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- Title
Um sistema eletrônico de alerta ajuda a reduzir o tempo para diagnóstico de sepse.
- Authors
Adrieno Westphal, Glauco; Braz Pereira, Aline; Maria Fachin, Silvia; Sperotto, Geonice; Gonçalves, Maurício; Albino, Lucimeri; Bittencourt, Rodolfo; de Rossi Franzini, Vanessa; Koenig, Álvaro
- Abstract
Objective: To describe the improvements of an early warning system for the identification of septic patients on the time to diagnosis, antibiotic delivery, and mortality. Methods: This was an observational cohort study that describes the successive improvements made over a period of 10 years using an early warning system to detect sepsis, including systematic active manual surveillance, electronic alerts via a telephonist, and alerts sent directly to the mobile devices of nurses. For all periods, after an alert was triggered, early treatment was instituted according to the institutional sepsis guidelines. Results: In total, 637 patients with sepsis were detected over the study period. The median triage-to-diagnosis time was reduced from 19:20 (9:10 - 38:15) hours to 12:40 (2:50 - 23:45) hours when the manual surveillance method was used (p = 0.14), to 2:10 (1:25 - 2:20) hours when the alert was sent automatically to the hospital telephone service (p = 0.014), and to 1:00 (0:30 - 1:10) hour when the alert was sent directly to the nurse's mobile phone (p = 0.016). The diagnosis-to-antibiotic time was reduced to 1:00 (0:55 - 1:30) hours when the alert was sent to the telephonist and to 0:45 (0:30 - 1:00) minutes when the alert was sent directly to the nurse's mobile phone (p = 0.02), with the maintenance of similar values over the following years. There was no difference in the time of treatment between survivors and non-survivors. Conclusion: Electronic systems help reduce the triage-todiagnosis time and diagnosis-to-antibiotic time in patients with sepsis.
- Publication
Revista Brasileira de Terapia Intensiva, 2018, Vol 30, Issue 4, p414
- ISSN
0103-507X
- Publication type
Article
- DOI
10.5935/0103-507X.20180059