Hi Sheree As you probably remember we have a policy to admit all patients with severe sepsis with hypoperfusion(lactate > or= 4) or septic shock ( hypotension after 30ml/kg fluid bolus) to the ICU since December 2010. So we did not include patients with severe sepsis unless they had lactate > = 4; the entire number of patients with severe sepsis was too large for our ICU capacity The population with unresolved hypotension and lactate greater than 4 were the patients at the highest risk for deterioration so by having them placed in the ICU we think we achieved the best outcome for our patients
We still get some push back---but we have achieved significant mortality reduction for the patients with severe sepsis that remain in the floor --we have a bundle of interventions that require increased monitoring and serial lactates to catch the patients before they deteriorate Hope this is helpful Pat Posa Sent from my iPhone > On Dec 22, 2014, at 10:19 AM, "Brown, Sheree" > <[email protected]> wrote: > > We are going to initiate a new protocol whereby all patients with suspected > severe sepsis (with or without shock) will be expedited to the ICU for > admission. > > We hope to reduce ED length of stay and prevent the progression of sepsis > that occurs due to inadequate treatment and/ or inadequate monitoring. We > believe this will help prevent the urgent transfers to ICU when these > patients have rapid deterioration on the floor. We anticipate a short ICU > stay for most of these patients. > > Have any of you tried an aggressive approach such as this? Was it > successful? Obviously we have a lot of push-back from the intensivists. > Most of these patients aren’t the typical ICU patient – i.e., non-ventilated, > normotensive, etc. > > Thanks, > Sheree > > > Sheree Brown MSN, RN, CNL > Manager, Performance Excellence > Phone: 517 788-4800 ext. 4209 > Pager: 517 534-0127 > Fax: 517 788-4715 > [email protected] > <image001.gif> > > > This e-mail message and any attachment(s) is intended only for the > individual(s) to whom it is addressed and may contain information that is > privileged, confidential or proprietary in nature. Any unauthorized > disclosure, copying or distribution of this e-mail or the content of this > message is prohibited. If you have received this e-mail message in error, > please immediately notify the sender at the e-mail address above, permanently > delete this e-mail and destroy any copies of this e-mail and attachments in > your possession. This electronic message (“e-mail”), including the typed name > of the sender, does not constitute an electronic signature unless there is a > specific statement to the contrary included in this e-mail. > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
