Ensuring a Locally Tailored Response to Early Onset Sepsis Screening Meets or Exceeds the Performance of Published Approaches

Fischer, Ashley; Mowrer, Michael Colin; Shallat, Shelly; Walker, Lucas; Shallat, Jaclyn

doi:10.1542/hpeds.2020-0153

Cited by 2 publications

(1 citation statement)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To explore potential barriers and facilitators of EOS calculator implementation and thereby identify relevant survey items, a preparatory literature search in Pubmed was combined with 12 exploratory semi-structured stakeholder interviews. Facilitators and barriers identified in literature an during the interviews were analyzed and summarized in a point-by-point list [16][17][18][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Subsequently, all factors were allocated to one of the 39 CFIR constructs using the CFIR codebook [21,43].…”

Section: Survey Preparationmentioning

confidence: 99%

Barriers and Facilitators to the Implementation of the Early-Onset Sepsis Calculator: A Multicenter Survey Study

van Veen,

van der Weijden,

van Bodegom-Vos

et al. 2023

Children

View full text Add to dashboard Cite

Prior studies demonstrated the neonatal early onset sepsis (EOS) calculator’s potential in drastically reducing antibiotic prescriptions, and its international adoption is increasing rapidly. To optimize the EOS calculator’s impact, successful implementation is crucial. This study aimed to identify key barriers and facilitators to inform an implementation strategy. A multicenter cross-sectional survey was carried out among physicians, residents, nurses and clinical obstetricians of thirteen Dutch hospitals. Survey development was prepared through a literature search and stakeholder interviews. Data collection and analysis were based on the Consolidated Framework for Implementation Research (CFIR). A total of 465 stakeholders completed the survey. The main barriers concerned the expectance of the department’s capacity problems and the issues with maternal information transfer between departments. Facilitators concerned multiple relative advantages of the EOS calculator, including stakeholder education, EOS calculator integration in the electronic health record and existing positive expectations about the safety and effectivity of the calculator. Based on these findings, tailored implementation interventions can be developed, such as identifying early adopters and champions, conducting educational meetings tailored to the target group, creating ready-to-use educational materials, integrating the EOS calculator into electronic health records, creating a culture of collective responsibility among departments and collecting data to evaluate implementation success and innovation results.

show abstract

Section: Survey Preparationmentioning

confidence: 99%

Barriers and Facilitators to the Implementation of the Early-Onset Sepsis Calculator: A Multicenter Survey Study

van Veen,

van der Weijden,

van Bodegom-Vos

et al. 2023

Children

View full text Add to dashboard Cite

show abstract

Comparison of Early-Onset Sepsis Risk-Stratification Algorithms in Neonates in a Kenyan Nursery

Fileccia¹,

Wood

Guthrie

et al. 2022

Hospital Pediatrics

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Risk stratification algorithms (RSAs) can reduce antibiotic duration (AD) and length of stay (LOS) for early-onset sepsis (EOS). Because of higher EOS and antibiotic resistance rates and limited laboratory capacity, RSA implementation may benefit low- and middle-income countries (LMIC). Our objective was to compare the impact of 4 RSAs on AD and LOS in an LMIC nursery. METHOD: Neonates <5 days of age admitted for presumed sepsis to a Kenyan referral hospital in 2019 (n = 262) were evaluated by using 4 RSAs, including the current local sepsis protocol (“local RSA”), a simplified local protocol (“simple RSA”), an existing categorical RSA that uses infant clinical examination and maternal risk factors (CE-M RSA) clinical assessment, and the World Health Organization’s Integrated Management of Childhood Illness guideline. For each RSA, a neonate was classified as at high, moderate, or low EOS risk. We used к coefficients to evaluate the agreement between RSAs and McNemar’s test for the direction of disagreement. We used the Wilcoxon rank test for differences in observed and predicted median AD and LOS. RESULTS: Local and simple RSAs overestimated EOS risk compared with CE-M RSA and the Integrated Management of Childhood Illness guideline. Compared with the observed value, CE-M RSA shortened AD by 2 days and simple RSA lengthened AD by 2 days. LOS was shortened by 4 days by using CE-M RSA and by 2 days by using the local RSA. CONCLUSIONS: The local RSA overestimated EOS risk compared with CE-M RSA. If implemented fully, the local RSA may reduce LOS. Future studies will evaluate the prospective use of RSAs in LMICs with other interventions such as observation off antibiotics, biomarkers, and bundled implementation.

show abstract

Ensuring a Locally Tailored Response to Early Onset Sepsis Screening Meets or Exceeds the Performance of Published Approaches

Cited by 2 publications

References 21 publications

Barriers and Facilitators to the Implementation of the Early-Onset Sepsis Calculator: A Multicenter Survey Study

Barriers and Facilitators to the Implementation of the Early-Onset Sepsis Calculator: A Multicenter Survey Study

Comparison of Early-Onset Sepsis Risk-Stratification Algorithms in Neonates in a Kenyan Nursery

Contact Info

Product

Resources

About