Sepsis Best Practice Advisories as Clinical Decision Support in the Pediatric ICU

Monday, March 23, 2026

9:00 AM - 10:00 AM Central Time

Location: Connections Central - RST 10

Juhi Rattan, MD, MS (she/her/hers)

NYU Langone Health/Hassenfeld Children's Hospital

Disclosure(s): No relevant financial relationship(s) to disclose.
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Jennifer van Helmond, MD

Assistant Professor, Department of Pediatrics at NYU Grossman School of Medicine
NYU Langone Medical Center and School of Medicine

Disclosure information not submitted.
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Ami Shah, MD

Clinical Assistant Professor, Department of Pediatrics
NYU Langone Medical Center and School of Medicine

Disclosure information not submitted.
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Sharon Calaman, MD

Professor, Department of Pediatrics at NYU Grossman School of Medicine
NYU Langone Medical Center and School of Medicine

Disclosure information not submitted.
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Denise C. Hasson, MD

Assistant Professor, Department of Pediatrics
NYU Langone Medical Center and School of Medicine

Disclosure information not submitted.
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Arun Chopra, MD

Associate Professor, Department of Pediatrics at NYU Grossman Long Island School of Medicine
NYU Langone Medical Center and School of Medicine

Disclosure information not submitted.
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Zoe Grabinski, MD

Assistant Professor, Ronald O. Perelman Department of Emergency Medicine at NYU Grossman School of M
NYU Langone Medical Center and School of Medicine

Disclosure information not submitted.

Introduction: Advances in clinical decision support (CDS), such as best practice advisories (BPAs) can assist providers in early recognition of sepsis. While such tools have shown high sensitivities in the emergency department, their use in highly monitored settings such as intensive care units (ICU) may risk alarm fatigue. The goal of this study is to evaluate how such CDS performs, defined by changes to clinical management in patients with newly or previously identified sepsis in the pediatric ICU (PICU).

Methods: Sepsis BPAs for all patients admitted in a single-center PICU over a 1-year period (2024) were reviewed. The sepsis BPA uses age-based SIRS criteria to alert a provider and prompt a bedside sepsis evaluation. Outcome measures included changes to clinical management within the 3-hour period following the BPA, reported as descriptive characteristics. Changes to clinical management included new blood culture collection, addition or broadening of antimicrobials, additional fluid administration, and/or initiation of vasoactives. Time-to intervention was also reviewed. Using the time of sepsis BPA, Sepsis-2 criteria was also applied to determine diagnosis of sepsis. As a secondary aim, we explored the performance of the BPA in previously reviewed sepsis cases identified by ICD-10 coding for state-reporting.

Results: This initiative is still undergoing chart review and analysis. Preliminary results demonstrated 1,736 sepsis BPAs amongst 352 patients with 404 admissions. There were 1,182 total PICU admissions in this period, thus approximately 34.2% of admissions triggered at least one sepsis BPA. Additionally, there were 6 patients with state-reportable sepsis, of which 100% had a sepsis BPA. Further results will include the proportion of BPAs which resulted in clinical management change and amongst patients with change in clinical management, those that meet a diagnosis of sepsis by Sepsis-2 criteria.

Conclusions: Current literature supports a timeframe of 1-3 hours for sepsis recognition and antimicrobial administration. This study reviews this timeframe after sepsis BPAs in the PICU to determine their effectiveness as a CDS tool. Overall, we hope to understand the yield of sepsis BPAs in appropriate sepsis recognition and their yield in prompting clinical management changes.