I think that a great distinction has been made – if there is a step-down unit available then that disposition is a great option. The challenge is for smaller (often community) hospitals who only have a choice between ICU or general med/surg.
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] From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Monday, December 22, 2014 12:51 PM To: Brown, Sheree Cc: [email protected] Subject: Re: [Sepsis Groups] ICU Admission for All Severe Sepsis? This happens frequently at our institution, and although some patients may get sicker, we find that a lot of these patients do well and then tie up ICU resources. This year, with the flu being so bad, it can be very challenging. I would advocate admission to an ICU step down unit, with a 1:3 nursing ratio. That would be a better use of resources. Hesham A. Hassaballa, MD, FCCP Program Medical Director, Critical Care Medical Director, Respiratory Therapy Rush-Copley Medical Center 2000 Ogden Avenue Aurora, IL 60504 Phone: (312) 515-3347 On Dec 22, 2014, at 2:36 PM, Brown, Sheree <[email protected]<mailto:[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]<allegiancehealth.org> <M1.2.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]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org This message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message.
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