Validation of a screening tool for the early identification of sepsis.

摘要: Background: Sepsis is the leading cause of mortality in noncoronary intensive care units. Recent evidence based guidelines outline strategies for management sepsis and studies have shown that early implementation these improves survival. We developed an extensive logic-based protocol; however, we found recognition was a major obstacle to protocol implementation. To improve this, three-step screening tool with escalating levels decision making. hypothesized aggressive would decrease sepsis-related by insuring appropriate interventions. Methods: Patients admitted surgical unit were screened twice daily our nursing staff. The initial screen assesses systemic inflammatory response syndrome parameters (heart rate, temperature, white blood cell count, respiratory rate) assigns numeric score (0―4) each. ≥4 positive proceed second step which midlevel provider attempts identify source infection. If patients screens both infection, intensivist notified determine whether implement protocol. Results: Over 5 months, 4,991 completed on 920 patients. prevalence 12.2%. yielded sensitivity 96.5%, specificity 96.7%, predictive value 80.2%, negative 99.5%. In addition, decreased from 35.1% 23.3%. Conclusions: three valid identification sepsis. Implementation this has SICU one third.