I personally feel strongly that once in place you should stick by the rules. If 
blood cultures should be done prior to antibiotics  and they were not then the 
criteria was not met. There are many reasons they may not be met, some 
legitimate some not. Because there are always some legitimate reasons I am 
always skeptical of reports of 100% compliance. That usually means the system 
is being gamed by finding ways to excluding the "legitimate reasons" for not 
complying. The problem is that the interpretation of "legitimate reasons" do 
not have rules around them and they become substitute excuses with huge 
variation from data collector to data collector until the database becomes 
useless. 

Unless there are specific rules around a situation (like emergency surgery 
taking priority) that is standard and used by everyone doing the data 
collection, then a failure is a failure. Clearly the reason we play this excuse 
game is to look better or meet a goal. Remember in making the system better it 
is the failures that push us forward. Would it not be better to develop a 
system in which in the future patients going to surgery emergently would always 
get the cultures done rather than using this as a precedence to not do them in 
the future?
 
Terry P. Clemmer, MD
Director: Critical Care Medicine
LDS Hospital
Professor of Medicine
University of Utah School of Medicine
Salt Lake City, Utan 84143

Work Phone: 801-408-3661
Work Fax: 801-408-1668


-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Dierks, Patricia
Sent: Wednesday, May 21, 2014 12:21 PM
To: '[email protected]'
Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 109, Issue 1



I would recommend sending blood cultures anyway.  What if the offending 
organism happens to be resistant to usual antibiotics? Just to be safe...

-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of [email protected]
Sent: Monday, May 12, 2014 2:11 PM
To: [email protected]
Subject: Sepsisgroups Digest, Vol 109, Issue 1

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Today's Topics:

   1. Blood culture timing question (Reidford, Tammy)


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Message: 1
Date: Fri, 9 May 2014 19:32:39 +0000
From: "Reidford, Tammy" <[email protected]>
To: "[email protected]"
        <[email protected]>
Subject: [Sepsis Groups] Blood culture timing question
Message-ID:
        <a16169235fc1ff4f80db47c5a050fc04035...@tx1p03dag0402.apptixhealth.net>
        
Content-Type: text/plain; charset="us-ascii"

I am asking input from others on behalf of one of our hospital sepsis champion 
on meeting the culture deadline for data extraction.  A patient was sent to the 
ER from a physician's office with a prior outpatient CT showing colitis and was 
diagnosed with sepsis.  Since the physicians already knew the source, the 
patient was sent emergently to OR for source control/colon resection without 
blood cultures.  Does this affect how question 5 on whether a blood culture was 
sent?
Thanks in advance for your input.

Tammy Reidford, RN, CCDS
Clinical Documentation Specialist
Phone 812-485-6543
Pager 812- 428-1274
[email protected]



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