# Impact of an evidence‐based sepsis pathway on paediatric hospital clinical practice: A quality improvement study

## TL;DR

A study found that using a sepsis pathway and education program in a children's hospital reduced the time to give antibiotics for sepsis.

## Contribution

The study demonstrates the effectiveness of a sepsis pathway and education program in improving antibiotic administration times in pediatric sepsis.

## Key findings

- The median time from recognition to antibiotic administration decreased significantly after the pathway was implemented.
- A higher proportion of patients received antibiotics within recommended timeframes post-intervention.
- No significant changes were observed in length of stay, intensive care admission, mortality, or antibiotic consumption.

## Abstract

To assess the impact of implementing a sepsis pathway and education program on key sepsis outcomes and performance targets in a tertiary paediatric hospital.

A quality improvement study using a multi‐modal screening process and pragmatic clinical definitions. Treatment of all children with septic shock and sepsis without shock 4 months prior to pathway/education package launch was compared with those meeting definitions 8 months post‐launch.

Over the study period, 1483 episodes were screened; 517 episodes met study definitions (171 pre‐launch; 346 post‐launch). Eighty‐two episodes met septic shock definitions (15.9%) and 435 met sepsis without shock definitions (84.1%). A total of 143 episodes pre‐launch and 271 episodes post‐launch were managed exclusively at Perth Children's Hospital (PCH). Post intervention, the pathway form was utilised in 146 of 271 episodes (53.9%). Pathway/education package introduction was associated with a reduction in the median time from recognition to antibiotic administration (60 [IQR: 26; 115] to 45 min [IQR: 16; 75] for those with septic shock and/or sepsis without shock treated exclusively at PCH; P < 0.001). The proportion receiving antibiotic therapy within recommended timeframes significantly increased (septic shock within 60 min: 70.0% to 92.5%, P < 0.03; sepsis without shock within 180 min; 86.2% to 94.8%, P = 0.005). No statistically significant change in length of stay, intensive care admission, mortality or antibiotic consumption was observed following pathway launch.

Paediatric sepsis pathway and education package implementation can reduce time to antibiotics in sepsis and aid local data collection and surveillance of patients treated for sepsis.

A quality improvement study at a Western Australian tertiary paediatric hospital found that implementing a paediatric sepsis pathway and associated education program can reduce the time to administer antibiotics in sepsis cases. A pragmatic audit supports local data collection and enables effective surveillance of sepsis patients.