OK so most of us have changed to time of triage for time zero  I would assume.  
I had a meeting with our data abstractor for Sepsis Core Measures yesterday and 
she mentioned time zero would be changing.  She then showed me the manual for 
the data abstractors.

It stated for Septic Shock Present the following:  Criteria

There must be documentation of severe sepsis present AND
Tissue hypoperfusion persists after crystalloid fluid administration evidenced 
by either SBP <90, or MAP<65, or a decrease in SBP by >40points OR Lactate 
level is >4

Soooo My abstractor was under the impression this would be the new time zero 
based on this.

There was a sheet on Severe Sepsis Present as well.  What concerns me is that 
based on documentation is what will que them for time zero.  I am worried that 
there will be delays in care if that is how it will be determined.  What are 
everyone's thoughts?

Am I missing something?  Will everyone just stay with time zero that we feel is 
"clinically correct" and consistent across the country and just let core 
measures monitor something different?  Can someone help me understand this.  I 
really hope I am not reading something correctly or just not understanding.

Thank you in advance - I am soo grateful for this List serve!!!

Angela Craig APN,MS,CCNS
Clinical Nurse Specialist
Intensive Care Unit
Cookeville Regional Medical Center
931-783-5035

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