To whom it may concern,

My name is Jennifer Nitroy, and I am an MSICU RN at the VA Palo Alto Health 
Care System. I am currently enrolled in an Evidence-Based Practice fellowship 
with an initiative surrounding sepsis (early recognition and EGDT).

My group is at the phase of constructing a screening tool and bundled care for 
inpatient settings. Much of the literature we have read suggests that screening 
should be completed on admission, once a shift (Q8 hours) and then with any 
unexplained changes in patient condition. However, we have not been able to 
find an explanation for how this frequency was chosen. Do you have any evidence 
to support or disprove this decision? Some nurses are asking if that is too 
often. To our group, we feel it is essential to be diligent in our tracking, 
but we want accurate evidence to support us if we are to institute this plan.

Also, we are attempting to implement this process across long term care and 
rehab settings (as the VA health care system is all encompassing). The 
literature to date has been sparse if not non-existent on this front. I notice 
on your homepage, your newest studies will be with patients on medical-surgical 
and telemetry floors. I will suggest applying for this opportunity with my 
group members. However, in the meantime, do you have any evidence to support a 
tailored approach to these less acute patients (or do you recommend immediate 
transfer to ICU?)

In the SSC guidelines it recommends regular screening of patients but does not 
offer the frequency with which to do so. Any insight you have on the matter 
would be greatly appreciated. We are passionate in our endeavors and want very 
much for this process to be a success. Thank you in advance!

Regards,

Jennifer Nitroy, RN, BSN, CCRN

Sent from my iPhone
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