Fry Margaret, Horvat Leanne, Roche Michael, Fong Jacqueline, Plowes Joanne
Faculty of Nursing, Midwifery and Health University of Technology, Sydney, Australia.
Int Emerg Nurs. 2013 Jul;21(3):163-7. doi: 10.1016/j.ienj.2012.07.004. Epub 2012 Aug 9.
Any infection can potentially develop into sepsis. Many patients present to the Emergency Department (ED) with infection and go on to require antibiotics. However, the timeliness of antibiotics can make a difference to patient survival and reduce the risk of infection developing into sepsis and or septic shock.
Our study was a 4month prospective descriptive exploratory pilot study.
Of all adult (n=18,807) presentations 3339 (18%) patients had a primary diagnosis related to infection. The study collected data on 104 (3%) patients who were administered antibiotics. One hundred (95%) patients who received antibiotics were admitted to hospital. Triage code did not influence time to antibiotic (p=.352). Eighty-five (81%) patients waited longer than 1h for their first antibiotic with the shortest administration time 19min (mean 233min, SD 247) and the maximum wait for antibiotics was 1481min. For sepsis or septic shock patients (n=8) the average time to antibiotics was 411min (SD=455min).
The study provides a detailed analysis of ED patients receiving antibiotics. Further research is needed to identify strategies to improve the timely delivery of antibiotics for patients with infections.
任何感染都有可能发展为脓毒症。许多感染患者前往急诊科就诊，随后需要使用抗生素。然而，抗生素使用的及时性对患者的生存情况有影响，并可降低感染发展为脓毒症和/或感染性休克的风险。
我们的研究是一项为期4个月的前瞻性描述性探索性试点研究。
在所有成年（n = 18,807）就诊患者中，3339名（18%）患者的初步诊断与感染有关。该研究收集了104名（3%）接受抗生素治疗患者的数据。100名（95%）接受抗生素治疗的患者被收治入院。分诊代码不影响给予抗生素的时间（p = 0.352）。85名（81%）患者等待首次使用抗生素的时间超过1小时，最短给药时间为19分钟（平均233分钟，标准差247），等待抗生素的最长时间为1481分钟。对于脓毒症或感染性休克患者（n = 8），给予抗生素的平均时间为411分钟（标准差 = 455分钟）。
该研究对急诊科接受抗生素治疗的患者进行了详细分析。需要进一步研究以确定改善感染患者抗生素及时给药的策略。
