{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:24:55Z","timestamp":1753878295190,"version":"3.41.2"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the impact of implementing a sepsis pathway and education program on key sepsis outcomes and performance targets in a tertiary paediatric hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A quality improvement study using a multi\u2010modal screening process and pragmatic clinical definitions. Treatment of all children with septic shock and sepsis without shock 4\u2009months prior to pathway\/education package launch was compared with those meeting definitions 8\u2009months post\u2010launch.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the study period, 1483 episodes were screened; 517 episodes met study definitions (171 pre\u2010launch; 346 post\u2010launch). Eighty\u2010two episodes met septic shock definitions (15.9%) and 435 met sepsis without shock definitions (84.1%). A total of 143 episodes pre\u2010launch and 271 episodes post\u2010launch 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\u2009min [IQR: 16; 75] for those with septic shock and\/or sepsis without shock treated exclusively at PCH; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The proportion receiving antibiotic therapy within recommended timeframes significantly increased (septic shock within 60\u2009min: 70.0% to 92.5%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.03; sepsis without shock within 180\u2009min; 86.2% to 94.8%, <jats:italic>P<\/jats:italic>\u2009=\u20090.005). No statistically significant change in length of stay, intensive care admission, mortality or antibiotic consumption was observed following pathway launch.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.70036","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T20:53:52Z","timestamp":1744059232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of an evidence\u2010based sepsis pathway on paediatric hospital clinical practice: A quality improvement study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9000-3593","authenticated-orcid":false,"given":"Bernard","family":"McCarthy","sequence":"first","affiliation":[{"name":"Department of Paediatric Emergency Medicine Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Child and Adolescent Health Service Sepsis Program Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5294-9790","authenticated-orcid":false,"given":"Natalie","family":"Middleton","sequence":"additional","affiliation":[{"name":"Child and Adolescent Health Service Sepsis Program Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4697-9640","authenticated-orcid":false,"given":"Fenella J","family":"Gill","sequence":"additional","affiliation":[{"name":"Child and Adolescent Health Service Sepsis Program Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"School of Nursing Faculty of Health Sciences, Curtin University  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoy","family":"Goff","sequence":"additional","affiliation":[{"name":"Child and Adolescent Health Service Sepsis Program Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Department of Infectious Diseases Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Paterson","sequence":"additional","affiliation":[{"name":"Child and Adolescent Health Service Sepsis Program Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2017-0683","authenticated-orcid":false,"given":"Christopher C","family":"Blyth","sequence":"additional","affiliation":[{"name":"Child and Adolescent Health Service Sepsis Program Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Department of Infectious Diseases Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Division of Paediatrics School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia  Perth Western Australia Australia"},{"name":"Wesfarmers Centre of Vaccine and Infectious Diseases The Kids Research Institute Australia, Perth Children's Hospital  Perth Western Australia Australia"},{"name":"Department of Microbiology PathWest Laboratory Medicine, QEII Medical Centre  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the CAHS Sepsis Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.0179"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001340"},{"volume-title":"Queensland Paediatric Sepsis Mortality Study","year":"2024","author":"Queensland Paediatric Sepsis Program at Children's Health Queensland","key":"e_1_2_10_6_1"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05878-6"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000002043"},{"volume-title":"Sepsis Clinical Care Standard","year":"2022","author":"The Australian Commission on Safety and Quality in Health Care","key":"e_1_2_10_9_1"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-14226-6"},{"volume-title":"CAHS Annual Report 2022\u201023","year":"2023","author":"Government of Western Australia Child and Adolescent Health Service","key":"e_1_2_10_11_1"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2021.09.004"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390\u2010024\u201003459\u2010y"},{"key":"e_1_2_10_14_1","article-title":"Current challenges in sepsis documentation and coding: a review of the literature","volume":"20","author":"Sand J","year":"2023","journal-title":"Perspect. Health Inf. Manag."},{"volume-title":"ICD\u201010\u2010AM 12th Edition Sepsis Codes","year":"2023","author":"Australian Commission on Safety and Quality in Healthcare","key":"e_1_2_10_15_1"},{"key":"e_1_2_10_16_1","unstructured":"Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation.Australian and New Zealand Paediatric Intensive Care Registry Activity Report.2018."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.33321\/cdi.2021.45.53"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-5021-8"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12610"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-021-05717-4"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000573"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-059938"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001663"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-007369"},{"volume-title":"Sepsis Pathways Behavioural Survey","year":"2024","author":"New South Wales Clinical Excellence Commission","key":"e_1_2_10_25_1"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-07128-2"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.16375"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)71003-5"},{"key":"e_1_2_10_29_1","article-title":"Increase in invasive group a streptococcal disease among Australian children coinciding with northern hemisphere surges","volume":"41","author":"Abo Y\u2010N","year":"2023","journal-title":"Lancet Reg. Health West. Pac."},{"volume-title":"2021 Australian Census","year":"2021","author":"Australian Bureau of Statistics","key":"e_1_2_10_30_1"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja16.00595"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.03.025"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T04:14:28Z","timestamp":1747368868000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/1742-6723.70036"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70036","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"type":"print","value":"1742-6731"},{"type":"electronic","value":"1742-6723"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70036"}}