Hello everyone
If the patient dies while an inpatient they would be included in our mortality 
rate, regardless of Hospice status.
Wendy Nieman RN 
ICU and Medical Quality Coordinator
St. Joeseph Mercy Hospital
Ann Arbor Michigan 48104


________________________________________
From: [email protected] 
[[email protected]] on behalf of Robyn Haddock 
Crosswhite [[email protected]]
Sent: Wednesday, January 08, 2014 12:03 PM
To: [email protected]
Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1

Our hospital includes hospice discharges regarding sepsis patients  in our 
mortality rates, I just wanted to know if other hospitals are doing this as 
well? Thanks

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Sent: Monday, January 06, 2014 2:07 PM
To: [email protected]
Subject: Sepsisgroups Digest, Vol 91, Issue 1

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Today's Topics:

   1. Re: Mortality (Angela Craig)
   2. Re: First Dose Antibiotics (Rick Rutherford)


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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

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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
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