Eduardo R Osegueda, Ben Webber, Tanvi Mehta, Deborah L Pestka, Joseph S Koopmeiners, Ivana Ninkovic, Genevieve B Melton, Timothy J Beebe, Michael G Usher
{"title":"败血症微学习干预的经验教训。","authors":"Eduardo R Osegueda, Ben Webber, Tanvi Mehta, Deborah L Pestka, Joseph S Koopmeiners, Ivana Ninkovic, Genevieve B Melton, Timothy J Beebe, Michael G Usher","doi":"10.1055/a-2677-6012","DOIUrl":null,"url":null,"abstract":"<p><p>Improving early recognition and treatment of sepsis is key to decreasing patient mortality. A large academic health system implemented several quality improvement initiatives, yet monthly compliance with sepsis best practices remained low.Develop and evaluate an electronic health record (EHR)-embedded microlearning intervention to address suboptimal adherence to sepsis care best practices.We conducted a randomized stepped-wedge trial of our microlearning intervention with randomization done at the nursing block level. Antibiotic delay and secondary outcomes extracted from the EHR were analyzed using mixed models to account for intracluster correlation.The microlearning intervention did not reduce antibiotic delay (mean difference = 0.71 hours; <i>p</i> = 0.49). Despite the alert firing over 30,000 times during the study period, the microlearning intervention was viewed only a total of 30 times.Our microlearning intervention did not improve sepsis care outcomes. We believe that although the content addressed key knowledge gaps, delivering the intervention through disruptive EHR alerts was not an accessible delivery channel to the nursing staff we targeted.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":"16 4","pages":"1165-1171"},"PeriodicalIF":2.2000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12473517/pdf/","citationCount":"0","resultStr":"{\"title\":\"Lessons Learned from Sepsis Microlearning Intervention.\",\"authors\":\"Eduardo R Osegueda, Ben Webber, Tanvi Mehta, Deborah L Pestka, Joseph S Koopmeiners, Ivana Ninkovic, Genevieve B Melton, Timothy J Beebe, Michael G Usher\",\"doi\":\"10.1055/a-2677-6012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Improving early recognition and treatment of sepsis is key to decreasing patient mortality. A large academic health system implemented several quality improvement initiatives, yet monthly compliance with sepsis best practices remained low.Develop and evaluate an electronic health record (EHR)-embedded microlearning intervention to address suboptimal adherence to sepsis care best practices.We conducted a randomized stepped-wedge trial of our microlearning intervention with randomization done at the nursing block level. Antibiotic delay and secondary outcomes extracted from the EHR were analyzed using mixed models to account for intracluster correlation.The microlearning intervention did not reduce antibiotic delay (mean difference = 0.71 hours; <i>p</i> = 0.49). Despite the alert firing over 30,000 times during the study period, the microlearning intervention was viewed only a total of 30 times.Our microlearning intervention did not improve sepsis care outcomes. We believe that although the content addressed key knowledge gaps, delivering the intervention through disruptive EHR alerts was not an accessible delivery channel to the nursing staff we targeted.</p>\",\"PeriodicalId\":48956,\"journal\":{\"name\":\"Applied Clinical Informatics\",\"volume\":\"16 4\",\"pages\":\"1165-1171\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12473517/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Applied Clinical Informatics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2677-6012\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICAL INFORMATICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Applied Clinical Informatics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2677-6012","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/26 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"MEDICAL INFORMATICS","Score":null,"Total":0}
Lessons Learned from Sepsis Microlearning Intervention.
Improving early recognition and treatment of sepsis is key to decreasing patient mortality. A large academic health system implemented several quality improvement initiatives, yet monthly compliance with sepsis best practices remained low.Develop and evaluate an electronic health record (EHR)-embedded microlearning intervention to address suboptimal adherence to sepsis care best practices.We conducted a randomized stepped-wedge trial of our microlearning intervention with randomization done at the nursing block level. Antibiotic delay and secondary outcomes extracted from the EHR were analyzed using mixed models to account for intracluster correlation.The microlearning intervention did not reduce antibiotic delay (mean difference = 0.71 hours; p = 0.49). Despite the alert firing over 30,000 times during the study period, the microlearning intervention was viewed only a total of 30 times.Our microlearning intervention did not improve sepsis care outcomes. We believe that although the content addressed key knowledge gaps, delivering the intervention through disruptive EHR alerts was not an accessible delivery channel to the nursing staff we targeted.
期刊介绍:
ACI is the third Schattauer journal dealing with biomedical and health informatics. It perfectly complements our other journals Öffnet internen Link im aktuellen FensterMethods of Information in Medicine and the Öffnet internen Link im aktuellen FensterYearbook of Medical Informatics. The Yearbook of Medical Informatics being the “Milestone” or state-of-the-art journal and Methods of Information in Medicine being the “Science and Research” journal of IMIA, ACI intends to be the “Practical” journal of IMIA.