Hi Mark, It is my understanding that the initial screen (completed by nursing) includes the temp, heart rate, and respiratory rate parameters and WBC. Based on 2 or more of these values being out of range...the nurse is then prompted to note whether there is a suspected infection (wound, line, UTI, incision, etc). If there is a suspicion of infection the nurse is prompted to report this to the physician. Perhaps this is when you would initiate the rapid response? At my facility nurses continue to screen despite a patient having a known infection, they just note that the infection is known and that it is being treated etc.
Dawn Dawn M. Drahnak, MSN, RN, CCRN Instructor Pitt-Johnstown Baccalaureate Nursing Program 141 Blackington Hall Johnstown PA 15904 814-269-2045 Office 814-269-2995 Nursing Office 814-242-9111 Cell [email protected]<mailto:[email protected]><mailto:[email protected]> "The eye cannot see what the mind does not know" author unknown ________________________________ From: [email protected] [[email protected]] On Behalf Of Richardson, Mark [[email protected]] Sent: Thursday, June 20, 2013 4:07 PM To: [email protected] Subject: [Sepsis Groups] Developing a Sepsis Bundle for my organization I am the Educator/Quality Coordinator of ICU in a community hospital on the north side of Chicago. We are extremely good about keeping up with the latest evidence based practice in critical care, so the bundles as individual interventions are not new to us. However, my colleague in the ED and I have been asked to develop a sepsis bundle protocol for the organization to follow. There are a few components that I perceive as barriers that we would like to learn more about: 1. We would like to initiate early recognition tools to trigger our Rapid Response Team in severe sepsis when it occurs in non-critical areas. The list of triggers from the latest SSC 2013 is quite extensive and we would like to target it a bit more. The 2001 triggers were very narrow, (e.g. t ≥ 38.3/≤36, HR > 90, RR > 20, and WBC > 12K or < 4K) but the new triggers for recognition are far more extensive, too numerous to describe here (see p. 585 in Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2012. Critical Care Medicine, 41 (2)). We fear an overload of RRT calls since nearly every patient in the organization meets at least one of these criteria. Do you have any suggestions to narrow the scope a bit? 2. We would like to empower our nurses to drive the use of the sepsis bundles where medicine could be less aggressive. Have you any suggestions? Thanks much, Mark Richardson, MSN RN CCRN Swedish Covenant Hospital 5145 N. California Avenue Chicago, IL 60625 773 878-8200 Ext 2644 Pager 773 781-7584 ________________________________ *** Confidentiality Statement *** This e-mail is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged and confidential. If the reader of this message is not the intended recipient, please notify the sender immediately by replying to this message and then delete it from your system. Any review, dissemination, distribution, or reproduction of this message by unintended recipients is strictly prohibited and may be subject to legal restriction. Thank you for your cooperation.
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