RE: sepsis tool question If you are screening all patients, my only concern would be workload issues with making the known or suspected infection the last decision tool.
Daniel Gerard RPh Critical Care Pharmacist McClaren-Northern Michigan Phone: 231-487-4770 FAX: 231-487-4817 [email protected] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Tuesday, July 29, 2014 9:49 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 119, Issue 2 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: sepsis tool question (Barnes-Daly, Mary Ann) 2. Re: sepsis tool question (Exstrom, Nancy) ---------------------------------------------------------------------- Message: 1 Date: Mon, 28 Jul 2014 10:33:37 -0700 From: "Barnes-Daly, Mary Ann" <[email protected]> To: "'Carlson, Barbara A. (Lincoln, NE)'" <[email protected]>, "'[email protected]'" <[email protected]> Cc: "'Exstrom, Nancy'" <[email protected]> Subject: Re: [Sepsis Groups] sepsis tool question Message-ID: <62b84847cb93ba4fbe626d1b1d6d6e430137cd1d2...@dcbl105vx.root.sutterhealth.org> Content-Type: text/plain; charset="us-ascii" First let me be clear that I am not rendering a decision here; just weighing in with my 2 cents. It is true that a large percentage of our hospitalized patients have SIRS criteria, and often a new or exacerbated organ failure And a part of the assessment process by the registered nurse, any new occurrences of SIRS and/or organ failure deserves immediate follow up. For the purposes of sepsis screening however, sepsis cannot be present without an infection. So many other reasons exist that cause SIRS for example, as you likely know. So what I am focusing on is not general assessment but the actual sepsis screen which starts with documented or suspected infection - and leads the RN down the path toward discovering where on the continuum the patient may fall based their body's response to that infection - as opposed to trying to explain the SIRS and/or organ failure by looking for an infection I know of places that have moved SIRS first - anecdotally it seems to cause and high sensitivity to SIRS and a higher false positive rate for screens Thanks, MARY ANN BARNES-DALY RN BSN CCRN DC | Clinical Performance Improvement Consultant Sutter Health - Clinical Integration Department | 2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| Office 916.286.6717 | [email protected]<BLOCKED::mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Carlson, Barbara A. (Lincoln, NE) Sent: Sunday, July 27, 2014 5:32 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20140728/b62091ed/attachment.htm> ------------------------------ Message: 2 Date: Mon, 28 Jul 2014 16:34:32 +0000 From: "Exstrom, Nancy" <[email protected]> To: "[email protected]" <[email protected]>, "Carlson, Barbara A. (Lincoln, NE)" <[email protected]>, "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] sepsis tool question Message-ID: <11802ba540e6d3439fd09979b1856f6087050...@chiex018.chi.catholichealth.net> Content-Type: text/plain; charset="us-ascii" Awesome news 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) From: [email protected] [mailto:[email protected]] Sent: Monday, July 28, 2014 11:13 AM To: Carlson, Barbara A. (Lincoln, NE); [email protected] Cc: Exstrom, Nancy Subject: RE: sepsis tool question That is how we do it- SIRS, then infection-if positive =lactic acid. Susan Susan McKinney, RN FCCM Clinical Quality Coordinator- -Sepsis-VTE Clinical Effectiveness Team Rapid City Regional Hospital Rapid City, SD [email protected]<mailto:[email protected]> 605-484-7381 Cell 605-755-4428-please note new number From: Sepsisgroups [mailto:[email protected]] On Behalf Of Carlson, Barbara A. (Lincoln, NE) Sent: Sunday, July 27, 2014 6:32 AM To: [email protected]<mailto:[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. 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