[Sepsis Groups] Evaluation for Severe Sepsis Screening Tool HMH revised

[Pamela Green]

After meeting with HIM and coding yesterday it was brought to my attention that 
the Lab normal range high is 2. Our screening form had only the > 4 mmol/L 
under #3. Criteria for Severe Sepsis. So I went back to the original form the 
actual value is supposed to be >2 . The edited form had the wrong  value of >4. 
So I have made that change on the screening form as indicated. I also, have a 
question out to the Sepsis Groups to understand how other facilities are using 
this measurement. Please make copies for your dept. and make changes to your 
existing forms thanks. Pam


Evaluation for Severe Sepsis Screening Tool HMH revised.docx
Description: Evaluation for Severe Sepsis Screening Tool HMH revised.docx
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Re: [Sepsis Groups] Sepsis-3 Definition

[Pamela Green]

We are using the qSOFA in our screening also.

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Vovan, Andre
Sent: Thursday, September 14, 2017 2:22 PM
To: Emily C. McKinney ; Sims, Chadrick L 
; 'sepsisgroups@lists.sepsisgroups.org' 

Subject: Re: [Sepsis Groups] Sepsis-3 Definition

Incorporated the qsofa in screening but not for defining until cms change.  Cms 
put out a  advisory that they are not yet ready to adopt.



Sent from my Verizon, Samsung Galaxy smartphone


 Original message 
From: "Emily C. McKinney" 
>
Date: 9/14/17 12:11 PM (GMT-05:00)
To: "Sims, Chadrick L" >, 
"'sepsisgroups@lists.sepsisgroups.org'" 
>
Subject: Re: [Sepsis Groups] Sepsis-3 Definition


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We did not make the change. As CMS has not yet made the change.

Thank you,

Emily

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Sims, Chadrick L
Sent: Tuesday, September 12, 2017 9:14 AM
To: 'sepsisgroups@lists.sepsisgroups.org'
Subject: [External] [Sepsis Groups] Sepsis-3 Definition

Warning:  This email originated from the Internet!
DO NOT CLICK links if the sender is unknown, and NEVER provide your Password.

Hello All:

Would love to get a sense of who has adopted the sepsis-3 definition and who 
has stayed with sepsis-2? I know this has been asked before, just trying to 
prepare for the future.

Chadrick Sims, BSN, RN, CFRN, SCRN
Sepsis and Rescue Coordinator
UT Medical Center

PerfectServe: Sepsis Care Coordinator

cs...@mc.utmck.edu

Office: (865)305-6497
Cell: (865)705-9996
Fax: (865) 305-6544

[cid:image001.png@01D33056.69224290]
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Re: [Sepsis Groups] posting on the ssc list serv

[Pamela Green]

Also, I would be interested I some examples of how your staff is addressing the 
performance measure for documenting a shift screening. I have created a 
question that allows them to check that the screening was addressed as a 
reminder to do it but it does not have specifics. Thanks Pam Green

From: Pamela Green
Sent: Friday, August 25, 2017 2:39 PM
To: 'Surviving Sepsis' <s...@sccm.org>; sepsisgroups@lists.sepsisgroups.org
Subject: RE: posting on the ssc list serv

I would like to know how other facilities are defining that Code Sepsis  alert 
is initiated and how do you have staff document that  a Sepsis alert has been 
communicated.

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Surviving Sepsis
Sent: Tuesday, August 22, 2017 8:09 AM
To: 
sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>
Subject: [Sepsis Groups] posting on the ssc list serv

Colleagues,

There was a technical problem with the SSC list serv on Monday. If you posted 
over the weekend or on Monday of this week (8/22/17) you posting was 
automatically discarded. Please resend to the list serv for approved 
dissemination. We apologize for any inconvenience.

