Rick, We have the same problem at our facility. We are currently looking into bringing in pro-calcitonins for antibiotic de-escalation to encourage the early administration of antibiotics and help to de-escalate early once cultures return negative. We are hearing the main concern in our facility is creating more abx resistance. Hope this idea is helpful.
Jessica Wonderly, RN DSRIP Front Line Facilitator Hospital Staff Nurse II Kern Medical Center Phone: (661) 326-5637 Pager: (661) 307-1098 * * * * * * * * * CONFIDENTIALITY STATEMENT * * * * * * * * * This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of the communication is strictly prohibited. If you received this communication in error, please notify us immediately by telephone and return the original message to us at the e-mail address above. Thank you. OWNED AND OPERATED BY THE COUNTY OF KERN 1830 Flower Street, Bakersfield California 93305-4197 (661) 326-2416 >>> <[email protected]> 1/6/2014 12:07 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: Mortality (Angela Craig) 2. Re: First Dose Antibiotics (Rick Rutherford) ---------------------------------------------------------------------- Message: 1 Date: Fri, 3 Jan 2014 13:31:38 -0600 From: Angela Craig <[email protected]> To: "'Michelle Corder'" <[email protected]>, "Philip S. Barie"<[email protected]>, Hesham Hassaballa <[email protected]>, "<[email protected]>" <[email protected]> Subject: Re: [Sepsis Groups] Mortality Message-ID: <343E31412FC9094487B54371286ADDA003D404B937@D109EXCHMB.crmchealth.hospital> Content-Type: text/plain; charset="windows-1252" I think of it as "All Cause Mortality" so, no matter where they are when they expire it counts Angela Craig APN,MS,CCNS Clinical Nurse Specialist Intensive Care Unit Cookeville Regional Medical Center 931-783-5035 ________________________________ From: [email protected] [mailto:[email protected]] On Behalf Of Michelle Corder Sent: Thursday, January 02, 2014 9:36 AM To: Philip S. Barie; Hesham Hassaballa; <[email protected]> Subject: Re: [Sepsis Groups] Mortality I have a question for the establishing mortality rate: Do you include a patient that is transfered out of the ICU but later expires on the floor in the mortality rate? or Do you only count the patients that expire while in the ICU? Michelle Corder PIH Health ________________________________ From: [email protected] [[email protected]] On Behalf Of Philip S. Barie [[email protected]] Sent: Friday, December 27, 2013 10:39 AM To: Hesham Hassaballa; <[email protected]> Subject: Re: [Sepsis Groups] Mortality Yes, unless you can prove it to be completely unrelated. Which, it seems as though you cannot. ________________________________ From: [email protected] [[email protected]] on behalf of Hesham Hassaballa [[email protected]] Sent: Tuesday, December 24, 2013 4:28 PM To: <[email protected]> Subject: [Sepsis Groups] Mortality I have a question: A patient was admitted with septic shock, and we successfully treated him and he survived to ICU discharge. Approximately 17 days later, he codes and dies on the floor (unknown reason why) the day before he was slated to be discharged from the hospital. Does this really count against our sepsis mortality? Hesham A. Hassaballa, MD Program Medical Director Critical Care Rush-Copley Medical Center Assistant Professor of Medicine Rush University Medical Center Phone: (331) 454-6572 ### CONFIDENTIALITY NOTICE ### This message and any included attachments are from Cogent HMG and are intended only for the addressee. The contents in this message contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or contact the Cogent HMG Privacy Officer at [email protected]<mailto:[email protected]>. ### CONFIDENTIALITY NOTICE ### This message and any included attachments are from Cogent HMG and are intended only for the addressee. The contents in this message contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or contact the Cogent HMG Privacy Officer at [email protected]. NOTICE: This electronic mail (email) message, including any attachments, is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED. If you have received this message by error, please notify the sender by reply and immediately destroy this email and any attachments. Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20140103/76983d4f/attachment.html> ------------------------------ Message: 2 Date: Sat, 4 Jan 2014 07:25:40 -0800 From: Rick Rutherford <[email protected]> To: Sepsis List Serve <[email protected]> Subject: Re: [Sepsis Groups] First Dose Antibiotics Message-ID: <[email protected]> Content-Type: text/plain; charset="iso-8859-1" Hello All, We are seeing resistance to giving antibiotics early in patients who meet criteria for severe sepsis but do not have a source. The argument often goes like this: "The patient is not critically ill and I do not have a source. Antibiotics will cloud an unclear picture further and have side effects such as liver and renal failure and breed resistance. I am going to hold off on antibiotics unless a source becomes apparent." Often, but not always, these patients will get their positive urine or blood culture 2-3 days later and we will have been out of compliance and put the patient at risk. Antibiotics noncompliance in nonshock septic patients is our most common miss in the bundles. I would appreciate help in formulating counterarguments to these concerns. Especially useful would be articles demonstrating the safety of single doses of antibiotics and the consequences of incorrect antibiotics in sepsis and severe sepsis (Not Septic Shock which Dr. Kumar and others have addressed nicely). Thanks, RIck RutherfordSepsis Task Force ChairVentura County Medical Center -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20140104/26cff8aa/attachment-0001.htm> ------------------------------ _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org End of Sepsisgroups Digest, Vol 91, Issue 1 *******************************************
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
