not differ significantly (p = 0.525). Overall, 47 (4.1%) patients had sepsis; intervention patients (18/25) received the first 6-h bundle element sooner (median 5 hours; 95% CI: 4–6) than baseline patients (15/22) did (median 12 hours; 95% CI: 0–33), however times were not significantly different (p = 0.470). While intervention patients were screened regularly, only one-third of patients that required sepsis alerts had them activated.

Conclusion
The implementation of the qSOFA-based SS tool resulted in early, but not significantly improved, provision of 6-h bundle care. Screening procedures were regularly conducted, but sepsis alerts rarely activated. Further research is needed to better understand implementation of sepsis care in developing settings.

Publication Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in International Journal for Quality in Health Care following peer review. The version of record Laura Alberto, Leanne M Aitken, Rachel Walker, Fernando Pálizas, Andrea P Marshall, Implementing a quick Sequential (Sepsis-Related) Organ Failure Assessment sepsis screening tool: an interrupted times series study, International Journal for Quality in Health Care, is available online at: https://doi.org/10.1093/intqhc/mzaa059
Publisher Keywords: implementation, qSOFA, sepsis screening, 6-h bundle, hospital ward, developing nation
Subjects: R Medicine > RC Internal medicine
R Medicine > RT Nursing
Departments: School of Health Sciences > Nursing
Date Deposited: 08 Jun 2020 11:22
URI: https://openaccess.city.ac.uk/id/eprint/24287
[img] Text - Accepted Version
This document is not freely accessible until 21 May 2021 due to copyright restrictions.

To request a copy, please use the button below.

Request a copy

Export

Downloads

Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login