Re: [Sepsis Groups] [**External**] Sepsis Screening

Sutter Health System: 1. Are you screening every patient? YES 2. Are they screened in Triage or not until they are in a room? Triage 3. If not screening every patient, what are the triggers for screening? 4. Is the screen on paper or electronic? EHR Thanks, MARY ANN BARNES-DALY

Re: [Sepsis Groups] [**External**] "Sepsis" Mortality vs. "Severe Sepsis" & Septic Shock Mortality

Hi Claudia; At Sutter Health we report severe sepsis and septic shock combined and separately. We show data as an aggregate for our combined 24 acute care facilities and for each discreet entity. We do NOT include "simple" sepsis patients and we do not use the new sepsis definitions. Thanks,

Re: [Sepsis Groups] [**External**] Sepsis Listserve question

I would suggest that the any hypotension in the face of sepsis can be considered organ failure - so 1 BP to define severe sepsis 2 BPs are needed to define septic shock Thanks, MARY ANN BARNES-DALY MS RN CCRN DC | Clinical Performance Improvement Consultant Quality & Clinical Effectiveness

Re: [Sepsis Groups] [**External**] Re: Sepsis Best Practice Alerts

At Sutter Health we have several: First is “possible sepsis” for Infection (active culture, problem list) plus available SIRS Second is “possible severe sepsis” – same as above plus available organ dysfunction (excludes BUN/Cr for example for ESRD) Third is “possible septic shock” - above with

Re: [Sepsis Groups] [**External**] MAP flagging/alerts in Epic

We are working on that currently. Email me directly and we can compare notes Sent from my Android phone using TouchDown (www.symantec.com) -Original Message- From: McKnight, Elise [elise.mckni...@uchealth.org] Received: Saturday, 19 Aug 2017, 5:10AM To:

Re: [Sepsis Groups] [**External**] Re: FLUID REQUIREMENTS

Interesting Angela – this has been an argument since the beginning of the SSC guidelines – whether to use actual or IBW. The argument that I have heard is that adipose tissue is poorly perfused and doesn’t require the same amount of fluid for resuscitation as lean mass. If we know the BMI –

Re: [Sepsis Groups] [**External**] Sepsis question

SEP-1 abstraction is done by specific core measure abstractors - as with other core measures at all of Sutter Health Thanks, MARY ANN BARNES-DALY MS RN CCRN DC | Clinical Performance Improvement Consultant Quality & Clinical Effectiveness Team | Office of Patient Experience Sutter Health

Re: [Sepsis Groups] [**External**] Sepsis Alert

Great points Ron; I agree with your conclusion Thanks, MARY ANN BARNES-DALY MS RN CCRN DC | Clinical Performance Improvement Consultant Quality & Clinical Effectiveness Team | Office of Patient Experience Sutter Health -2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604|

Re: [Sepsis Groups] [**External**] lactic acid

Ms. Gibbs; First I would emphasize that metformin does not exactly falsely elevate lactate levels; it has been shown to actually elevate levels as part of gluconeogenesis from several sources. What is more likely is a coincidental lactate elevation in the face of infection. I would caution

Re: [Sepsis Groups] [**External**] One low MAP can trigger Severe Sepsis presentation

.org “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” ~R. Buckminster Fuller From: Townsend, Sean, M.D. Sent: Monday, April 17, 2017 10:27 AM To: Barnes-Daly, Mary Ann, MS, RN, CCRN, DC <barne...@sutterhea

Re: [Sepsis Groups] [**External**] Re: One low MAP can trigger Severe Sepsis presentation

Emily; We discovered the discrepancy as well. The short story is that the mathematical algorithm in the monitor that is used to calculate the MAP is far more sophisticated (and therefore more accurate) than the simple formula that we had been using - sys + 2dys/3. Therefore we always accept

Re: [Sepsis Groups] [**External**] One low MAP can trigger Severe Sepsis presentation

Yes, I have feedback that occurs and it is problematic. We need to bring this to CMS. I would suggest that in the same way 2 consecutive BPs are required to identify SEPTIC SHOCK after fluids, the same should be true to signify the onset of hypotension. Thanks, MARY ANN BARNES-DALY MS RN CCRN