Intravenous Access in Gastrointestinal Hemorrhage: A Multidisciplinary Quality Improvement Initiative Led by Emergency Department Nurses and Internal Medicine Physicians.

Background: The management of acute gastrointestinal hemorrhage (GIH) is focused on early resuscitation through 2 large-bore intravenous (2LBIV) catheters, although adherence to this recommendation is low.

Local Problem: Of 100 patients hospitalized with GIH in 2017, only 14 received 2LBIV access. The goal of this study was to improve this measure.

Early Machine-Human Interface around Sepsis Severity Identification: From Diagnosis to Improved Management?

Objective: To investigate the statistical measures of the performance of 2 interventions: a) early sepsis identification by a computerized sepsis "sniffer" algorithm (CSSA) in the emergency department (ED) and b) human decision to activate a multidisciplinary early resuscitation sepsis and shock response team (SSRT).

Methods: This study used a prospective and historical cohort study design to evaluate the performance of two interventions.

Intervention: A computerized sepsis sniffer algorithm (CSSA) to aid in early diagnosis and a multidisciplinary sepsis and shock response team (SSRT) to improve patient care by increasing compliance with Surviving Sepsis Campaign (SSC) bundles.