Appraisal of Australian and New Zealand paediatric sepsis guidelines

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dc.contributor.authorSasse, R.
dc.contributor.authorBorland, M.L.
dc.contributor.authorGeorge, S.
dc.contributor.authorJani, S.
dc.contributor.authorTan, E.
dc.contributor.authorNeutze, J.
dc.contributor.authorPhillips, N.
dc.contributor.authorKochar, A.
dc.contributor.authorCraig, S.
dc.contributor.authorLithgow, A.
dc.contributor.authorRao, A.
dc.contributor.authorDalziel, S.R.
dc.contributor.authorWilliams, A.
dc.contributor.authorBabl, F.E.
dc.contributor.authorWent, G.
dc.contributor.authorLong, E.
dc.date.issued2024
dc.description.abstractObjective: Clinical practice guidelines (CPGs) are an important tool for the management of children with sepsis. The quality, consistency and concordance of Australian and New Zealand (ANZ) childhood sepsis CPGs with the Australian Commission on Safety and Quality in Healthcare (ACSQHC) sepsis clinical care standards and international sepsis guidelines is unclear. Methods: We accessed childhood sepsis CPGs for all ANZ states and territories through Paediatric Research in Emergency Departments International Collaborative members. The guidelines were assessed for quality using the AGREE-II instrument. Consistency between CPG treatment recommendations was assessed, as was concordance with the ACSQHC sepsis clinical care standards and international sepsis guidelines. Results: Overall, eight CPGs were identified and assessed. CPGs used a narrative and pathway format, with those using both having the highest quality overall. CPG quality was highest for description of scope and clarity of presentation, and lowest for editorial independence. Consistency between guidelines for initial treatment recommendations was poor, with substantial variation in the choice and urgency of empiric antimicrobial administration; the choice, volume and urgency of fluid resuscitation; and the choice of first-line vasoactive agent. Most CPGs were concordant with time-critical components of the ACSQHC sepsis clinical care standard, although few addressed post-acute care. Concordance with international sepsis guidelines was poor. Conclusion: Childhood sepsis CPGs in current use in ANZ are of variable quality and lack consistency with key treatment recommendations. CPGs are concordant with the ACSQHC care standard, but not with international sepsis guidelines. A bi-national sepsis CPG may reduce unnecessary variation in care.
dc.description.statementofresponsibilityRosemary Sasse, Meredith L Borland, Shane George, Shefali Jani, Eunicia Tan, Jocelyn Neutze, Natalie Phillips, Amit Kochar, Simon Craig, Anna Lithgow, Arjun Rao, Stuart R Dalziel, Amanda Williams, Franz E Babl, Grace Went, Elliot Long on behalf of the Paediatric Research in Emergency Departments International Collaborative, PREDICT, Network
dc.identifier.citationEMA - Emergency Medicine Australasia, 2024; 36(3):436-442
dc.identifier.doi10.1111/1742-6723.14381
dc.identifier.issn1742-6731
dc.identifier.issn1742-6723
dc.identifier.urihttps://hdl.handle.net/2440/142326
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1171228
dc.rights© 2024 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
dc.source.urihttp://dx.doi.org/10.1111/1742-6723.14381
dc.subjectpaediatrics; practice guideline; review; sepsis
dc.subject.meshHumans
dc.subject.meshSepsis
dc.subject.meshChild
dc.subject.meshAustralia
dc.subject.meshNew Zealand
dc.subject.meshPractice Guidelines as Topic
dc.titleAppraisal of Australian and New Zealand paediatric sepsis guidelines
dc.typeJournal article
pubs.publication-statusPublished

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