Introduction: Antibiotic administration within 1 hour of sepsis recognition reduces mortality with every hour of delay increasing all-cause mortality by 7-10%. However, significant delays do occur, affecting outcomes. An Antibiotic Dashboard was created to monitor antibiotic administration times and identify process inefficiencies and barriers associated with delay.
Methods: A retrospective analysis of all patients admitted to MICU who received new antibiotics from Jan – Dec 2023 was performed. We measured median time to administer antibiotics along with proportion of antibiotics that were administered within 1 hour of the order. Unpaired t test and Chi Square was used to compare two groups.
Results: A total of 939 antibiotic orders were included. The median time to administration of first antibiotics dose from order entry was 51(27- 83) minutes with 59 % administered within 1 hour. There were 619 (66%) daytime administrations and 320 (34%) nighttime administrations with no significant differences in median time (51 (27-83) vs. 51 (27-83) min as well as proportion receiving antibiotics within 1 hour. (59% vs. 58%). However, a statistically significant difference (P < 0.0003) was observed in administration times for antibiotics stored in the ICU (91%) vs those delivered from pharmacy (9%). The median time was 50 (26-80) min for antibiotics stored in the ICU vs 76 (43-108) min for those delivered from pharmacy . There was also a significant difference in the proportion of patients receiving antibiotics within 1 hour (61% for antibiotics stored in ICU vs 35 % for antibiotics delivered from pharmacy) within 1 hour.
Conclusions: This study highlights the importance of the Antibiotic Dashboard for monitoring antibiotic administration times and processes that cause delays. The dashboard enabled real-time identification of key process inefficiencies, particularly delays associated with antibiotics not stored in the ICU. By distinguishing between system-related and logistical barriers, such as medication location, the dashboard provides actionable insights to guide targeted interventions. These findings support the continued use and expansion of such monitoring tools to drive quality improvement initiatives aimed at reducing time to antibiotic administration in critically ill patients.
