Utilization of Pharmacist Responders as a Component of a Multidisciplinary Sepsis Bundle

Flynn, Jeremy D.; McConeghy, Kevin W.; Flannery, Alexander H.; Nestor, Melissa; Branson, Pam; Hatton, Kevin

doi:10.1177/1060028014538773

Cited by 21 publications

(32 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Pharmacist Involvementmentioning

confidence: 85%

“…A similar study was performed by Flynn et al 26 in which pharmacists responded as part of a multidisciplinary team to a new sepsis treatment bundle initiated at their institution. The bundle included an order set, a physical response by the team including 26 In addition, patients being treated with the bundle were more likely to reach a central venous pressure greater than 8 mm Hg within 6 hours (OR, 2.4; 95% CI 1.0-5.6), however no difference was seen in achieving a mean arterial pressure (MAP) greater than 65 mm Hg.…”

Section: Pharmacist Involvementmentioning

confidence: 93%

“…The timing and appropriateness of the antibiotics can decrease mortality and health care costs. The Beardsley and Flynn 25,26 studies demonstrated how pharmacists as members of a multidisciplinary team can decrease time to antibiotic administration while still appropriately treating those patients. The descriptive retrospective review by Weant also identified that pharmacists were often consulted for dosing and correct empiric therapy recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…The bundle included an order set, a physical response by the team including 26 In addition, patients being treated with the bundle were more likely to reach a central venous pressure greater than 8 mm Hg within 6 hours (OR, 2.4; 95% CI 1.0-5.6), however no difference was seen in achieving a mean arterial pressure (MAP) greater than 65 mm Hg. 26 Pharmacists, as members of a multidisciplinary sepsis response team, were able to demonstrate improved time to antibiotic administration.…”

Section: Pharmacist Involvementmentioning

confidence: 99%

See 3 more Smart Citations

Importance of Pharmacy Involvement in the Treatment of Sepsis

et al. 2017

View full text Add to dashboard Cite

Purpose: A review of the impact of pharmacists on appropriate medication selection, timing of administration, and as members of a multidisciplinary sepsis response team. Summary: Early goal-directed therapy (EGDT), currently recommended by the 2013 Surviving Sepsis Campaign guidelines for the management of patients with sepsis, includes the administration of appropriate antibiotics in patients with septic shock within the first hour. Multidisciplinary teams containing pharmacists have been shown to decrease time to antibiotic delivery, time to antibiotic administration, and patient mortality. The pharmacist can act as a drug information resource, expedite the medication verification and procurement process, and offer suggestions on how to better manage the patients. Pharmacists are often consulted for dosing and antibiotic selection recommendations for patients with sepsis, but they can also help increase the appropriateness of antibiotics selected. Additional recommendations and interventions made by pharmacists include fluid management and vasopressor facilitation for the more severe patients. A sepsis management team that included a pharmacist increased the number of patients receiving appropriate antibiotics within the first hour by as much as 22-fold. Another study has demonstrated that intensive care units with a pharmacist are associated with a 4% decrease in sepsis patient mortality compared to those without a pharmacist. Conclusion: Multidisciplinary teams containing pharmacists have been shown to decrease time to administration of antibiotics, increase appropriate selection of medications, and decrease mortality; they may also decrease overall health care costs.

show abstract

Section: Pharmacist Involvementmentioning

confidence: 85%

Section: Pharmacist Involvementmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Pharmacist Involvementmentioning

confidence: 99%

See 2 more Smart Citations

Importance of Pharmacy Involvement in the Treatment of Sepsis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In healthcare, QI has made substantial cost-saving impacts on outputs and outcomes related to infection control, hospital operations, and reducing surgical complications [23][24][25]. While the barriers and process failures related to service delivery in LMICs often mirror those in high-income settings, these obstacles are compounded by critical resource constraints in LMICs [3,26,27]. QI has significant potential for strengthening service delivery and health tics as a significant source of delay in antibiotic administration.…”

