title: Computerised sepsis protocol management. Description of an early warning system.
abstract: 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.
authors.affiliation: Unidad Multidisciplinar de Sepsis, Hospital Son Llàtzer, Palma de Mallorca, España. Electronic address: begomarsella@hotmail.com.
authors.forename: Begoña
authors.initials: B
authors.lastname: de Dios
authors.affiliation: Unidad Multidisciplinar de Sepsis, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Marcio
authors.initials: M
authors.lastname: Borges
authors.affiliation: Servicio de Medicina Intensiva, Clínica Juaneda, Palma de Mallorca, España.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Smith
authors.affiliation: Servicio Medicina Intensiva, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Del Castillo
authors.affiliation: Servicio Medicina Intensiva, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Antonia
authors.initials: A
authors.lastname: Socias
authors.affiliation: Servicio Medicina Intensiva, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Leticia
authors.initials: L
authors.lastname: Gutiérrez
authors.affiliation: Servicio de Farmacia, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Nicolás
authors.affiliation: Servicio de Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Lladó
authors.affiliation: Servicio de Urgencias, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Roche
authors.affiliation: Servicio de Microbiología, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Díaz
authors.affiliation: Unidad Multidisciplinar de Sepsis, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Lladó
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D057189:Checklist; D002985:Clinical Protocols; D003428:Cross Infection / Q000175:diagnosis* / Q000188:drug therapy; D003936:Diagnosis, Computer-Assisted; D019468:Disease Management; D057915:Drug Substitution; D042241:Early Diagnosis; D006748:Hospital Departments; D006751:Hospital Information Systems / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D009102:Multiple Organ Failure / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy; D012984:Software; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis; D013689:Telephone
chemical_list: D000900:Anti-Bacterial Agents
keywords: Computer-assisted sepsis management protocol; Hospital multidisciplinary sepsis team; Protocolo Informático de Manejo Integral de la Sepsis; Sepsis; Unidad multidisciplinar de sepsis