[Sepsis Groups] [sepsis group] focused exam- septic shock

[Osburn, Jennifer R. RN]

I need to know how to document a focused exam when you have a hand written H 
note but the full report, which includes the required information, is not 
dictated until after the 6 hour timeframe.  Would I be able to use the 
handwritten note date and time for my focused exam?
Example- septic shock presentation is 1300.  Handwritten note is 1500- states 
VS stable and includes all other elements required in the focus exam.  Dictated 
H is at 2000 which includes the actual VS results- BP, temp, pulse, etc.

Thanks

Jennifer Osburn, RN, BSN
Quality and Accreditation
St. Mary's Medical Center
304-526-1506
jennifer.osb...@st-marys.org


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Re: [Sepsis Groups] Repeat volume assessment and tissue perfusion CMS requirements

[Patricia Posa]

Hi Theresa 

The full 30ml/kg needs to be given. There are no exceptions per CMS guidelines 

The reassessment can be done anytime after the fluid bolus is completed and 6 
hours from time met criteria for septic shock 

Pat

Sent from my iPhone

> On Jan 13, 2016, at 1:09 PM, "Murray, Theresa"  wrote:
> 
> At our shop we are talking about the volume resuscitation.  Does it have to 
> be the entire 30ml/kg, or can the clinician treat the hypotension with volume 
> to the point of normotension especially in a renal or CHF patent and still 
> get credit for the metric? I have heard different responses.
> Thanks in advance for the info 
> 
> 
> 
> Theresa Murray RN, MSN, CCRN, CCNS 
> Critical Care Clinical Nurse Specialist 
> Community Health Network 
> 1500 N. Ritter Ave 
> Indianapolis Indiana 46219 
> 1-317-355-4258 office 
> 1-317-351-7860 fax 
> 1-317-904-7212 pager 
> 1-317-627-9350 Mobile 
> tmur...@ecommunity.com  
> 
> Cookeville Regional Medical Center
> 931-783-5035
> 
> 
> 
> This email message has been delivered safely and archived online by Mimecast. 
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Re: [Sepsis Groups] Arterial line versus venous draw

[Carter, Anne]

As long as ALL future lactic acids are drawn arterially; you cant mix and 
match. Once arterial always arterial.

Anne Carter MS, ACNS-BC, CEN
Coordinator
Outcomes Management
Riverview Medical Center
732-450-2735
acar...@meridianhealth.com


“This document and the information attached is Patient Safety Work Product & as 
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and the Federal Patient Safety & Quality Improvement Act of 2005 and should not 
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From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Andre Vovan
Sent: Tuesday, January 12, 2016 6:18 PM
To: Gerolamo, Jeannine 
Cc: sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

"Note, this is an external email and did not originate at Meridian Health”.

Venous or arterial line samples are both good.

Andre Vovan, MD, MBA
President/CEO
Newport Critical Care, Inc

On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine 
> wrote:
Are lactic acids drawn from an arterial line acceptable?

Jeannine Gerolamo (Fahy), MSN, BS, RN
Safety/Quality Specialist

The Center for Patient Safety and Healthcare Quality
215-481-4334 (Office)
215-481-3510 (Fax)
jgerol...@abingtonhealth.org
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Re: [Sepsis Groups] Repeat volume assessment and tissue perfusion CMS requirements

[Bruce Ushkow, MD, FACEP]

If I may expand the key question posed by Ms. Murray:   Per SEP-1, CMS, may 
chart abstractors give credit for less than 30 mL/Kg intentionally not being 
infused in "at risk"of fluid overload patients?  Based on clinical judgement or 
better yet judgement linked with objective measures as bedside Cardiovascular 
Ultrasound as per Surviving Sepsis?

For our patients,
Bruce Ushkow, MD, MS, FACEP
Director, Emergency Critical Care
Samaritan Hospital, Troy NY


From: Sepsisgroups  on behalf of 
Murray, Theresa 
Sent: Wednesday, January 13, 2016 1:09 PM
To: Prabhakar, Brenda; Angela Craig; 'Townsend, Sean, M.D.'; Cobb, Amy L.
Cc: Sullivan-Wright, Dawn M.; Gieselman,Morris; 
sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] Repeat volume assessment and tissue perfusion  
CMS requirements

At our shop we are talking about the volume resuscitation.  Does it have to be 
the entire 30ml/kg, or can the clinician treat the hypotension with volume to 
the point of normotension especially in a renal or CHF patent and still get 
credit for the metric? I have heard different responses.
Thanks in advance for the info



Theresa Murray RN, MSN, CCRN, CCNS
Critical Care Clinical Nurse Specialist
Community Health Network
1500 N. Ritter Ave
Indianapolis Indiana 46219
1-317-355-4258 office
1-317-351-7860 fax
1-317-904-7212 pager
1-317-627-9350 Mobile
tmur...@ecommunity.com

Cookeville Regional Medical Center
931-783-5035



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