Dear Sondra,

I am a PGY-1 Pharmacy Practice Resident at a community hospital in south 
Florida. I am in the early phases of revising our current sepsis bundle, as 
well as possibly implenting a sepsis team and sepsis screening tool.Would you 
(and anyone else that reads this) mind sharing your sepsis bundle and/or 
screening tool with me so that I can get an idea of what other institutions are 
doing and the best way to go about this project I have taken on. Thanks so much 
for your help. My email address is below.

Kristen Hillebrand, PharmD.
PGY-1 Pharmacy Practice Resident
Indian River Medical Center
1000 36th Street
Vero Beach, Fl 32960
P: 772 567 4311 x 5419
F: 772 563 4429
[email protected]
www.irmc.cc

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Sent: Monday, September 10, 2012 9:40 AM
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Subject: Sepsisgroups Digest, Vol 24, Issue 3

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Today's Topics:

   1. Re: Monitoring sepsis care (Sondra Mesnard)
   2. Re: Monitoring sepsis care (Jeffrey R Hanlon RN)
   3. Re: Physician Buy-in (Jennifer Thoe)


----------------------------------------------------------------------

Message: 1
Date: Fri, 7 Sep 2012 13:09:53 -0400
From: Sondra Mesnard <[email protected]>
To: "Dr.Mohan Ranganathan" <[email protected]>
Cc: "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] Monitoring sepsis care
Message-ID:
        <CAFd=sp_s+gqbfknjdibxm6odggnigl3cywn6raa1qzafple...@mail.gmail.com>
Content-Type: text/plain; charset="iso-8859-1"

Dr Mohan Ranganathan,
 I  am an RN at Saint Joseph Mercy,  and I am the sepsis champion for the
CCU. We monitor all sepsis patient with a lactic acid log. Any patient that
had a lactic acid drawn  in the hospitial , shows up in the log and is
audit. This has helped our health system to identify patient's that would
of been mised without the use of the lactic acid log.
 I also monitor a sepsis screening tool that nurses use to screen patients
for sepsis, bundle sheet for severe sepsis for early goal therepy and
cam-icu data.
 I highly recommend a ICU physcian, ICU nurse and other medical staff
to form and join a sepsis team at  the hospital that you work at. Have
those team members trained with sepsis, treatment and protocols. Then the
train staff can serve as a resource for others.
  The sepsis team that I am on, meets once a month. We review sepsis cases
and things that was not done per protocol, we take back to that individual
or group. We use this as an opportunity to discover knowledge deficit
issues related to sepsis and provide education.
 I hope this information is helpful.
Thank you,
Sondra

>  Dear all,
>
> Does any one know how to audit/monitor the care given to sepsis patients.
>
> My hospital is asking us to monitor and report back the sepsis care.
> Presently we do not have any system to do this. We take info. given by
> outreach nurses (who are all ICU trained) to capture sepsis patients
> currently. This does not capture all the sepsis patients in the hospital
> since some patients are not that unwell to require outreach nursing care.
>
> I thought of asking all of you, especially people from UK if you have any
> system/way to capture all the sepsis patients in your hospital. I remember
> Ron Daniels replied something along this line in another e-mail few months
> ago.
>
> I would be grateful for your reply.
>
> Many thanks in advance
> Mohan
>
> Dr Mohan Ranganathan
> Consultant Anaesthetist
> Lead for sepsis
> George Eliot Hospital NHS Trust
> Nuneaton
> UK
>
> _______________________________________________
> Sepsisgroups mailing list
> [email protected]
> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
>
>
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Message: 2
Date: Fri, 7 Sep 2012 21:40:29 -0400 (EDT)
From: Jeffrey R Hanlon RN <[email protected]>
To: [email protected], [email protected], [email protected]
Cc: [email protected]
Subject: Re: [Sepsis Groups] Monitoring sepsis care
Message-ID: <[email protected]>
Content-Type: text/plain; charset="us-ascii"


My first question would be, do you have a sepsis coordinator? One nurse 
responsible for data collection and monitoring bundle compliance etc. If the 
answer is no, you need to look into this. Next, your IT department needs to be 
on board assisting the sepsis coordinator with the data collection. Without 
their assistance your coordinator will drown in paperwork. They can develop the 
tools necessary to pull the required data. The sepsis coordinator will need to 
develop the data points required and IT can pull this information. A Sepsis 
Steering Committee, that meets regularly involving all departments will be of 
benefit so that all remain on the same page. There are several audit tools that 
others have developed, which I am sure will be shared.