With best regards,
Lori


Lori A. Harmon, RRT, MBA | Director of Quality | Society of Critical Care 
Medicine
500 Midway Drive, Mount Prospect, IL 60056-5811 USA
t: +1 847.493.6403 | m: +1 847.693.0359 | www.sccm.org<http://www.sccm.org>
www.facebook.com/SCCM1<http://www.facebook.com/SCCM1> | 
www.twitter.com/SCCM<http://www.twitter.com/SCCM> | 
www.youtube.com/SCCM500<http://www.youtube.com/SCCM500>

Visit www.survivingsepsis.org<http://www.survivingsepsis.org> and 
www.iculiberation.org<http://www.iculiberation.org>


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Re: [Sepsis Groups] posting on the ssc list serv

[Pamela Green]

I would like to know how other facilities are defining that Code Sepsis  alert 
is initiated and how do you have staff document that  a Sepsis alert has been 
communicated.

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Surviving Sepsis
Sent: Tuesday, August 22, 2017 8:09 AM
To: sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] posting on the ssc list serv

Colleagues,

There was a technical problem with the SSC list serv on Monday. If you posted 
over the weekend or on Monday of this week (8/22/17) you posting was 
automatically discarded. Please resend to the list serv for approved 
dissemination. We apologize for any inconvenience.

With best regards,
Lori


Lori A. Harmon, RRT, MBA | Director of Quality | Society of Critical Care 
Medicine
500 Midway Drive, Mount Prospect, IL 60056-5811 USA
t: +1 847.493.6403 | m: +1 847.693.0359 | www.sccm.org
www.facebook.com/SCCM1 | 
www.twitter.com/SCCM | 
www.youtube.com/SCCM500

Visit www.survivingsepsis.org and 
www.iculiberation.org


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[Sepsis Groups] Sepsis Readmissions

[Pamela Green]

What is the threshold for sepsis readmissions percentage?

Pam Green BSN RN CCRN
Clinical Informatics

[cid:image001.png@01D0FCE5.2E7479C0]

130 Medical Circle
Nashville, Ark. 71852
Work-870-845-4400 (ext. 8918)
Cell-870-703-1360
Email: pa...@howardmemorial.com
 www.howardmemorial.com
 Improving the Health of the Communities We Serve
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Re: [Sepsis Groups] severe sepsis presentation

[Pamela Green]

We use the initial Triage Vital Signs, Elevated Lactate etc... as Time zero if 
they meet criteria for Severe Sepsis or Septic Shock.  The Criteria for 
Screening is any of those Vitals that screen Sepsis is present or Labs etc.. 
that have a time stamp. If you are waiting until the doctor decides that it is 
final Diagnosis for admit you are already in a late presentation. Our policy is 
nurse driven protocol to initiate Code Sepsis if the patient Screens as at Risk 
of/or having Severe Sepsis/Septic Shock. That is time Zero and starts the 
clock.  The scenario that was used indicates that time from initial triage 
vital signs is outside of 3 hour window.  Are you waiting until the Physician 
final diagnosis of Sepsis documented to initiate EGDT when indicated?

From: Sepsisgroups  On Behalf Of 
Schrecengost, Lisa M.
Sent: Tuesday, June 26, 2018 9:00 AM
To: sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] severe sepsis presentation

Hello all.


Need help!!   We are having issues with figuring out severe sepsis presentation 
times.   We are having discrepancies at our facility understanding what times 
to use, especially when the physician has severe sepsis as the impression and 
there are other times within the note.


We have a patient that comes into the ED.  The note was opened at 16:37 by the 
physician. In the body of the report, it says "Time of sepsis diagnosis is 
19:50". Pulse of 104 at 16:19. Respirations of 24 at 16:19. Lactate 2.9 at 
17:50. He documents in the body of the note "the patient has severe sepsis but 
not septic shock".
Primary impression documented on the ED Physician Report is Pneumonia, 
additional impression is Severe Sepsis. What time should we collect as Time of 
Severe Sepsis?   Do we take the time the note was opened since he has an 
impression of severe sepsis or use the times within the body of the note?


