After implementing the multifaceted intervention including e-alert and SRT, cases were identified with less severe clinical and laboratory abnormalities and the processes of care improved.
Implementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and LOS.
The implementation process was based on a multifaceted intervention including a local sepsis team, protocols, screening procedures, laboratory and antibiotics flowchart for emergency department (ED), wards and intensive care units (ICU), checklists, physicians and nurses training nd audit/feedback strategies.
This was a pre post two-phased implementation study that consisted of a pre-intervention phase (January 01 , 2011 September 24 , 2012 intervention phase I (multifaceted intervention including e-alert, from September 25 , 2012 March 03 , 2013and intervention phase II when SRT was added (March 04 , 2013 October 30 , 2013in a 900-bed tertiary-care academic hospital.
In conclusion, the implementation of a multifaceted intervention including a sepsis e-alert system with SRT was associated with improvement in care processes of sepsis and septic shock and reduced need for mechanical ventilation as well as reduced mortality and LOS.
The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department.
A multifaceted intervention including several active strategies is more likely to be effective than a single active strategy [ 21].
We compared patients managed according to CPW to those managed by usual care, and patients treated within a multifaceted intervention including a CPW compared to usual care.
In the study by Litzelman et al. (23), patients received "usual care" (not defined) or a multifaceted intervention, including foot care education, behavior contract, and regular reminders.
A multifaceted intervention including a combination of small group interactive postgraduate training, with personalized feedback, and additional instruction material, such as a website, was found to be more successful for implementation of a guideline than a single-faceted intervention [ 7– 9].
