Hi Nancy,
The number one questions during severe sepsis identification is "are the changes related to suspected or confirmed infection". Many sites have changed to SIRS and organ dysfunction for triggering alerts largely because the EMR cannot answer question number 1. I recommend proceeding with caution with the use of SIRS and organ dysfunction to screen for severe sepsis because neither SIRS nor organ dysfunction are specific to infection, other than elevated bands on differential. Any shock or critical illness can produce a positive SIRS/Organ dysfunction finding. The question "are the changes related to suspected or confirmed infection" is the critical thinking piece. Investing in sepsis progression education for bedside nurses is effective. They consistently identify patients, more accurately than alerts. With that said, the order in which you identify is up to your site. Stress the importance of "suspected infection" during screening. Patty Cormack From: Sepsisgroups [mailto:[email protected]] On Behalf Of Carlson, Barbara A. (Lincoln, NE) Sent: Sunday, July 27, 2014 7:32 AM To: [email protected] Cc: Exstrom, Nancy Subject: [Sepsis Groups] FW: sepsis tool question Please see question below. Barbara Carlson RN, BAN, CPHQ Performance Improvement St Elizabeth Regional Medical Center P 402-219-7332 F 402-219-8992 From: Exstrom, Nancy Sent: Saturday, July 26, 2014 12:41 AM To: Carlson, Barbara A. (Lincoln, NE) Subject: sepsis tool question I would like to ask the surviving sepsis campaign if it would be OK to have the SIrS criteria first, Organ criteria 2nd, and Infection criteria 3rd in figuring the sepsis tool as the novice nurse sometimes doesn't think big picture of suspecting an infection despite sirs and organ function being positive and therefore if infection is 1st criteria to answer, they would answer no and it is an automatic negative screen but if in reverse order, they make think... the patient may have infection? Nancy Exstrom RN, MSN, CCRN, CSC Clinical Educator Critical Care Services 555 South 70th Lincoln, Ne 68510 402-440-5964 (Cell) 402-219-8021 (work) This electronic mail and any attached documents are intended solely for the named addressee(s) and contain confidential information. If you are not an addressee, or responsible for delivering this email to an addressee, you have received this email in error and are notified that reading, copying, or disclosing this email is prohibited. If you received this email in error, immediately reply to the sender and delete the message completely from your computer system. This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of West Suburban Medical Center. This footer also confirms that this email message has been scanned for the presence of computer viruses.
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
