I would like anything for SNF as well. Thank you, Amy From: Sepsisgroups [mailto:[email protected]] On Behalf Of Messineo, Laura Sent: Tuesday, August 05, 2014 1:08 PM To: Walker, Patricia Ann; [email protected] Subject: Re: [Sepsis Groups] Combination therapy with Vancomycin given within TOP
Does anyone have any SNF sepsis screening tools you would be willing to share? Thanks, Laura Messineo Laura Messineo RN BS System Manager eICU Operations Presence Health 1000 Remington Blvd Suite 100 | Bolingbrook, Illinois 60440 Office: 630.914.2905 | Fax: 630.914.2901 [email protected]<mailto:[email protected]> www.presencehealth.org<http://www.presencehealth.org> From: Sepsisgroups [mailto:[email protected]]<mailto:[mailto:[email protected]]> On Behalf Of Walker, Patricia Ann Sent: Monday, August 04, 2014 9:00 PM To: '[email protected]' Subject: [Sepsis Groups] Combination therapy with Vancomycin given within TOP Hello, Based on our patient population (elderly and SNF) , our hospital tends to frequently utilize Vancomycin. We are seeing cases were Vanco is administered in the ED after Blood cultures were drawn but administration is still within 3 hours of TOP, also a combination of broad spectrum antibiotics are administered but not within 3 hours of TOP. The addition of the second agent has been determined by a physician's judgment of the patient's severity of illness. My question is based on literature where combination therapy is advocated in critically ill patients with severe sepsis or septic shock. My question: Can we answer yes for meeting the bundle based on the fact that Vanco was given within 3 hours of TOP, and a broad spectrum antibiotic was also administered, but the broad spectrum antibiotics of the TOP 3 hour window. Some literature found Antibiotic therapy should be narrowed to target the isolated pathogen when culture results become available. Patients who have milder forms of infection may be more appropriately treated with narrow spectrum agents and antibiotic choices in these patients should be based upon current guidelines and clinical judgment. De-escalation to a single active agent is strongly recommended when culture and susceptibility results return. 4. C. difficile colitis should be treated with enteral antibiotics if tolerated. Oral Vancomycin is preferred for severe disease (grade 1A). Rationale. In adults, metronidazole is a first choice; however, response to treatment with C. difficile can be best with enteral Vancomycin. In very severe cases where diverting ileostomy or colectomy is performed, parenteral treatment should be considered until clinical improvement is ascertained (539-541). Thank you, Patricia Walker, RN-BC. BSN Evidence Based Practice Manager 924 Westwood Blvd., Suite 900 Los Angeles, CA 90095 T 310.794.8522 F 310.794.3284 "The character of a nurse is just as important as the knowledge he/she possesses." - Carolyn Jarvis ________________________________ IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by return email, and delete this message from your computer. ________________________________ The information contained in this e-mail and any accompanying documents is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you.
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
