Background: The CDC Core Elements of Antibiotic Stewardship recommend that patients initiated on broad-spectrum antibiotics (BSA) undergo antibiotic de-escalation within 48-72 hours based on available culture data. However, adherence with this recommendation in patients with sepsis has not been well studied. We assessed the incidence of, and characteristics associated with, anti-methicillin resistant staphylococcus aureus (MRSA) [...]

Background: The CDC Core Elements of Antibiotic Stewardship recommend that patients initiated on broad-spectrum antibiotics (BSA) undergo antibiotic de-escalation within 48-72 hours based on available culture data. However, adherence with this recommendation in patients with sepsis has not been well studied. We assessed the incidence of, and characteristics associated with, anti-methicillin resistant staphylococcus aureus (MRSA) [...]

Background: Increased Emergency Department (ED) boarding has been linked to worse patient outcomes, including delays in treatment (Jiraporn et al 2014), increased length of stay (Singer et al 2011), and increased mortality (Singer et al 2011; Sun et al 2013). Patients who meet time zero (T-0) for diagnosis with severe sepsis while boarding in the [...]

Background: Sepsis affects over 19 million patients worldwide annually. While there was a reduction in in-hospital mortality for sepsis over the past two decades, the readmission rate among its survivors has increased. Sepsis is a leading cause of 30-day hospital readmission in the United States at 21.4%, compared to all-cause readmissions of 17%, and imposes [...]

Background: Patients with undifferentiated but stable clinical presentations may manifest sepsis “time zero” (T-0) or the onset of sepsis-defining conditions while undergoing further evaluation in observation units (OUs). Since these units are often designed to facilitate diagnostic and clinical risk assessments, we hypothesize that patients experiencing T-0 while in OUs will likely experience similar or [...]

Background: The diagnosis of sepsis is often associated with high rates of morbidity and mortality. When it occurs in patients with Heart failure (HF), those rates increase dramatically. This study focuses on the differences in the outcomes in septic patients with Heart Failure with preserved Ejection Fraction (HFpEF) versus patients with Heart Failure with reduced [...]

Background: Septic shock is a significant burden: average length of stay (LOS) for sepsis patients in US hospitals is 75% greater than most other conditions. Mean LOS dramatically increases with sepsis severity: 4.5 days for sepsis, 6.5 for severe sepsis, and 16.5 for septic shock. Administration of antibiotics in < 1 hour after presentation at [...]

Background: Sepsis is the leading cause of death in US hospitals, and prompt recognition and treatment is critical. To improve general floor sepsis care, our hospital created a “sepsis squashing squadron” (S3) – a response team that uses scoring tools displayed in the EHR to improve efficiency, sensitivity, and specificity of sepsis identification. We previously [...]

Background: Sepsis is a major cause of mortality in hospitalized patients, and early treatment is critical to survival. However, there is a paucity of research on methods to assist real-time clinical decision-making for sepsis treatment. Utilizing data on patients who had sepsis in the ICU, we propose a novel data-driven framework for recommending treatments by [...]

Background: Early sepsis recognition and treatment can save lives. The Centers for Medicare & Medicaid Services defines appropriate treatment using the Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) components. To help improve sepsis identification, documentation, and organizational compliance with SEP-1, our hospital implemented a “best-practice alert” (BPA) comprised of Epic’s “sepsis score,” but the rates [...]