There is no literature that I am aware of that parses the sirs criteria however what you say does make sense and is what I actually do in defining sepsis
William E. Haik, M.D., F.C.C.P., C.D.I.P. AHIMA Approved ICD-10-CM/PCS Trainer Office: (850) 863-2110 Cell: (850) 803-5854 Fax: (850) 864-4438 > On Jan 17, 2015, at 12:50 PM, Malik,Imrana <[email protected]> wrote: > > SIRS criteria is only met if 2 out of the 4 are positive, of which one MUST > be a derangement in Temp or WBC. So tachycardia with tachypnea alone should > not be considered positive. Hope that helps. > > From: Sepsisgroups [[email protected]] on behalf of > Orth, Claudia [[email protected]] > Sent: Tuesday, January 13, 2015 2:00 PM > To: [email protected] > Subject: [Sepsis Groups] SIRS/Sepsis Criteria and Coding > > I am writing to inquire how other institutions are handling or if you are > even encountering concerns, that we are “over-calling” early sepsis, > especially when the only SIRS criteria are tachycardia and tachypnea > (sometimes only a single set of VS). We are reviewing all short stay > (Observation, 1-2 day stays) and see “septic” patients who are “in no acute > distress”, are only here in Observation status and never Inpatient, or stay > as IP only 1-2 days, are not sent home on any antibiotics or only a short > course of oral antibiotics. > > Often their only SIRS criteria are tachycardia and tachypnea—which are quite > non-specific markers that can be seen with anxiety, pain, etc. but when > paired with a suspected or documented infection role up to Sepsis?! > > Since Sepsis is a high-paying condition it’s also a high audit DRG (mainly > because, in the past, many patients were in ICU, very ill, and expending lots > of resources). Now that “early sepsis” is being diagnosed quite frequently, > external auditors are reviewing sepsis DRG charts, and disagree that sepsis > was present at all, recode the chart, reassign the DRG and reduce payment to > UTI, pneumonia, etc. This is so frustrating as we are trying to educated our > providers and nurses on the importance of having a high suspicion for sepsis > and early recognition and now are turning around and saying don’t say > ‘Sepsis’ unless they are “sick” because we need to be able to defend it!? L > > Any feedback, thoughts, or tools on how other institutions are handling this, > would be greatly appreciated especially when it comes to the SIRS criteria > which most of our clinicians call “soft criteria”? > > Thank you in advance for your time and expertise! > Claudia > Claudia Orth BSN, RN, CCRN-K > Regional Sepsis Coordinator > Munson Medical Center > (231) 935-5692 (Voice) > [email protected] > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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