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Shorter duration of hospital stay noted when sepsis protocol followed
The 2006 Pediatric Advanced Life Support guidelines can help reduce the duration of pediatric hospital stays associated with sepsis. However, few clinicians are employing the guidelines, according to recently published findings.
Raina Paul, MD, of the division of emergency medicine at Boston Children’s Hospital, and colleagues prospectively reviewed data on 126 children with severe sepsis or septic shock.
The researchers assessed whether all parts of the guidelines were followed. The recommended bundle is: “early recognition of septic shock, obtaining vascular access, administering intravenous fluids, delivery of vasopressors for fluid refractory shock, and antibiotic administration.”
The study results indicated that adhering to all of these bundle components reduced the hospitalization time for pediatric patients by about 57%. However, the researchers reported a 19% compliance rate with all components.
They said poor adherence to the fluid guidelines was one of the primary reasons for poor bundle adherence.
“The lack of timely intravenous fluid administration can be attributed to either a lack of knowledge regarding Pediatric Advanced Life Support (PALS) recommendations or the inability to administer fluid quickly,” the researchers wrote.
They added that their study has prompted a quality improvement intervention in their hospital to improve PALS adherence.
“This research has demonstrated that hospitals continue struggle with ideal care for children, and collaborative quality improvement efforts are necessary to improve our adherence to national sepsis guidelines. Where guidelines exist, a critical look at adherence to these guidelines and barriers to care provides a valuable glimpse into the workings of a current system,” Paul told Infectious Diseases in Children.
Disclosure: Dr. Paul reports no relevant financial disclosures.
