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Sepsis Electronic Prompting for Timely Intervention and Care for Emergency Department Patients (SEPTIC-ED)

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Columbia University

Status

Completed

Conditions

Electronic Health Records
Clinical Decision Support Systems
Sepsis

Treatments

Other: Nurse SIRS alert
Other: Prescribing clinician SIRS alert

Study type

Interventional

Funder types

Other

Identifiers

NCT06117605
AAAU1002 - ED

Details and patient eligibility

About

The goal of this clinical trial is to study systemic inflammatory response syndrome (SIRS) electronic health record (EHR) alerts for sepsis in the emergency department (ED). The main question it aims to answer is: do nurse alerts, prescribing clinician alerts, or both nurse and prescribing clinician alerts improve time to sepsis treatment for patients in the ED?

Nurses and prescribing clinicians will receive SIRS alerts based on the group to which the patient is randomly assigned. Researchers will compare four groups: no alerts, nurse alerts only, prescribing clinician alerts only, or both nurse and prescribing clinician alerts.

Full description

SEPTIC is a master protocol for two trials on distinct subpopulations: emergency department (ED) patients and inpatients. This protocol "ID: AAAU1002 - ED" describes the ED subpopulation study while "ID: AAAU1002 - IP" describes the inpatient subpopulation study.

Sepsis is a major cause of death both globally and in the United States. Early identification and treatment of sepsis are crucial for improving outcomes. International guidelines recommend hospital sepsis screening programs, which are commonly implemented in the electronic health record (EHR) as an interruptive screening alert based on systemic inflammatory response syndrome (SIRS) criteria. Despite widespread use, it is unknown whether these sepsis screening and alert tools improve the delivery of high-quality sepsis care. This study tests interruptive (pop-up) EHR alerts. Epic Systems, the company that produces the EHR, refers to these types of alerts as BestPractice Advisories (BPAs).

Enrollment

25,668 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Patient Inclusion Criteria:

  • age > 18 years-old
  • meets SIRS criteria
  • physically located in the emergency department
  • not located in a hospital unit that takes care of pregnant and peri-partum patients
  • not SARS-COV-2 PCR positive in past 7 days
  • does not have an active order for "comfort measures only"

Patient Exclusion Criteria:

  • already having sepsis treatment ordered (if prescribing clinician alert) or collected/completed (if nurse alert)
  • already enrolled in the SEPTIC study (including as an emergency department patient or as an inpatient)

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Factorial Assignment

Masking

Triple Blind

25,668 participants in 4 patient groups

No alert
No Intervention group
Description:
Participants will receive no physician alert or registered nurse (RN) alert.
Nurse alert
Experimental group
Description:
Participants will receive RN alert.
Treatment:
Other: Nurse SIRS alert
Prescribing clinician alert
Experimental group
Description:
Participants will receive physician alert.
Treatment:
Other: Prescribing clinician SIRS alert
Nurse alert and prescribing clinician alert
Experimental group
Description:
Participants will receive physician alert and RN alert.
Treatment:
Other: Prescribing clinician SIRS alert
Other: Nurse SIRS alert

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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