How well are sepsis and a sense of urgency documented throughout the acute care chain in the Netherlands? A prospective, observational study.

BMJ Open
Gideon LattenPatricia Stassen

Abstract

To investigate the documentation of sepsis and a sense of urgency throughout the acute care chain. Prospective cohort study. Emergency department (ED) in a large district hospital in Heerlen, The Netherlands. Participants included patients ≥18 years with suspected sepsis who visited the ED during out-of-hours between September 2017 and January 2018 (n=339) and had been referred by a general practitioner and/or transported by ambulance. We defined suspected sepsis as suspected or proven infection and the presence of ≥2 quick Sepsis-related Organ Failure Assessment and/or ≥2 Systemic Inflammatory Response Syndrome criteria. We analysed how often sepsis and a sense of urgency were documented in the prehospital and ED medical records. A sense of urgency was considered documented when a medical record suggested the need of immediate assessment by a physician in the ED. We described documentation patterns throughout the acute care chain and investigated whether documentation of sepsis or a sense of urgency is associated with adverse outcomes (intensive care admission/30-day all-cause mortality). Sepsis was documented in 16.8% of medical records and a sense of urgency in 22.4%. In 4.1% and 7.7%, respectively, sepsis and a sense of urg...Continue Reading

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