Thanks for your time,
Lisa




Lisa Schrecengost RN BSN
Quality Management
ACMH Hospital
One Nolte Drive
Kittanning, PA 16201
Phone:  724-543-8871
email:  schrecengo...@acmh.org
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Re: [Sepsis Groups] Procalcitonin and Lactate Questions

[Pamela Green]

Sorry I was referring to initial Lactate on the second statement

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Pamela Green
Sent: Tuesday, January 09, 2018 8:43 AM
To: Robert Hattabaugh <rhattaba...@johnsonmemorial.org>; 
'sepsisgroups@lists.sepsisgroups.org' <sepsisgroups@lists.sepsisgroups.org>
Subject: Re: [Sepsis Groups] Procalcitonin and Lactate Questions

We use it for ABX stewardship on all patients for Antibiotic effectiveness.  We 
count as meeting the compliance if it was attempted within the 3 and 6 hour 
time frame, however our expectation is  that we document a result if at all 
possible in presence of Sever or Septic Shock.

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Robert Hattabaugh
Sent: Wednesday, January 03, 2018 12:03 PMmeasured
To: 'sepsisgroups@lists.sepsisgroups.org' 
<sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>>
Subject: [Sepsis Groups] Procalcitonin and Lactate Questions


1.  Procalcitonin: is anyone using this in their sepsis protocol, as a 
routine lab with Sepsis patients or how is it being used in your facility 
overall; ABX stewardship...

2.  If the provider or nurse is unable to obtain blood for initial or 
repeat lab work, lactate, etc..., secondary to shock, etc... are you 
abstracting the cases as meeting the measure or falling out of the measure.  
CMS SEP-1 notes for Abstraction- "if a lactate level is ordered and there is an 
attempt to collect it, but the attempt results in failure to collect the 
specimen (too dehydrated to get a vein) or the specimen was contaminated during 
or after the draw."

Thanks in advance for your response
Robert Hattabaugh MSN, RN, ACNS-BC, CMSRN
Adult Health Clinical Nurse Specialist
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Re: [Sepsis Groups] Procalcitonin and Lactate Questions

[Pamela Green]

We use it for ABX stewardship on all patients for Antibiotic effectiveness.  We 
count as meeting the compliance if it was attempted within the 3 and 6 hour 
time frame, however our expectation is  that we document a result if at all 
possible in presence of Sever or Septic Shock.

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Robert Hattabaugh
Sent: Wednesday, January 03, 2018 12:03 PMmeasured
To: 'sepsisgroups@lists.sepsisgroups.org' 
Subject: [Sepsis Groups] Procalcitonin and Lactate Questions


1.  Procalcitonin: is anyone using this in their sepsis protocol, as a 
routine lab with Sepsis patients or how is it being used in your facility 
overall; ABX stewardship...

2.  If the provider or nurse is unable to obtain blood for initial or 
repeat lab work, lactate, etc..., secondary to shock, etc... are you 
abstracting the cases as meeting the measure or falling out of the measure.  
CMS SEP-1 notes for Abstraction- "if a lactate level is ordered and there is an 
attempt to collect it, but the attempt results in failure to collect the 
specimen (too dehydrated to get a vein) or the specimen was contaminated during 
or after the draw."

Thanks in advance for your response
Robert Hattabaugh MSN, RN, ACNS-BC, CMSRN
Adult Health Clinical Nurse Specialist
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Re: [Sepsis Groups] [External] Sepsis Validation

[Pamela Green]

I was wondering if anyone has a  "Sepsis ruled out"  checkbox and time or 
indicator included in their screening forms or systems. We use
Screening form in the system that screens for patients who are at risk for 
Severe Sepsis and/or Septic Shock. The Staff are asking if we can add a 
checkbox to the bottom of the form that indicates a time that sepsis was ruled 
out. I am just not sure that that is appropriate or if it is something that we 
should be doing. I would appreciate any input or guidance in this area. Pam
From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Mary Draper
Sent: Wednesday, December 20, 2017 3:16 PM
To: DHILLON, ROOPINDER ; 
sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] [External] Sepsis Validation

No one to date that I know of has been validated by CMS. I don't think it 
matters if you use branch logic or not. Once a metric isn't met the abstraction 
stops there.

