Dana, I would suggest that your exclusion criteria be what makes sense at your facilities. The one thing that I know from experience, is that the last thing the well meaning folks in the E.D. want is to do a great job with most of the patients only to be presented with a fall-out for a patient who had multiple dx and had the proper care for the most eminently urgent one; that is GIB or MI. I like to use these cases to demonstrate that patients are allowed to have more than one dx requiring treatment, and that severe sepsis is often the cause of the seemingly more prominent issue; e.g. severe sepsis causing DKA or worsening heart failure or even MI. So this is a gray answer to your question; in summary do what makes sense, give feedback where opportunities exist, but consider not counting the patients that you described as fallouts. IMHO
Thanks, Mary Ann Barnes-Daly, RN BSN CCRN DC Regional Clinical Initiative Lead-Sepsis and ICU Liberation (ABCDE) Gordon and Betty Moore Foundation Grant Sutter Health Sacramento- Sierra Region Blackberry: 916.200.5604 Office: 916.614.6370 Assissant: Ruby Dulay 916-614-6362 [email protected] E-mail: [email protected]<mailto:[email protected]> [cid:[email protected]] You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete. R. Buckminster Fuller From: [email protected] [mailto:[email protected]] On Behalf Of DanaMarie Smith Sent: Friday, November 22, 2013 6:00 AM To: [email protected] Subject: [Sepsis Groups] exclusions Hi Everyone, I am collecting data on Sepsis Alerts we are currently running in our three EDs not inpatient yet. I also get HIM reports on severe sepsis we might have missed in the ed and not alerted. My question is on exclusions I know if they come in and are made comfort measures right away they are excluded. I have had some cases where the person came in as a STEMI and was treated for that first then discovered they also have sepsis and another case came in for severe GI bleed had to be stabilized and then realized they had severe sepsis. So I just want to be clear what patients should be excluded from the data collection. Thank You, Dana Dana Marie Smith RN Clinical Data Analyst Quality/Performance Improvement Phone # 215- 612-5354 Fax # 215-612-4463
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