Sepsis Screening Tool
One clinical decision support tool that is being used in my E.D. is the sepsis screening tool. The sepsis screening tool identifies patients meeting SIRS (systemic inflammatory response syndrome) criteria. Once the criteria are aligned based on patient VS during intake/triage or reassessment of patients while in the emergency department (abnormal labs, abnormal vital signs), an alert is activated prompting the healthcare team with notifications delivered to them for action. Prompt recognition and early intervention of SEPSIS may reverse the inflammatory response of high-risk patient populations improving patient outcomes (Amland et al., 2015).
The C.D.S. that generates an alert in the E.H.R. however sometimes cause alert fatigue and sometimes interruption of workflow due to the detection algorithm. A slight change in patient status like increased heart rate or WBC count however will trigger the alert system without obvious signs of patient deterioration. Often nurses must huddle with providers before cancelling the prompt and proceed with standard patient care. If providers are not around, the alert continues causing alert fatigue for the nurse disrupting workflow in the process.
If I was to create a clinical decision support tool in my practice, it would be the recognition of patients who are “frequent flyers” in the emergency department. I often see the same patients come in multiple times with the same complaints but with different providers, approach to treatments can sometimes vary. The C.D.S. will alert providers about the patient and will provide clinical decisions on how to better care for that patient without ordering multiple tests. This will save money and time.
References:
Amland, R.C., Hahn-Cover K.K., (2019). Clinical decision support for early recognition of sepsis. American journal of medical quality, 34(5). https://doi.org/10.1177/1062860619873225