Mary Draper RN BSN
Coordinator Quality Improvement
Peer Review Support CV/CT
JMH Quality Management
Office (925) 674-2045
Cell (925) 451-8792
Fax (925) 674-2373
mary.dra...@johnmuirhealth.com
[cid:image004.png@01D3807D.0452F810][cid:image005.png@01D3807D.0452F810]
"O, let us always have a mountain within our soul,  with a peak so high that we 
never quite reach the top...
  For then we will always strive for greater things and will not be content  
with merely climbing hills." Ardath Rodale

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of DHILLON, ROOPINDER
Sent: Friday, December 15, 2017 7:34 AM
To: 
sepsisgroups@lists.sepsisgroups.org
Subject: [External] [Sepsis Groups] Sepsis Validation


Caution: This email originated outside JMH. Do not open attachments or click on 
links if you do not recognize the sender.

Hi,
I wanted to know if any hospital has been validated by CMS for Core Measure 
SEP-1. My question is, are we supposed to use branching logic for abstraction? 
For example, if we answer 'Yes' to Severe sepsis, but we don't have an Initial 
Lactate collected and we say 'No' to Initial Lactate question; do we stop at 
that point or do we have to still go ahead and answer the rest of the questions?

If anyone has been validated, what did you do? If you used branching logic (did 
not answer rest of the questions) was it taken against the hospital and 
considered as 'wrong' abstraction?


Thank you,
Roopa Dhillon MBBS, MBA
Clinical Quality Analyst I
Quality Improvement/Clinical Outcomes
University Hospitals Elyria Medical Centre
630 East River
Elyria, Ohio  44035
T 440-329-4959 F 440-329-5971
Roopinder.Dhillon@UHhospitals .org
Quality Assurance/Peer Review Privileged Pursuant to Ohio Rev. Code secs. 
2305.24, 2305.25, 2305.251, 2305.252 and 2305.253
[UH-Master-RGB-v1]


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Re: [Sepsis Groups] ideas for September Sepsis Awareness Month

[Pamela Green]

We have a hospital wide hunt for the Sepsis bug (stuffed toy bug) for a prize! 
We use clues that lead to sepsis! Also we are ordering a sepsis awareness 
banner and set up a table with questions for test your knowledge about sepsis 
and put in a drawing for prize. We are planning to make bug and critter shaped 
snacks for the table. That's all we have discussed so far. 
[cid:image004.jpg@01D43A2E.D3529BA0]

Pam Green BSN RN CCRN
Clinical Informatics

[cid:image001.png@01D0FCE5.2E7479C0]

130 Medical Circle
Nashville, Ark. 71852
Work-870-845-4400 (ext. 8918)
Cell-870-703-1360
Email: pa...@howardmemorial.com
 www.howardmemorial.com
 Improving the Health of the Communities We Serve
HIPAA PRIVACY NOTICE: The information contained in or attached to this email 
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From: Sepsisgroups  On Behalf Of 
Posani, Theresa
Sent: Tuesday, August 21, 2018 11:15 AM
To: sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] ideas for September Sepsis Awareness Month

Please share any and all ideas for celebrating Sepsis Awareness Month in 
September.
Our facility is looking for ideas to bring awareness to our staff and patients.
Thank you
Theresa

Theresa Posani, MS, RN, ACNS-BC | Med/Surg CNS/Sepsis Coordinator
T 817.250-3907 | M 972.838-7954
theresapos...@texashealth.org


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Re: [Sepsis Groups] Question re: documentation of attestation that focused exam was completed

[Pamela Green]

Good  afternoon everyone,
We are having a difficult time getting the appropriate documentation to meet 
the bundle compliance even though everything is done correctly! Use of our 
Sepsis  Screening and Evaluation Documentation tool is hit and missed although 
I can see by the labs and treatment protocol that they are doing it.  On the IP 
side it  is the issue with getting them to document to the Sepsis Shift Screen 
and Focus reassessment. With the physicians if they are here when patient is 
admitted to the floor they usually do an admit note that includes a focused 
reassessment so we will catch those.  If it is after hours we are hoping to 
hold the ER physicians accountable to documenting a focused reassessment prior 
to moving patient to PCU or ICU.  I would be open to suggestions for better 
documentation compliance also. Pam
Pam

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Duane, Molly
Sent: Thursday, April 05, 2018 11:18 AM
To: Sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] Question re: documentation of attestation that focused 
exam was completed

Hello All,
I was wondering if your physicians were using the attestation statement instead 
of documenting the specific focused exam components. If so, how is that going? 
How did you implement this?

