Computer-assisted decision support for changing practice in severe sepsis and septic shock

J Int Med Res. Sep-Oct 2010;38(5):1605-16. doi: 10.1177/147323001003800505.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Computer-Aided Design*
  • Decision Support Systems, Clinical*
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Prospective Studies
  • Retrospective Studies
  • Sepsis / etiology
  • Sepsis / mortality*
  • Sepsis / therapy
  • Shock, Septic / etiology
  • Shock, Septic / mortality*
  • Shock, Septic / therapy
  • Survival Rate