Pulling these entities together will help provide the information needed to 
those that request it.


Jeffrey R Hanlon RN
Stamp Out Sepsis




---- Original Message ----
From: Dr.Mohan Ranganathan <[email protected]>
To: Ron Elkin <[email protected]>; Dr.Sunil T Pandya <[email protected]>
Cc: Sepsisgroups <[email protected]>
Sent: Fri, Sep 7, 2012 10:36 am
Subject: [Sepsis Groups] Monitoring sepsis care



Dear all,


Does any one know how to audit/monitor the care given to sepsis patients.


My hospital is asking us to monitor and report back the sepsis care. Presently 
we do not have any system to do this. We take info. given by outreach nurses 
(who are all ICU trained) to capture sepsis patients currently. This does not 
capture all the sepsis patients in the hospital since some patients are not 
that unwell to require outreach nursing care.


I thought of asking all of you, especially people from UK if you have any 
system/way to capture all the sepsis patients in your hospital. I remember Ron 
Daniels replied something along this line in another e-mail few months ago.


I would be grateful for your reply.


Many thanks in advance
Mohan


Dr Mohan Ranganathan
Consultant Anaesthetist
Lead for sepsis
George Eliot Hospital NHS Trust
Nuneaton
UK


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Message: 3
Date: Fri, 7 Sep 2012 09:50:12 -0500
From: "Jennifer Thoe" <[email protected]>
To: "'[email protected]'"
        <[email protected]>, "Luginbuhl, Ryan S."
        <[email protected]>
Subject: Re: [Sepsis Groups] Physician Buy-in
Message-ID: <[email protected]>
Content-Type: text/plain; charset="utf-8"

We also struggle with this issue.  We have built a very simple database to keep 
track of meeting the elements of the bundles and use of the order sets by 
ordering physician at the point of care.  Our goal is to give individual / 
group data feedback as education alone has not seemed to drastically increase 
our compliance to bundles or use of order sets.  We are in the process of 
entering and tweaking the database to meet our needs.  It is very time 
intensive, but we are hoping it will yield positive outcomes as demonstrated by 
other initiatives using the same method.

Jen



Jennifer Thoe, RN, MSN
Stroke and Sepsis Care Coordinator
Mercy Medical Center-North Iowa
1000 4th Street SW
Mason City, IA 50401
Phone: (641) 428-7109
Fax: (641) 428-6383
This message originates from Mercy Medical Center - North Iowa.  It may contain 
privileged information for the individual(s) or entity named above.  It is 
prohibited for anyone else to disclose, copy, distribute or use the contents of 
this message.  If you received this message in error, please delete the message 
and notify me immediately.



>>> "Luginbuhl, Ryan S." <[email protected]> 09/06/2012 8:38 
>>> AM >>>

  Hello,
    I'm a black belt that's starting a sepsis initiative at our facility. 
Currently we do have a the sepsis bundle in place according to the best 
practice guidelines but the order sets are not being utilized by our 
physicians. My team is made of mostly physicians with a PharmD, and nurses. I'm 
looking for some insight on how some facilities got physicians to utilize the 
order sets and got them to buy-in to using the order set. There is recognition 
of the problem, but seems there's an overwhelming majority that don't use the 
order sets. Preliminary numbers are showing that around 13% of our discharged 
sepsis patients were treated with the order set and that only means they used a 
portion of the order set, not the entire thing. Our mortality has dropped from 
33% to 21%, but there's still room for major improvement after the order sets 
have been in place. I'd appreciate anyone's feedback.

Thanks,

Ryan Luginbuhl RT(R), BS
Six Sigma Black Belt | Process Improvement
OSF Saint Francis Medical Center
613 NE Jefferson Street | Peoria, IL | 61603
p 309.624.2245 | c 309.678.4993 | f 309.624.2236
www.osfsaintfrancis.org

"Serving With the Greatest Care and Love"

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