Sara,
If the physicians and nurses are screening in the ED, ICU, Step down, and med=surg, you can have a specific place where staff put the sepsis screens. You can then gather the screens and evaluate the screening process and implementation of the protocol. If a patient was incorrectly screened and later is confirmed with severe sepsis, you can go to the person who performed the screen and provide education. If a patient screened positive and the protocol was not initiated, you can follow up with the staff. Attending physicians often do not understand the protocol unless specifically educated about the screen and management. Concurrent chart review has many advantages. First, it allows you to provide close to real time feedback to providers. It is faster because the active chart is in front of you. Management can be adjusted while the patient is in the hospital. As far as relying on rapid response- those patients may have progressed undetected until there is an obvious change in condition noted with the progression of severe sepsis. We just instituted a sepsis alert that is triggered by a positive screen. If the patient screens positive and has not been placed on the sepsis protocol, an alert is sent through a group page to the ICU senior, ICU code nurse, phlebotomy, respiratory, and pharmacy. The goal is to assess the progression of sepsis, implement the protocol with first antibiotic within 20 minutes of the screen, and to determine whether the patient needs to transfer to the ICU (signs of hypoperfusion) or our step down unit (severe sepsis without signs of hypoperfusion). Hope this helps- concurrent review will solve many of the issues you’ve identified and is less time intensive once you get used to it. Patty From: [email protected] [mailto:[email protected]] On Behalf Of Sara Valentine Sent: Monday, December 17, 2012 2:17 PM To: [email protected] Subject: [Sepsis Groups] Concurrent Monitoring Hello, I am interested to learn the process of how anyone’s institution is implementing concurrent monitoring of SS or SSH patients. Currently, my process is to get the patient’s name of suspected sepsis and I screen for the SIRS, infectious source, and the organ dysfunction. Unfortunately, most of my chart reviews are done retrospectively, usually days after initial presentation, thus not allowing appropriate time to help intervene to encourage use of the protocol. There is ongoing education within the facility of the nursing staff, hopefully getting nurses to call a rapid response, which I will respond to and there is a specific Sepsis protocol to follow. But I was curious to see if anyone has a great program that wouldn’t mind sharing how they go about monitoring their patients and interventions. Thanks for your time! Sara Valentine, BSN, RN, CNRN Nurse Educator/Clinical Sepsis Coordinator Medical Center Hospital 500 West 4th Street Odessa, Texas 79761 ph: 432.640.1085 fax:432.640.2885 ________________________________ CONFIDENTIALITY NOTICE: The documents accompanying this email transmission contain confidential information belonging to the sender that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this email in error, please notify the sender immediately to arrange for return of these documents. This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of West Suburban Medical Center. This footer also confirms that this email message has been scanned for the presence of computer viruses.
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