The sepsis protocol (Rothman Index) was established in 2003 so if there was likely to be a problem we would probably have heard about it by now. The fact is, it reduces 24 hour and 1 year mortality dramatically, and reduces the number of codes and rapid responses. A severe sepsis comes on very fast and can kill the patient pretty quickly, so the point of all the studies is to show that action must be quick. Since its inception, the decrease in sepsis mortality has been between 30 and 50%. Many hospitals are now incorporating a sepsis alert in their EHR which is brilliantly designed and programmed to detect possible sepsis parameters much more quickly than the naked human eye alone can. It actually detects up to 50 parameters, and if a patient is exhibiting a positive in many of these markers, it's highly recommended that they begin therapy as soon as possible, as every hour that goes by increases their mortality. The pathway is not applied willy-nilly...many things are taken into consideration before the application of antibiotics. I was on the team that developed the sepsis pathway in our EHR and it's an amazing tool.
It detects the following parameters:
Two signs of systemic inflammatory response syndrome, one sign of organ dysfunction and utilizes Temp, BP, HR, RR, Glucose, Lactate, bands, creatinine, bilirubin, platelets, PTT, blood cultures, UA and WBC measurements. In the event of a number of these being highlighted as positive, there is an increased likelihood ratio that the patient is positive for sepsis and so administration of antibiotics is appropriate and timely. Many studies have shown that initiation of the sepsis protocol lowers 24 hour mortality, reduces 30 day readmission rates and reduces the number of codes and rapid responses and also reduced LOS of sepsis patients from 16.5 to 13.6 days, achieving $5,882 in medical savings per treated patient, a 21 percent reduction in length of stay, and a 24 percent reduction in in-hospital patient mortality (Cerner).
Finlay, G. D., Rothman, M. J., & Smith, R. A. (2014). Measuring the modified early warning score and the Rothman index: advantages of utilizing the electronic medical record in an early warning system. Journal of hospital medicine, 9(2), 116-119.
Hagland, M. (2015). Applying the Rothman Index to Reduce Mortality: Oconee ... Retrieved October 24, 2016, from Applying the Rothman Index to Reduce Mortality: Oconee Memorialâs Bold Push | Healthcare Informatics Magazine | Health IT | Information Technology