Early Sepsis Response System Does Not Correlate with Pediatric Early Warning Score in Sepsis Recognition.

ABSTRACT

Sepsis is a leading cause of pediatric morbidity and mortality worldwide with early recognition and management improving patient outcomes. Early recognition warning systems, utilizing the electronic medical record (EMR), are recommended for children's hospitals. Validated pediatric early warning score (PEWS) recognize hospitalized children at risk for worsening and need for higher level of care. The goal of this study was to develop a novel pediatric sepsis early response warning system and compare this tool with the existing generic PEWS system in recognizing sepsis. A novel early sepsis warning system was integrated into the EMR of a tertiary pediatric children's hospital. In patients meeting criteria a best practice alert (BPA) triggers and children with a sepsis BPA trigger were evaluated from December, 2018 through May, 2020. BPA data was analyzed and identified children meeting sepsis criteria. Subjects identified as having sepsis were then correlated with PEWS scores at the time of the BPA. The BPA triggered in 736 pediatric subjects, with 181 in the emergency department, 275 in the pediatric inpatient floor and 280 in the pediatric intensive care unit. Pediatric sepsis criteria identified 524 of 736 (71%) as having sepsis. PEWS scores identified only 66 (13%) of the 524 subjects who had sepsis. Implementation of a sepsis trigger tool into EMR is feasible. Best practice alerts identify subjects with early sepsis and can be implemented to electronic medical record.