Alerts and Alarms-Can Electronic Medical Records Help Children and Adolescents Survive Sepsis?

Driver, B; Babl, FE; Cheng, D; Gelbart, B; Long, E; McNab, S; Osowicki, J; Salib, P; Williams, A; Haeusler, GM

Author(s): Driver, B; Babl, FE; Cheng, D; Gelbart, B; Long, E; McNab, S; Osowicki, J; Salib, P; Williams, A; Haeusler, GM;
Details: Publication Year 2026-08,Volume 62,Issue #8,Page 1314-1326
Journal Title: Journal of Paediatrics and Child Health
Publication Type: Review
Abstract: Early recognition and treatment of paediatric sepsis has been shown to improve survival. Automated sepsis alerts embedded in electronic medical records (EMRs) offer real-time identification of high-risk patients and may improve timeliness of sepsis care, with possible limitations including overdiagnosis, overtreatment and alert fatigue. It is currently unclear whether automated alerts improve clinical outcomes in paediatric sepsis. We conducted a systematic review and narrative synthesis of studies evaluating clinical outcomes (mortality, PICU admission rate, length of stay), process measures (time to fluids/antibiotics, bundle adherence), and balancing measures (hospitalisation rate, antibiotic use) after implementation of EMR-based automated sepsis alerts in patients under 18 years of age. Twelve studies met inclusion criteria. Automated alerts were associated with improvements in process measures, notably reduced time to antibiotics (4/6 studies) and fluids (2/5 studies). Mortality was reduced in one study of PICU patients (29.9% vs. 17.4%, p = 0.011), and a trend towards reduced PICU admissions was observed. No significant impact on hospital or PICU length of stay was noted. Alerts did not increase hospital admission rates or antibiotic usage. Automated sepsis alerts may improve time to fluids and antibiotics in paediatric sepsis. While inconsistently reported, alerts were not found to increase hospital admission rates or antibiotic use. The impact on clinical outcomes, particularly mortality, remains uncertain. High quality randomised studies are needed to define their role in improving paediatric sepsis outcomes.
Publisher: Wiley
Keywords: Humans; *Sepsis/diagnosis/mortality/therapy; *Electronic Health Records; Child; Adolescent; *Clinical Alarms; Child, Preschool; Anti-Bacterial Agents/therapeutic use; alert; children; electronic medical record; paediatric; sepsis
Department(s): Infectious Diseases
Publisher's Version: https://doi.org/10.1111/jpc.70412
Open Access at Publisher's Site: https://doi.org/10.1111/jpc.70412
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-05-14 12:09:39

Last Modified: 2026-09-03 12:44:11