We had a miss this month: even though the physician documented in his note the 
specific amount of fluid that was given, followed with "after these 
interventions the patient was reassessed", we missed because the attestation 
did not have a specific time included. The time the note was opened/started was 
used. This was an ED note, started at the beginning of the pt's visit, so that 
was prior to fluids being given.

It is frustrating to see that the correct care is being given, yet we are 
missing on documentation technicalities.
Does anyone have suggestions?
Thanks,
Molly



Molly Duane RN, BSN, CCRN
Sepsis Program Coordinator
Detroit Receiving Hospital
Harper-Hutzel Hospital
Mobile: 248-709-6218
DRH: 313-966-8087
HUH: 313-745-4340
Email: mdu...@dmc.org


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Re: [Sepsis Groups] Vasopressor administration

[Pamela Green]

Our Sepsis protocol at HMH uses "Initiate Vasopressors for persistent 
Hypotension <90 syst or MAP<65 after initial Fluid Resuscitation of 30 ml/kg".  
Either measure meets the Bundle compliance Goals of therapy. Pam
From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Tara Miller
Sent: Thursday, April 19, 2018 9:39 AM
To: 'sepsisgroups@lists.sepsisgroups.org' 
Subject: [Sepsis Groups] Vasopressor administration

Pam Green BSN RN CCRN
Clinical Informatics

[cid:image001.png@01D0FCE5.2E7479C0]

130 Medical Circle
Nashville, Ark. 71852
Work-870-845-4400 (ext. 8918)
Cell-870-703-1360
Email: pa...@howardmemorial.com
 www.howardmemorial.com
 Improving the Health of the Communities We Serve
HIPAA PRIVACY NOTICE: The information contained in or attached to this email 
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in or attached to this email may be personal and sensitive and you are 
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Is anyone having issues with patients who have persistent hypotension after 
fluids defined as SBP < 90, but they still have a MAP of > or equal to 65 and 
no vasopressors being ordered? My facility's vasopressor orders read to 
initiate when the MAP is < 65. We have had two patients who did not meet that 
criteria until after the 6 hour window was up for vasopressors.

Are other facility's changing their practice to start pressors for SBP < 90?

Thanks.

Tara R Miller, RN
Team Leader, Quality Management
Mobile Infirmary Medical Center
Office: 435-5109
Cell: 605-8270

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[Sepsis Groups] Total Bundle compliance

[Pamela Green]

We are having trouble getting consistent 3 and 6 hr documentation of tissue 
perfusion status. So I fail the bundle compliance if there is no documentation 
found at 3 hr and 6 hr. Even though all other components are present. Most 
times the patient is leaving the ER before or at 3 hours and by the time the 
Attending if admitted sees it is outside of 3 hr parameter. I was wondering if 
anyone else counts the entire bundle compliance as fail if the documentation is 
not there at the accurate parameter for Focused re-exam. It's frustrating 
because we don't get credit for what is being done for Bundle compliance for 
these patients. Would appreciate other observations. Thanks Pam

[cid:image001.png@01D47770.34A0C160][cid:image002.png@01D47770.34A0C160]

Pam Green BSN RN CCRN
Clinical Informatics / Sepsis Team Leader /Coordinator

[cid:image001.png@01D0FCE5.2E7479C0]

130 Medical Circle
Nashville, Ark. 71852
Work-870-845-4400 (ext. 8918)
Cell-870-703-1360
Email: pa...@howardmemorial.com
 www.howardmemorial.com
 Improving the Health of the Communities We Serve
HIPAA PRIVACY NOTICE: The information contained in or attached to this email 
may be private, may contain Protected Health Information covered under the 
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must be protected in accordance with its provisions. The information contained 
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Re: [Sepsis Groups] [External Email] Re: Sepsis Screening

