[Sepsis Groups] Clarification

[Broughton, Susan]

I just read through the transcript for "Sep-1 Early Management Bundle, Severe 
Sepsis/Shock Part II"  which was presented by Bob Dickerson on 9/21/15.

So much useful information!  I recommend everyone read this document because it 
is chock full of information and cleared up many confusing elements for me.

  I have one question though.  Page 24 of the transcript states Vasopressors 
are to be given within 6 hours of Severe Sepsis presentation.  Since the 
patient is in Shock, I thought this might be a "typo" and should have stated 
within 6 hours of Septic Shock presentation.  Cross checking with the Spec 
Manual it appears it is a type.  Can we verify?

Thank You!
Susan Broughton RN, QI Specialist
Santa Rosa Medical Center
6002 Berryhill Rd
Milton, FL  32570
850 626-5054
850 712-9113

"Imagine how much could be accomplished if we didn't care who got the credit!"
Author Unknown






[cid:image003.jpg@01CB653A.730BC1D0]

CHS PSO, LLC confidential patient safety work product communication. It is 
protected from disclosure pursuant to the provisions of the Patient Safety and 
Quality Improvement Act (42 CFR, Part 3) and other state and federal laws. 
Unauthorized disclosure or duplication is prohibited.
This email is intended only for the use of the individual(s) and entity named 
in the message. If you are not an intended recipient of this message, please 
notify the sender immediately and delete the material from your computer. Do 
not deliver, distribute or copy this message and do not disclose its contents 
or take any action in reliance on the information it contains.



--
Disclaimer: This electronic message may contain information that is 
Proprietary, Confidential, or legally privileged or protected. It is intended 
only for the use of the individual(s) and entity named in the message. If you 
are not an intended recipient of this message, please notify the sender 
immediately and delete the material from your computer. Do not deliver, 
distribute or copy this message and do not disclose its contents or take any 
action in reliance on the information it contains.
___
Sepsisgroups mailing list
Sepsisgroups@lists.sepsisgroups.org
http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org

Re: [Sepsis Groups] Septic Shock Present [Incident: 151007-000178]

[Belfi, Karen]

This answer doesn't address crystalloid fluids, however.
In the CMS power point, Bob stated that the patient needed to receive 
crystalloid fluids in order to select septic shock if only criteria is lactate.

Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
484-476-8092
Pager: 5240
[cid:image001.png@01D12688.DA9B3EB0]

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Tribuiani, Barbara
Sent: Friday, November 20, 2015 10:54 AM
To: 'sepsisgroups@lists.sepsisgroups.org'
Subject: [Sepsis Groups] FW: Septic Shock Present [Incident: 151007-000178]

Hello All-

Please see below response form Qnet re: septic shock present. I found this to 
be very helpful.

Barb

From: IQR Q System [mailto:cms...@mailps.custhelp.com]
Sent: Friday, November 20, 2015 10:11 AM
To: Tribuiani, Barbara
Subject: Septic Shock Present [Incident: 151007-000178]



Recently you requested personal assistance from our on-line support center. 
Below is a summary of your request and our response.

If this issue is not resolved to your satisfaction, you may reopen it within 
the next 2 days.

Thank you for allowing us to be of service to you.

To access your question from our support site, click 
here.

 Subject

Septic Shock Present



 Discussion Thread

 Response Via Email (Deb Lindner)

11/20/2015 10:10 AM

Barbara,

An addendum to the Specifications Manual for the National Hospital Inpatient 
Quality Reporting (IQR) Program (5.0b) has been posted to QualityNet at 
www.qualitynet.org/dcs/ContentServer?c=Page=QnetPublic%2FPage%2FQnetTier2=1141662756099.

There are 3 ways Septic Shock can be present:

1. Documentation of severe sepsis present and persistent hypotension in the 
hour after the conclusion of the 30 mL/kg Crystalloid Fluid Administration

2. Documentation of severe sepsis present and an initial lactate level is >= 4 
mmol/L

3. Physician/APN/PA documentation of Septic Shock

If you have documentation of severe sepsis being present and an initial lactate 
>= 4 mmol/L then you can answer "Yes" to Septic Shock Present.

 Response Via Email (Martha Boese)

10/08/2015 09:19 AM

Due to the volume of inquires related to the SEP-1 measure we are experiencing 
a response lag time. Responses to SEP-1 questions are being answered daily. 
Please be reminded that Q are available in the QualityNet knowledge base 
tool and a SEP-1 fact sheet 

  is posted on QualityNet. A 
recording,
 
slides
 , and 
Q
 from the August 24th National Provider call are available for review. The 
recording and 
slides
 for September 21st are available for review.

The following link will give you more information on the upcoming October 26th 
National Provider call and the opportunity to register for the event: 
http://www.qualityreportingcenter.com/wp-content/uploads/2015/08/IQR_Sepis_series-Flyer-vFINAL-1508.pdf.

Please close your question if it is answered by these resources. We will 
continue working diligently to reduce response lag time in replying to 
questions.

 Customer By Web Form (barbara tribuiani)

10/07/2015 05:56 PM

Hello,
For this data element is lactate >4 (initial or repeat) enough to say "yes"? I 
know the other criteria is "peristent hypotension after 30ml/kg" but I am 
somewhat confused about how the lactate plays into this. Is it necessary to 
have "severe sepsis present" via all three criteria to answer "yes"?
Thank you very much



 Question Reference #151007-000178

Escalation Level:

5 Business Days

Product Level 1:

Hospital Inpatient Quality Reporting

Category Level 1:

Hospital Inpatient - Sepsis

Category Level 2:

Septic Shock Present

Date Created:

10/07/2015 05:56 PM

Last Updated:

11/20/2015 10:10 AM

Status:

Resolved (IP only)

Discharge Period:

N/A

CCN:




[---001:002376:40406---]

Confidentiality Notice:
This e-mail, including any attachments is the property of Trinity Health and is 
intended for the sole use of the intended recipient(s). It may contain 
information that is privileged and confidential.  Any unauthorized review, use, 
disclosure, or distribution is prohibited. If you