The impact of an emergency department code sepsis alert on empiric antibiotic effectiveness
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Publication Date
2025
Keywords
oregon, oaa 2025, psvmc
Disciplines
Emergency Medicine | Infectious Disease | Medical Education | Pharmacy and Pharmaceutical Sciences
Abstract
Abstract: Sepsis bundles, known as SEP-1, provide hourly recommendations to ensure timely identification and administration of antibiotics to patients with sepsis or septic shock. To ensure compliance with SEP-1, the Centers for Medicare and Medicaid Services (CMS) tied hospital reimbursements to SEP-1 protocol adherence in early 2024. Since these reimbursements have been put in place, there have been limited studies to evaluate antibiotic prescribing practices. This study aims to evaluate the impact of a Code Sepsis alert on empiric antibiotic prescribing practices for patients with sepsis or septic shock in the Emergency Department at Providence St. Vincent Medical Center (PSVMC). This is a single-center, retrospective chart review study including adult patients > 18 years old who met CMS sepsis criteria and received antibiotics in the Emergency Department (ED) from February 2023 to May 2024. This study utilizes the Providence Acute Care Sepsis Matrix Explorer, an existing data set for patients who qualify for sepsis diagnoses based off CMS sepsis criteria in the ED at PSVMC. The primary outcome is an assessment of the effectiveness of the empiric antibiotic(s) prescribed for patients meeting sepsis criteria in the ED before and after a Code Sepsis alert implementation. Effectiveness will be assessed by using culture data to evaluate antibiotic coverage and discharge diagnoses to determine if patients had true infections. Secondary outcomes include SEP-1 compliance (time to antibiotic administration < 60 minutes), inpatient mortality, and changes in prescribing patterns using the antibiotic spectrum index (ASI) score. Baseline characteristics will be evaluated using descriptive statistics. Chi-squares tests will be used to evaluate the primary and secondary outcomes. The effects of multifactorial variables (lactate value, vasopressor use, duration of septic shock, and number of hypotensive episodes) on survivorship at 24 and 72 hours will be evaluated using linear binomial regression. A two-tailed significance of p < 0.05 will be considered statistically significant. Preliminary results will be presented, and conclusions will be presented when the project is completed (IRB approved). Learning Objectives: Evaluate the impact of a code sepsis alert on empiric antibiotic effectiveness for patients with sepsis or septic shock. Presentation Category: Emergency Department
Specialty/Research Institute
Graduate Medical Education
Specialty/Research Institute
Emergency Medicine
Specialty/Research Institute
Pharmacy
