Re: [Sepsis Groups] [EXTERNAL] Sepsisgroups Digest, Vol 358, Issue 4

[Pierce1, Marie]

  1.  Re: I need some clarification and would appreciate some input
(Cooke, Susan)
The abstractors are technically correct. However, if the physician has stated 
that the patient had severe sepsis [which would trump just the criteria] then 
the case could be included.

Marie Pierce   MSN, RN, CCDS
Quality Specialist
marie.pier...@mclaren.org​
p 989.894.3881 fax 989.891.8198


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From: Sepsisgroups  On Behalf Of 
sepsisgroups-requ...@lists.sepsisgroups.org
Sent: Tuesday, February 9, 2021 5:45 PM
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Subject: [EXTERNAL] Sepsisgroups Digest, Vol 358, Issue 4

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Today's Topics:

1. Re: I need some clarification and would appreciate some input
(Cooke, Susan)
2. Surviving Sepsis Campaign COVID-19 Guidelines Webcast
(Lori Harmon)


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Message: 1
Date: Wed, 3 Feb 2021 22:01:34 +
From: "Cooke, Susan" 
mailto:susan.co...@lcmchealth.org>>
To: 
"sepsisgroups@lists.sepsisgroups.org"
mailto:sepsisgroups@lists.sepsisgroups.org>>
Subject: Re: [Sepsis Groups] I need some clarification and would
appreciate some input
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I'm sorry I mean to say the Abstractor said the patient did NOT have evidence 
of organ failure because CMS does not recognize AMS as organ dysfunction so 
they did not proceed with examining the case for compliance because it did not 
meet SEV-SEP criteria. They placed it in the Excluded column.

Thanks


Susan Cooke MSN RN NEA-BC
Sepsis Program Coordinator

University Medical Center New Orleans
2000 Canal Street
New Orleans, LA 70112

O 504.702.2924
F 504.702.2119

susan.co...@lcmchealth.org@LCMChealth.org>
umcno.org>


From: Cooke, Susan
Sent: Wednesday, February 3, 2021 10:41 AM
To: 
sepsisgroups@lists.sepsisgroups.org
Subject: I need some clarification and would appreciate some input

Hi everybody,

I am going round and round with our Abstracting company related to a UTI sepsis 
case. Patient came to ED meeting SIRS criteria and a change in mental status 
which was reported as definitely improved after antibiotic administration. The 
Bundle elements were met. The coding was for Sepsis and UTI with a primary of 
Altered Mental Status. All were POA. The Abstractors excluded the case because 
they say the patient did have evidence of organ dysfunction because CMS does 
not recognize Altered Mental Status as Organ dysfunction (but SCCM does).

1. Is this correct that the case should be excluded even though the patient 
clearly had sepsis. Improved with antibiotics and it was coded as such by the 
physician?
2. In my email to the Abstractor I had mentioned (because I'm somewhat new to 
this level of detail and didn't realize the altered mental status wasn't an 
organ dysfunction) that it was clearly stated in the Discharge Summary that the 
patient had Altered Mental Status that improved with Antibiotics and the source 
was a UTI. I was told that -Also,any documentation in the discharge summary is 
not to be used to determine the presence of severe sepsis/septic shock. Is this 
true? Isn't the entire chart a possible source for a sepsis diagnosis?



Any insight to this type of scenario would be so helpful!!




Thanks so much.

Sue

Susan 

Re: [Sepsis Groups] Sepsisgroups Digest, Vol 250, Issue 1

[Pierce1, Marie]

Documentation that the Sepsis Focused Exam Completed that includes a date and 
time of the documentation, that is sufficient. 



Marie Pierce MSN, RN, CCDS
Quality Specialist
Quality and Resource Management
McLaren Bay Region
email: marie.pier...@mclaren.org
office phone: (989) 894-3881


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-Original Message-
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Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org
Sent: Tuesday, June 13, 2017 9:40 AM
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Subject: Sepsisgroups Digest, Vol 250, Issue 1

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Today's Topics:

   1. Sepsis Focused Reexamination (Rutherford, Richard)
   2. Re: Sepsis Focused Reexamination (Belfi, Karen)
   3.  Sepsis Transfers (Carol Groen)


--

Message: 1
Date: Fri, 9 Jun 2017 16:17:48 +
From: "Rutherford, Richard" 
To: "sepsisgroups@lists.sepsisgroups.org"

Cc: "Vasquez, Ashley" 
Subject: [Sepsis Groups] Sepsis Focused Reexamination
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Hello All,


We are struggling with compliance with the focused sepsis reexamination and 
struggling with the interpretation of the rule changes in v5.2.  I would 
appreciate advice on the minimal acceptable documentation to pass this element 
for septic shock patients.  We would like the standardize this documentation 
for our providers.  Would the following be acceptable?


VS  BP 120/60  HR 110  RR 18  T 98.6

Sepsis Focused Exam Completed.


Or do the individual components need to be documented:


VS  BP 120/60  HR 110  RR 18  T 98.6

Capillary refill evaluation complete

Peripheral pulse examination complete

Skin examination complete


Or do the actual results need to be recorded


VS  BP 120/60  HR 110  RR 18  T 98.6

Capillary refill evaluation complete:  Cap refill 2 seconds

Peripheral pulse examination complete:  radial pulses strong and symmetric

Skin examination complete:  skin pink warm dry


Thank you,


Rick Rutherford, M.D.


