Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: “The Severe Sepsis and Septic Shock Management Bundle” (SEP-1) is mandated for hospitals to report compliance with elements impacting sepsis patient morbidity and mortality. One of the core measures is obtaining blood cultures prior to antibiotics. A Best Practice Advisory (BPA) was built July 1, 2022 in the electronic health record to alert end-users during barcode medication administration of the antibiotic before the blood culture collection.
Research Question or Hypothesis: The primary outcome is to evaluate the impact of the BPA on compliance with collection of blood cultures prior to antibiotics portion of the SEP-1 measure.
Study Design: This is a single-center retrospective study evaluating the impact on compliance rates after the BPA implementation. Statistics for the primary outcome was chi-square and continuous data for baseline demographics with t-tests.
Methods: Data were collected through the electronic health record system. Patients were included if they were over the age of 18 years old, admitted to the hospital through the emergency department (ED). The pre-BPA group included patients from August 1, 2021 to April 30, 2022 and the post-BPA groups included patients from August 1, 2022, to April 30, 2023. Patients were included if they had an order for blood cultures and intravenous antibiotics within 6 hours of arrival to the ED. Patient were excluded if they received oral antibiotics.
Results: The BPA improved order compliance from 90.4% (1556/1721) to 92.6% (1656/1788), p<0.019. There were 168 BPAs that were triggered and led to corrective action (blood culture prior to the antibiotic), which occurred with the BPA at 52% (89/168).
Conclusion: The use of best practice advisories at the point of use can modify behavioral outcomes and improve compliance for blood culture collection before antibiotics. There are several pieces of the SEP-1 measures and improving each individual component that may improve overall compliance.
Presenting Author
Deborah Booth Pharm.D., MSAtlantic Health System
Authors
Rakesh Babu PharmD
Atlantic Health System
Jude Lark BSN, RN, CEN, CCRN
Atlantic Health System
Cristen Mackwell DNP
Atlantic Health System
Laura Geron DNP
Atlantic Health System
Susan Higgins MSN, BSN
Atlantic Health System