Hi Ryan, We have an alert system called Code Sepsis. We started this in November 2012. Our current criteria is: Positive screen with 2 or more SIRS + confirmed or suspected infection
- RN notifies Charge RN to validate screen, RN draws a lactate, calls RRT, notifies primary service - If lactate > 2 --> Code Sepsis is called Positive screen with organ dysfunction + confirmed or suspected infection - RN notifies Charge RN to validate screen, RN calls Code Sepsis, draws a lactate, notifies primary service Code Sepsis team process: in-patient units only, pager alert (not overhead page) to ICU Fellow, RRT, an pharmacist. Separate page to primary service. All are expected to come to the bedside within 10 minutes except for the pharmacist. The pharmacist reviews the patient history and medication profile, awaits for an antibiotic order ready to mix and dispense as needed. We have a first dose guideline so that the first dose of antibiotic is a medication that needs no mixing by pharmacy, but can be readily pulled from the Pyxis medication station on the nursing unit. Results: So far disappointing. Our program is being piloted in 2 med/surg units and 2 ICUs. We get about 107 positive screens per month. A fair amount are false positive screens as the SIRS or organ dysfunction are not new changes. We have about 6 Code Sepsis calls per month (so under-utilization of the process) and almost none are found to have severe sepsis. All patients do get treated with some part of the bundle, so we feel that the team is being called for sepsis, but not severe sepsis. So far there has been only one call that was associated with severe sepsis - and I am happy to say that the patient received all aspects of appropriate care. We are in the process of re-evaluating our process. We are providing more teaching via bedside nurse coaches, flyers, huddles, feedback letters to drive accountability for accurate screening, drawing lactates and calling a code sepsis. Given the number of positive screens and the broad reach of our screening process, we will probably change the criteria for code sepsis. Jim Stotts RN, MS, CNS Sepsis Project Manager | Innovations In Population Health (DSRIP) University of California San Francisco Medical Center [email protected]<mailto:[email protected]> (c) 415-717-0098 (o) 415-514-8495 From: [email protected] [mailto:[email protected]] On Behalf Of Luginbuhl, Ryan S. Sent: Friday, February 22, 2013 12:14 PM To: [email protected] Subject: [Sepsis Groups] Sepsis Alert help Hello, The sepsis initiative I'm leading is going to pursue a "sepsis alert" model starting in the ED first then moving it out the floors. I was wondering if any other facilities could explain their Sepsis Alert process. What's worked well? Are you running into any problems with this type of program? I really appreciate your feedback! Ryan Luginbuhl Six Sigma Black Belt | Process Improvement OSF Saint Francis Medical Center "Serving With the Greatest Care and Love" ==================== The information in this message is confidential and may be legally privileged. Access to this message by anyone other than the addressee is not authorized. If you are not the intended recipient, or an agent of the intended recipient, any disclosure, copying, or distribution of the message or any action or omission taken by you in reliance on it, is prohibited and may be unlawful. If you have received this message in error, please contact the sender immediately and permanently delete the original e-mail, attachment(s), and any copies. ====================
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