[Pamela Green]

1.   Are you screening every patient? Not always

2.   Are they screened in Triage or not until they are in a room? both

3.   If not screening every patient, what are the triggers for screening? 
Based on Suspect infection and q SOFA

4.   Is the screen on paper or electronic? Paper at the moment but 
implementing electronic


From: Sepsisgroups  On Behalf Of 
Joyce Luster
Sent: Monday, March 04, 2019 1:14 PM
To: 'Maupin, Christina' ; 
Maykel, Julie ; Krall, Eva 
; Orth, Claudia ; 
sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] [External Email] Re: Sepsis Screening


1.   Are you screening every patient? 18 & older

2.   Are they screened in Triage or not until they are in a room? In triage

3.   If not screening every patient, what are the triggers for screening?
4.   Is the screen on paper or electronic?  electronic

Joyce C. Luster, RN, CPHQ
System Sepsis Program Coordinator
Quality Management
Baptist Health
MOB 2, Suite 2600
350 Taylor Road
Montgomery, AL  36117
(334) 747-8727





From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Maupin, Christina
Sent: Friday, January 18, 2019 12:42 PM
To: Maykel, Julie; Krall, Eva; Orth, Claudia; 
sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] [External Email] Re: Sepsis Screening

We screen all patients in ED triage using a paper form at this point. The 
nurses follow a protocol to initiate the labs/BCs if positive.

Chris

Christina Maupin MN, RN, CNS
Clinical Outcomes Specialist
Bakersfield Heart Hospital
3001 Sillect Ave.
Bakersfield Heart Hospital 93308
661-316-6016

Strive not to be a success, but rather to be of value.
Albert Einstein




From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Maykel, Julie
Sent: Thursday, January 17, 2019 2:35 PM
To: Krall, Eva 
mailto:eva.kr...@palomarhealth.org>>; Orth, 
Claudia mailto:cor...@mhc.net>>; 
sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] [External Email] Re: Sepsis Screening

We screen all patients 18 years and older in triage; the tool is in our 
electronic record.

Thank you,
Julie

Julie Maykel, RN, BSN
Quality Coordinator

juliemay...@verity.org
Seton Medical Center | Part of Verity Health System
1900 Sullivan Avenue, Daly City CA 94015
Office  650-991-6366
Fax  650-991-6390

seton.verity.org | Verity.org

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From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Krall, Eva
Sent: Wednesday, January 16, 2019 5:09 PM
To: Orth, Claudia; 
sepsisgroups@lists.sepsisgroups.org
Subject: [External Email] Re: [Sepsis Groups] Sepsis Screening

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I would appreciate this information as well

Eva Bunny Krall MSN APRN ACNS-BC CDE CPHQ
Clinical Nurse Specialist
Quality and Patient Safety


[cid:image001.jpg@01D4AF1A.3B9B48F0]

 2185 Citracado Parkway | Escondido, CA 92029

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Re: [Sepsis Groups] lactic acid reflex time

[Pamela Green]

We reflex if LA >2 also. Usually 3 hours from initial draw regardless what 
result is.  This helps to not miss in repeats  most of the time.

[cid:image003.png@01D521EB.76A76250]
http://www.sepsis.org/sepsis-heroes/

Pam Green BSN RN CCRN
Clinical Informatics / Sepsis Team Leader /Coordinator

[cid:image001.png@01D0FCE5.2E7479C0]

130 Medical Circle
Nashville, Ark. 71852
Work-870-845-4400 (ext. 8918)
Cell-870-703-1360
Email: pa...@howardmemorial.com
 www.howardmemorial.com
 Improving the Health of the Communities We Serve
HIPAA PRIVACY NOTICE: The information contained in or attached to this email 
may be private, may contain Protected Health Information covered under the 
Health Insurance Portability and Accountability Act of 1996 (PL 104-191) and 
must be protected in accordance with its provisions. The information contained 
in or attached to this email may be personal and sensitive and you are 
obligated to maintain it in a safe, secure and confidential manner. Further 
disclosure without express written consent is prohibited. If you are not the 
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please immediately notify the sender via telephone or return email and delete 
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From: Sepsisgroups  On Behalf Of 
Laura Soares
Sent: Thursday, June 06, 2019 3:50 PM
To: 'sepsisgroups@lists.sepsisgroups.org' 
Subject: [Sepsis Groups] lactic acid reflex time

Good afternoon,

Currently we reflex any lactic acid that is > 2 to be re-drawn in 2 hrs.

