Journal
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
Volume 38, Issue 5, Pages 1605-1616Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/147323001003800505
Keywords
SEPSIS; COMPUTER-ASSISTED DECISION SUPPORT SYSTEMS (CDSS); STANDARD OPERATING PROCEDURES (SOP); INTENSIVE CARE UNITS (ICU); MORTALITY; ANTIBIOTIC REGIMEN
Funding
- Roche GmbH
- SIRS-Lab GmbH Jena
- Merck Sharp
- Dohme GmbH
- Wyeth Pharma GmbH
- Astra Zeneca
- Bristol-Myers Squibb GmbH
- Pfizer
- Fresenius Kabi
- Sanofi/Aventis
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Computer-assisted decision support systems (CDSS) are designed to improve infection management. The aim of this prospective, clinical pre- and post-intervention study was to investigate the influence of CDSS on infection management of severe sepsis and septic shock in intensive care units (ICUs). Data were collected for a total of 180 days during two study periods in 2006 and 2007. Of the 186 patients with severe sepsis or septic shock, 62 were stratified into a low adherence to infection management standards group (LAG) and 124 were stratified into a high adherence group (HAG). ICU mortality was significantly increased in LAG versus HAG patients (Kaplan-Meier analysis). Following CDSS implementation, adherence to standards increased significantly by 35%, paralleled with improved diagnostics, more antibiotic-free days and a shortened time until antibiotics were administered. In conclusion, adherence to infection standards is beneficial for patients with severe sepsis or septic shock and CDSS is a useful tool to aid adherence.
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