Editorial Cites 'Growing Fatigue' Around Sepsis Reports

The Lancet Respiratory Medicine's editorial notes that early detection of sepsis is vital but is hampered by signs and symptoms of the condition being similar to other disorders.

The Lancet Respiratory Medicine has published an editorial this month titled "Crying wolf: the growing fatigue around sepsis alerts," which suggests that sepsis alerts from primary care systems are being "over-triggered," and that doctors may become desensitized to the high number of frequent alarms and fail to spot real cases of sepsis.

The editorial says sepsis is challenging to diagnose, particularly in the early stages, even though the global incidence of sepsis is estimated to be around 30 million episodes annually. "According to the UK Sepsis Trust, sepsis claims more lives per year in the UK than lung cancer, and more lives than bowel, breast, and prostate cancer combined," it says. "Complexity in the diagnosis of sepsis arises from the heterogeneity of this disorder—it can be caused by a wide range of pathogens acting on different organs. The definition of sepsis has also changed, owing to increasing understanding of its pathobiology, and in 2016, consensus definitions emphasized organ dysfunction as a key factor in its characterization."

It mentions two UK reports that highlighted avoidable deaths from sepsis, recommending earlier detection and treatment and having clinical settings consider sepsis as an immediate life-threatening condition that should be treated as an emergency. This brought about automated alerts for the identification of sepsis, a series of escalating prompts when a doctor records potential symptoms of sepsis in the patient's electronic health record.

"There is now increasing anecdotal evidence, and an admission by the UK National Health Service (NHS) England in January, 2018, that sepsis alerts from primary care systems are being over-triggered," the editorial says. "Doctors have pointed to a low threshold for sending alerts, with example complaints including alerts being triggered when a patient's temperature is measured, but no fever has been recorded. The consequence is so-called alert fatigue, where doctors become desensitized to the high number of frequent alarms, which can lead to alerts being ignored or switched off, and real cases of sepsis being missed."

It is not yet clear whether the alerts are being triggered too often because of issues with implementing the algorithm or problems with the algorithm itself, it says.

The editorial's summation notes that early detection of sepsis is vital but is hampered by signs and symptoms of the condition being similar to other disorders. "GPs see many patients with symptoms of infection, but the proportion that will have sepsis is very small. Alerting systems to help doctors should have a high specificity and sensitivity, present clear information, facilitate safe and efficient handling of the alerts, and shouldn't unnecessarily disrupt workflow. A careful assessment of the system is also needed to ensure these criteria are met, and that the correct balance between false and valid alarms is achieved. Alerts must maintain their intended urgency and attention-grabbing power," it says.

Download Center

HTML - No Current Item Deck
  • Safety Management Software - Free Demo

    IndustrySafe Safety Software’s comprehensive suite of modules help organizations to record and manage incidents, inspections, hazards, behavior based safety observations, and much more. Improve safety with an easy to use tool for tracking, notifying and reporting on key safety data.

  • Create Flexible Safety Dashboards

    IndustrySafe’s Dashboard Module allows organizations allows you to easily create and view safety KPIs to help you make informed business decisions. Our best of breed default indicators can also save you valuable time and effort in monitoring safety metrics.

  • Schedule and Record Observations

    IndustrySafe's Observations module allows managers, supervisors, and employees to conduct observations on employees involved in safety critical behavior. IndustrySafe’s pre-built BBS checklists may be used as is, or can be customized to better suit the needs of your organization.

  • Why Is Near Miss Reporting Important?

    A near miss is an accident that's waiting to happen. Learn how to investigate these close calls and prevent more serious incidents from occurring in the future.

  • Get the Ultimate Guide to Safety Training

    When it comes to safety training, no matter the industry, there are always questions regarding requirements and certifications. We’ve put together a guide on key safety training topics, requirements for certifications, and answers to common FAQs.

  • Industry Safe
comments powered by Disqus

OH&S Digital Edition

  • OHS Magazine Digital Edition - June 2019

    June 2019


      New Orleans Networking
      Heed These Summer Safety Tips
      Education, Skill Development, and Behavior Change
      What Good Looks Like
    View This Issue

Bulwark Quiz