I'm wondering what others' practices are when reflexing the lactic acid - do 
you use a 2 hr timeframe, or 3 hr, or?

Thanks so much!

Laura Soares MSN RN SCRN
Sepsis & Stroke Program Coordinator
559.788.6067 Office
559.280.2036 Cell

"Teamwork is the ability to work together toward a common vision--the ability 
to direct individual accomplishments toward organizational objectives. It is 
the fuel that allows common people to attain uncommon results"- Andrew Carnegie

[SVMC Logo]
465 W. Putnam Ave
Porterville, CA  93257
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The information contained in this email transmission may be protected under the 
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Re: [Sepsis Groups] lactic acid reflex time

[Pamela Green]

I am wondering if anyone is currently using a POC testing  device for Lactic 
acid using Finger stick blood levels how accurate is it? Pam

From: Sepsisgroups  On Behalf Of 
Pamela Green
Sent: Thursday, June 13, 2019 1:25 PM
To: Laura Soares ; 
'sepsisgroups@lists.sepsisgroups.org' 
Subject: Re: [Sepsis Groups] lactic acid reflex time


We reflex if LA >2 also. Usually 3 hours from initial draw regardless what 
result is.  This helps to not miss in repeats  most of the time.

[cid:image002.png@01D525E6.9E4D0090]
http://www.sepsis.org/sepsis-heroes/

Pam Green BSN RN CCRN
Clinical Informatics / Sepsis Team Leader /Coordinator

[cid:image001.png@01D0FCE5.2E7479C0]

130 Medical Circle
Nashville, Ark. 71852
Work-870-845-4400 (ext. 8918)
Cell-870-703-1360
Email: pa...@howardmemorial.com<mailto:pa...@howardmemorial.com>
 www.howardmemorial.com<http://www.howardmemorial.com/>
 Improving the Health of the Communities We Serve
HIPAA PRIVACY NOTICE: The information contained in or attached to this email 
may be private, may contain Protected Health Information covered under the 
Health Insurance Portability and Accountability Act of 1996 (PL 104-191) and 
must be protected in accordance with its provisions. The information contained 
in or attached to this email may be personal and sensitive and you are 
obligated to maintain it in a safe, secure and confidential manner. Further 
disclosure without express written consent is prohibited. If you are not the 
intended recipient, be advised that any unauthorized use, disclosure, copying, 
distribution, or the taking of any action in reliance on the contents of this 
information is strictly prohibited. If you have received this email in error, 
please immediately notify the sender via telephone or return email and delete 
the email immediately.




From: Sepsisgroups 
mailto:sepsisgroups-boun...@lists.sepsisgroups.org>>
 On Behalf Of Laura Soares
Sent: Thursday, June 06, 2019 3:50 PM
To: 'sepsisgroups@lists.sepsisgroups.org' 
mailto:sepsisgroups@lists.sepsisgroups.org>>
Subject: [Sepsis Groups] lactic acid reflex time

Good afternoon,

Currently we reflex any lactic acid that is > 2 to be re-drawn in 2 hrs.

I'm wondering what others' practices are when reflexing the lactic acid - do 
you use a 2 hr timeframe, or 3 hr, or?

Thanks so much!