Section: Resultsmentioning

confidence: 99%

Modeling Quality Improvement Strategies to Reduce Treatment Delays for Severe Sepsis at a Tertiary Care Hospital in India

Cattamanchi¹,

C²,

Felicity³

et al. 2018

Int J Crit Care Emerg Med

View full text Add to dashboard Cite

Objectives: Extensive evidence from high-income countries has demonstrated the value of quality improvement (QI) methods yet reports of their use in LMICs are markedly limited. We aim to explore how QI can be implemented in the setting of an LMIC to remove barriers to timely antibiotic therapy for severe sepsis. Methods: Using a mixed-methods assessment, we explored key barriers to the timely antibiotic administration for sepsis in an urban, tertiary care facility in India. This was designed as a resource-sparing exploratory investigation. We sent questionnaires to five randomly selected nurses and five randomly selected physicians working in the emergency department and tracked time point data for patients with presumed sepsis over a one-month period. Results: Time to antibiotics ranged in this investigation from 20 to 540 minutes (Mean: 227 minutes). A process map was drawn from these findings. Three key barriers to timely antibiotic administration were readily detected by our investigation: Delay from the admitting team antibiotic selection process, delay in family purchasing prescribed antibiotics from outside locations, and delay in the physical administration of antibiotics. Conclusions: This investigation demonstrated the importance and practicality of instituting and institutionalizing QI methods in the care delivery process in resource-constrained settings. In this relatively small and low-resource assessment, key obstacles were readily detected, and furthermore without disrupting patient care. While augmented resource support and health systems strengthening are essential to improve sustainable emergency care delivery in LMICs, QI methods present a vital pathway to improve care with relatively small resource investment.

show abstract

Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Atkins

Bastin

Morgan

et al. 2022

J Am Coll Clin Pharm

Self Cite

View full text Add to dashboard Cite

Introduction Sepsis is a life‐threatening medical emergency and a leading cause of morbidity and mortality worldwide. Reductions in time to antibiotics in patients presenting with sepsis or septic shock are associated with reduced mortality, and Surviving Sepsis Campaign guidelines recommend antibiotics within 1 h of recognition. Pharmacists are well‐equipped to help navigate the therapeutic and operational challenges associated with achieving this goal. Objectives To assess the association of pharmacist involvement in sepsis response with time to antibiotics in hospitalized patients with sepsis and septic shock. Methods A systematic review of the following databases was conducted: PubMed/MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Studies must have included a designated role of an individual pharmacist in the management of sepsis or septic shock and not be considered an operational change. The primary outcome of interest was time to antibiotic administration, with secondary outcomes including intensive care unit (ICU) and hospital length of stay as well as in‐hospital mortality. Results We identified 10 studies including 1772 patients with sepsis or septic shock that evaluated a sepsis response in which a pharmacist was included. Studies included patients in the ICU, emergency department, and hospital ward setting. Seven studies demonstrated a significant reduction in time to antibiotics, with two other studies supporting this conclusion in extrapolation or sensitivity analysis. There was not a consistent reduction in ICU or hospital length of stay nor in‐hospital mortality between those interventions involving a pharmacist compared with their defined control groups. Conclusion Pharmacist involvement in sepsis response, often as part of a multiprofessional team‐based approach to sepsis care, is associated with a reduced time to antibiotic administration for hospitalized patients with sepsis or septic shock.

show abstract

Utilization of Pharmacist Responders as a Component of a Multidisciplinary Sepsis Bundle

Cited by 21 publications

References 19 publications

Importance of Pharmacy Involvement in the Treatment of Sepsis

Importance of Pharmacy Involvement in the Treatment of Sepsis

Modeling Quality Improvement Strategies to Reduce Treatment Delays for Severe Sepsis at a Tertiary Care Hospital in India

Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Contact Info

Product

Resources

About