Seattle-based Harborview Medical Center relies on an automated sepsis-detection system — supported by the cohesive integration of nurses and technology — that seeks to treat potential sepsis patients within three hours of detection, reports NPR.
Here are six things to know.
1. David Carlbom, MD, a critical care pulmonologist, and medical director of Harborview's sepsis program, helped introduce the warning system in 2011 to improve sepsis detection and treatment.
"Sepsis is a really frustrating disease," Dr. Carlbom told NPR. "There's no blood test for sepsis. … There's nothing you can look at under the microscope and say, 'This is sepsis.'"
2. The automated system analyzes EHR data to pinpoint patterns of symptoms like high temperature or low blood pressure that may indicate an emerging sepsis infection. When the system detects a potential sepsis infection, a red box appears next to a patient's name on the computer. This alert prompts a nurse to assess whether the patient's symptoms are an early sign of sepsis.
"If the nurse says yes, then the provider is automatically paged, out of the computer system," said Rosemary Grant, RN, a registered nurse who coordinates sepsis care at Harborview,
3. Once paged, physicians must respond within half an hour, with the goal of getting a patient who may be developing sepsis on antibiotics within three hours.
4. If the nurse believes the symptoms do not point to sepsis, the computer system will ask why the patient has abnormal vital signs, according to Ms. Grant. In these instances, the nurses may type that the patient's heart rate was elevated due to exercise or other explainable reasons.
5. Since clinicians must manually enter EHR data into the alert system — a shortcoming consistent with many automated sepsis-detection systems — clinicians sometimes identify and treat signs of an infection before the computer system can catch up.
6. Yet overall, the system has proven effective and Harborview has seen hospital mortality rates drop since the system's implementation, according to Ms. Grant.