Laura Soares MSN RN SCRN
Sepsis & Stroke Program Coordinator
559.788.6067 Office
559.280.2036 Cell

"Teamwork is the ability to work together toward a common vision--the ability 
to direct individual accomplishments toward organizational objectives. It is 
the fuel that allows common people to attain uncommon results"- Andrew Carnegie

[SVMC Logo]
465 W. Putnam Ave
Porterville, CA  93257
DISCLAIMER: The information contained in this email transmission is 
confidential and intended for the addressee only. If the reader of this message 
is not the addressee or addressee's agent, you are hereby advised that any 
dissemination, distribution or copying of the information is strictly 
prohibited.

The information contained in this email transmission may be protected under the 
Attorney/Client Privilege and protected from disclosure under California 
Evidence Code section 1157. If protected by the attorney/client privilege or by 
California Evidence Code Section 1157, the information contained in this email 
transmission shall continue to be protected and will not be negated by virtue 
of sending the information via this email.

If you receive this email in error, please call the Information Technology 
Security Coordinator at (559) 788-6090 (collect if necessary) immediately upon 
receipt. Thank you for your cooperation.




DISCLAIMER: The information contained in this email transmission is 
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is not the addressee or addressee's agent, you are hereby advised that any 
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The information contained in this email transmission may be protected under the 
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California Evidence Code Section 1157, the information contained in this email 
transmission shall continue to be protected and will not be negated by virtue 
of sending the information via this email.

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receipt. Thank you for your cooperation.
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Re: [Sepsis Groups] Procalcitonin in Sepsis Order Set?

[Pamela Green]

We are CAH 20 Bed Inpatient and * Bed ER. PCT is included in both order sets. 
WE use this  to Differentiate if Infection is suspected but unconfirmed. Also 
as part of our AB Stewardship.

[cid:image002.png@01D58372.E1327B30]
http://www.sepsis.org/sepsis-heroes/
Pam Green BSN RN CCRN
Clinical Informatics / Sepsis Team Leader /Coordinator

[cid:image001.png@01D0FCE5.2E7479C0]

130 Medical Circle
Nashville, Ark. 71852
Work-870-845-4400 (ext. 8918)
Cell-870-703-1360
Email: pa...@howardmemorial.com
 www.howardmemorial.com
 Improving the Health of the Communities We Serve
HIPAA PRIVACY NOTICE: The information contained in or attached to this email 
may be private, may contain Protected Health Information covered under the 
Health Insurance Portability and Accountability Act of 1996 (PL 104-191) and 
must be protected in accordance with its provisions. The information contained 
in or attached to this email may be personal and sensitive and you are 
obligated to maintain it in a safe, secure and confidential manner. Further 
disclosure without express written consent is prohibited. If you are not the 
intended recipient, be advised that any unauthorized use, disclosure, copying, 
distribution, or the taking of any action in reliance on the contents of this 
information is strictly prohibited. If you have received this email in error, 
please immediately notify the sender via telephone or return email and delete 
the email immediately.





From: Sepsisgroups  On Behalf Of 
Rosemary Grant
Sent: Thursday, October 10, 2019 1:28 PM
To: sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] Procalcitonin in Sepsis Order Set?

Hello!  I'm curious how many hospitals include procalcitonin in their sepsis 
order set (both for ED and inpatient if you have different order sets?)

How many beds does your hospital have and do you include procalcitonin in 
sepsis order sets?

Thank you!
Rosemary

Rosemary Mitchell Grant, BSN, RN, CPHQ
Director, Safety and Quality- Sepsis and Readmissions

Washington State Hospital Association
999 Third Avenue, Suite 1400
Seattle, WA   98104
Phone:  206-216-2516
Email:  rosema...@wsha.org

[WSHA_logo_blue_SignatureFriendlySize--2_PhotoGalleryReSize]

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Re: [Sepsis Groups] Fluid management

[Pamela Green]

Maintenance 150 ml/hr Unless Fluid responsive continues then 500 ml bolus over 
15 to 30 min. And reassess. Vasopressor if continues to be hypotensive after 
fluid resuscitation of course and continue with boluses as indicated. Pam

From: Sepsisgroups  On Behalf Of 
Jenny Clarke
Sent: Tuesday, November 12, 2019 3:43 PM
To: sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] Fluid management

What is everyone using for fluid management after the 30 ml/kg? Thanks for help
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