de Dios Begoña, Borges Marcio, Smith Timothy D, Del Castillo Alberto, Socias Antonia, Gutiérrez Leticia, Nicolás Jordi, Lladó Bartolomé, Roche Jose A, Díaz Maria P, Lladó Yolanda
Unidad Multidisciplinar de Sepsis, Hospital Son Llàtzer, Palma de Mallorca, España.
Unidad Multidisciplinar de Sepsis, Hospital Son Llàtzer, Palma de Mallorca, España.
Enferm Infecc Microbiol Clin (Engl Ed). 2018 Feb;36(2):84-90. doi: 10.1016/j.eimc.2016.11.011. Epub 2017 Jan 10.
New strategies need to be developed for the early recognition and rapid response for the management of sepsis. To achieve this purpose, the Multidisciplinary Sepsis Team (MST) developed the Computerised Sepsis Protocol Management (PIMIS). The aim of this study was to evaluate the convenience of using PIMIS, as well as the activity of the MST.
An analysis was performed on the data collected from solicited MST consultations (direct activation of PIMIS by attending physician or telephone request) and unsolicited ones (by referral from the microbiology laboratory or an automatic referral via the hospital vital signs recording software [SIDCV]), as well as the hospital department, source of infection, treatment recommendation, and acceptance of this.
Of the 1,581 first consultations, 65.1% were solicited consultations (84.1% activation of PIMIS and 15.9% by telephone). The majority of unsolicited consultations were generated by the microbiology laboratory (95.2%), and 4.8% from the SIDCV. Referral from solicited consultations were generated sooner (5.63days vs 8.47days; P<.001) and came from clinical specialties rather than from the surgical ward (73.0% vs 39.1%; P<.001). A recommendation was made for antimicrobial prescription change in 32% of first consultations. The treating physician accepted 78.1% of recommendations.
The high rate of solicited consultations and acceptance of recommended prescription changes suggest that a MST is seen as a helpful resource, and that PIMIS software is perceived to be useful and convenient to use, as it is the main source of referral.
需要制定新策略，以便对脓毒症进行早期识别和快速应对管理。为实现这一目的，多学科脓毒症团队（MST）开发了计算机化脓毒症方案管理（PIMIS）。本研究旨在评估使用PIMIS的便利性以及MST的活动情况。
对收集的数据进行分析，这些数据来自主动寻求的MST会诊（由主治医生直接激活PIMIS或电话请求）和被动寻求的会诊（通过微生物实验室转诊或通过医院生命体征记录软件[SIDCV]自动转诊），以及医院科室、感染源、治疗建议及其接受情况。
在1581次首次会诊中，65.1%是主动寻求的会诊（84.1%通过激活PIMIS，15.9%通过电话）。大多数被动寻求的会诊由微生物实验室发起（95.2%），4.8%来自SIDCV。主动寻求会诊的转诊时间更早（5.63天对8.47天；P<0.001），且来自临床专科而非外科病房（73.0%对39.1%；P<0.001）。在32%的首次会诊中提出了更改抗菌药物处方的建议。主治医生接受了78.1%的建议。
主动寻求会诊的高比例以及对推荐处方更改的接受表明，MST被视为一种有用的资源，并且PIMIS软件被认为有用且便于使用，因为它是转诊的主要来源。