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Message: 2
Date: Tue, 13 Jun 2017 07:40:07 -0400
From: "Belfi, Karen" 
To: "Rutherford, Richard" ,
"sepsisgroups@lists.sepsisgroups.org"

Cc: "Vasquez, Ashley" 
Subject: Re: [Sepsis Groups] Sepsis Focused Reexamination
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<4485be66b239a2419df2e2a0a81e2f7c10bb8d1...@mlhmb2.ad.mlhs.org>
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>From what I've read, the first one, that says "sepsis focus exam completed" is 
>sufficient, even without the vitals above being listed.

Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
(484)476-8092

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Rutherford, Richard
Sent: Friday, June 09, 2017 12:18 PM
To: sepsisgroups@lists.sepsisgroups.org
Cc: Vasquez, Ashley
Subject: [EXTERNAL] [Sepsis Groups] Sepsis Focused Reexamination


This message originated from outside MLHS systems. Any attachments or links 

Re: [Sepsis Groups] Sepsisgroups Digest, Vol 239, Issue 1

[Pierce1, Marie]

Potential shock pt:

If there is any documentation within the 6 hour timeframe to indicate lactate 
elevation is due to an infectious process with unknown source--then I would say 
yes.

Otherwise, if no indication of infectious source it would be excluded.

Marie Pierce MSN, RN, CCDS
Quality Specialist
Quality and Resource Management
McLaren Bay Region
email: marie.pier...@mclaren.org
office phone: (989) 894-3881

-Original Message-
From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org
Sent: Tuesday, March 21, 2017 3:11 PM
To: sepsisgroups@lists.sepsisgroups.org
Subject: Sepsisgroups Digest, Vol 239, Issue 1

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Today's Topics:

   1. Septic shock question (Davis, Diana)


--

Message: 1
Date: Mon, 20 Mar 2017 17:58:40 +
From: "Davis, Diana" 
To: "'sepsisgroups@lists.sepsisgroups.org'"

Subject: [Sepsis Groups] Septic shock question
Message-ID:



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Septic shock

To everyone:

Hoping to get some clarification re: potential septic shock pt.

1207- B/P-  84/57 P- 135.

Lactate at 1430- 4.8- lactate  at 1810- 4.3

WBC- 0.1 at 1621

Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

No source identified

Will this patient meet septic shock due to lactate level?

We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

Thank you.

Diana Davis, Quality Outcomes Coordinator

CMH Regional Health System

937-382-9315


Diana Davis, Quality Outcomes Coordinator CMH Regional Health System
937-382-9315

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Re: [Sepsis Groups] Sepsisgroups Digest, Vol 236, Issue 1

[Pierce1, Marie]

We abstract everything. We share at the Sepsis committee meeting or with other 
departments that may impact that part of the measure. We also use it to help 
with communications with physicians, both individually and as departments to 
inform them of where the failures are occurring, how it fits in the core 
measure and also, most importantly... what they can do to positively impact it.

Marie Pierce MSN, RN, CCDS
Quality Specialist
Quality and Resource Management
McLaren Bay Region
email: marie.pier...@mclaren.org
office phone: (989) 894-3881

-Original Message-
From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org
Sent: Wednesday, March 01, 2017 9:09 AM
To: sepsisgroups@lists.sepsisgroups.org
Subject: Sepsisgroups Digest, Vol 236, Issue 1

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Today's Topics:

   1. Re: Abstract to failure (Pesek, Elizabeth)
   2. Re: Abstract to failure or further? (Patricia Posa)
   3. TJC certification in sepsis (Posani, Theresa)


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Message: 1
Date: Mon, 27 Feb 2017 16:35:05 +
From: "Pesek, Elizabeth" 
To: "'sepsisgroups@lists.sepsisgroups.org'"

Subject: Re: [Sepsis Groups] Abstract to failure
Message-ID:
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We abstract all elements of the bundle and track them for improvement, to serve 
performance improvement initiatives.

Betsy Pesek MN, BSN, RN, CCRN, CPHQ |
Clinical Outcomes Specialist| Clinical Effectiveness Overlake Hospital Medical 
Center |1231 116th Ave NE - 6th floor| Bellevue WA 98004|
fax: 425-467-3950|direct: 425.688.5935 | elizabeth.pe...@overlakehospital.org|


-Original Message-
From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org
Sent: Friday, February 24, 2017 3:23 PM
To: sepsisgroups@lists.sepsisgroups.org
Subject: Sepsisgroups Digest, Vol 235, Issue 13

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Today's Topics:

   1. Abstract to failure or further? (Aceves, Christine)


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Message: 1
Date: Thu, 23 Feb 2017 21:06:40 +
From: "Aceves, Christine" 
To: "sepsisgroups@lists.sepsisgroups.org"

Subject: [Sepsis Groups] Abstract to failure or further?
Message-ID:



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For SEP-1:
We would like to know if centers are abstracting only to failure as required by 
CMS? Or, abstracting for all elements of the measure? If abstracting for all 
elements, how do you utilize the data?

Thank you!

Christine Aceves, MSN, RN, CNL, CEN
Sepsis Program Manager
Nursing Quality
Stanford Health Care
300 Pasteur Dr., HG021A  MC 5221 Stanford, CA 94305
O: 650.498.0971   C: 650.483.2248  P: 650.723.8222 ID# 26611
cace...@stanfordhealthcare.org

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