We do not do them either in the ED. I found from our lab that it is a send-out and could take 24 H to come back. Our hospital is looking at doing them in-house.
>>> "Siegel, Jeffrey" <[email protected]> 3/28/2013 2:23 PM >>> We do not do routine PCT in the ED. The admitting physician adds it to the blood drawn in the ED if he needs it. Sent from my iPad On Mar 28, 2013, at 11:15 AM, "Angela Long" <[email protected]> wrote: I have a topic - Is Procalcitonin routinely drawn in the ED? I just was reading an article that there is no data on routine Procalcitonin level evaluation in the ED. Just wondering if other hospitals get this level while in the ED. >>> <[email protected]> 3/27/2013 6:24 PM >>> Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Re: EPIC facilities and ED Sepsis (Miller, Kevin - SFMH) ---------------------------------------------------------------------- Message: 1 Date: Wed, 27 Mar 2013 13:47:30 -0700 From: "Miller, Kevin - SFMH" <[email protected]> To: "Hunter, Patricia" <[email protected]>, "Alexander O. Sy" <[email protected]>, that <[email protected]>, "[email protected]" <[email protected]>, "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis Message-ID: <14d6990dd3b8104c82254ccd1826f9f31471ce0...@phx-msg-006-n1.chw.edu> Content-Type: text/plain; charset="us-ascii" We currently have a Sepsis screening tool in Cerner. It does have a smart template which pulls in abnormal vital signs, and abnormal labs within the last 16 hours on the screening form. Another smart template pulls in antibiotics that are currently ordered on the patient. The tool we developed in Cerner is built on conditional logic. The first question is Signs of Infection, if the nurse documents "None", then they are done with the Sepsis screening. The other options are "Suspected Infection, Known infection, Failed outpatient therapy, On antibiotic therapy", if they choose any of these on the first question the SIRS box opens with all of the SIRS criteria (this is where the labs and vital signs are useful to have in the smart template). If the patient meets 2 or more SIRS criteria, the Organ Dysfunction Signs and Symptoms box lights up. If they document Signs of Organ dysfunction, when signing the form they receive a Discern Alert which instructs them to notify the physician immediately of the positive Sepsis screen. This tool has inherent problems: 1. If the nurse does not suspect infection, they will not get to the SIRS or Organ dysfunction screens 2. Some clinicians are more focused on "overall" presenting picture of patient, than others which can lead to different assessments between different clinicians. 3. This alert is based upon human entry and is not automated from the system to identify from data points a patient that might meet SIRS or Sepsis. [cid:[email protected]] "Procrastination is the thief of time" Kevin P. Miller, RN, BSN Manager, Risk Management Saint Francis Memorial Hospital Phone: (415) 353-6296 Fax: (415) 353-6177 Right Fax: (415) 591-6364 [email protected] [cid:[email protected]] Confidentiality Notice: This message and any attachments are for the sole use of the intended recipient(s) and may contain information that is legally privileged and/or confidential. This message may also contain confidential health information. If you are not the intended recipient or a person responsible for delivering this message to an intended recipient, you are hereby notified that any review, dissemination, distribution, or copying of this communication is strictly prohibited. If you are not the intended recipient or a person responsible for delivering this message to an intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message. Confidential health information is protected by state and federal law, including but not limited to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and related regulations. From: [email protected] [mailto:[email protected]] On Behalf Of Hunter, Patricia Sent: Wednesday, March 27, 2013 12:44 PM To: Alexander O. Sy; that; [email protected]; [email protected] Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis We will be launching CERNER in the near future. Any advice from current CERNER users as to what to build into the product for Sepsis - pulling data, sepsis alert, identification of patients, auditing, etc.? Thanks, Pat Patricia Hunter, RN Clinical Data Analyst Performance Excellence Mercy Medical Center - Des Moines, Iowa 515-643-2206 "Life is not about waiting for the storms to pass... it's about learning to dance in the rain!" From: [email protected] [mailto:[email protected]] On Behalf Of Alexander O. Sy Sent: Monday, March 25, 2013 12:06 PM To: that; [email protected]; [email protected] Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis If you have access to the Epic Users website, you can search the library for a sepsis Best Practice Alert developed by UVA and another hospital in the Washington area. You can start with this. We have Epic but our institution launched with the bare bones with nothing built or tested beyond copying a small percentage of our legacy CPOE and notes. We are trying to get this built into our Epic (with much resistance) to no avail so far. So believe it or not, we are using paper documentation for this! Alexander Sy MD, FCCP, FACP, FAASM Diplomate, American Board of Sleep Medicine Associate Professor Associate Director, MICU Associate Director, Pulmonary Critical Care Fellowship Program Director, MICU -Advance Practice Providers Program Pulmonary, Critical Care, Allergy and Immunology Wake Forest University Health Sciences Medical Center Blvd Winston- Salem, NC 27157 Tel. No. (336) 716- 4328 Fax No. (336) 716-7277 Pager No. (336) 806-6111 Email: [email protected]<mailto:[email protected]> [cid:[email protected]] Confidential and Privileged The information contained in this e-mail may be privileged and confidential information intended for the sole use of the addressee. If the reader of this e-mail is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this e-mail in error, please immediately notify me by responding to this message. From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of that Sent: Saturday, March 23, 2013 4:53 PM To: [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]> Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis We are just rolling over to Epic in the fall so this would be very helpful to us as well. Jeffrey R Hanlon RN Stamp Out Sepsis [http://www.world-sepsis-day.org/cgi-bin/WebObjects/WsdCMS.woa/2/wr?wodata=Media%2FWSD%2FMedia%2FWorld+Sepsis+Day+Logo%2Fstop.png]<http://www.world-sepsis-day.org/WSD/en?sid=u5iqdrmsatL1SZb01Ehxkw&iid=2> -----Original Message----- From: Luginbuhl, Ryan S. <[email protected]<mailto:[email protected]>> To: '[email protected]' <[email protected]<mailto:[email protected]>> Sent: Sat, Mar 23, 2013 12:31 pm Subject: [Sepsis Groups] EPIC facilities and ED Sepsis Hello, This question is for Epic hospitals. I was wondering if any you have a validated and reliable Epic built solution for early recognition of sepsis in the ED. We are open to any solution that is Epic-based. We want a solution that pulls the data (vitals, complaint, labs) and alerts of a sepsis risk and allows the staff to easily use the sepsis protocol (a direct link to an orderset). We are open to any other ideas as well. Your feedback would be greatly appreciated. Thanks, Ryan Luginbuhl RT(R), BS Six Sigma Black Belt | Process Improvement OSF Saint Francis Medical Center www.osfsaintfrancis.org<https://owa.osfhealthcare.org/owa/redir.aspx?C=c43N-PDc7kaFMnRQlHCcYipj0FJ8hc8IkrC_p1D1vQYHG5RbKolwAcwIpYCqS51mTzc2RyOjBXc.&URL=http%3a%2f%2fwww.osfsaintfrancis.org%2f> "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]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org This electronic mail and any attached documents are intended solely for the named addressee(s) and contain confidential information. If you are not an addressee, or responsible for delivering this email to an addressee, you have received this email in error and are notified that reading, copying, or disclosing this email is prohibited. 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