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In a prospective cohort study, investigators compared adherence to Pediatric Advance Life Support (PALS) sepsis guidelines before and during a quality improvement intervention at a Boston pediatric hospital. The intervention included education, use of intravenous (IV) fluid pressure bags rather than IV pumps for more rapid fluid administration, regular feedback, surveys to identify barriers to timely care, distribution of the PALS algorithm and pocket cards, electronic standardized order sets with a visual alert system, and bedside “shock clocks” to track time from diagnosis.
A total of 126 children (median age, 9 years) with severe sepsis or septic shock were identified during the 16-month preintervention period and 116 children (median age…