Effect of a Sepsis Order Set on Morbidity and Mortality within a community Hospital Emergency Department

Abstract

Specific Aims: To determine whether the implementation of a sepsis order set decreases the mortality rate and time to crucial sepsis treatment options in a community hospital setting. Methods: Electronic medical records (EMR) were analyzed from a specific community hospital to determine if a patient met SIRS criteria. Patients meet SIRS when at least two of the criteria are met. The patients were included in the study if they met SIRS criteria and were assigned to comparator groups based on date of presentation (before vs after order set implementation). Results: 168 patients were included in the pre-implementation group and 183 patients were included in the post-implementation group. The EMR was utilized to determine mortality and time to initiation of antibiotics, labs, and fluids. There was no statistical difference in patient mortality between the pre and post order set groups (8.3% vs 14.2%, p=0.0834). For the outcome of time to lactic acid, blood cultures, antibiotics, and fluids, there was statistical significance (time to lactic acid (24 vs 9 minutes, p=0.0065), blood culture (43.5 vs 16 minutes, p=0.0016), antibiotics (127 vs 98 minutes, p=0.0002), fluids (51 vs 29 minutes, p=0.0252)). Conclusion: The mortality rate depicted no change with the implementation of a sepsis order set. However, time to initiation of significant care metrics such as antibiotics, labs, and fluids were greatly decreased after implementation, and indicated statistical significance for each.