Deborah.
Per CMS measure, the focused exam must be completed by a physician, APN, or PA 
within the 6 hours - it cannot be RN documentation.

Maureen A. Seckel, APN, ACNS-BC, CCNS, CCRN, FCCM
Lead CNS Medical Pulmonary Critical Care
Sepsis Coordinator
Christiana Care Health System
4755 Ogletown-Stanton Road
3E29
Newark, DE 19718
Office 302 733-6023



From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of [email protected]
Sent: Wednesday, May 27, 2015 3:25 PM
To: [email protected]
Subject: [Sepsis Groups] CMS Guidelines

So, I've read through the new CMS Guidelines and it states that a repeat 
assessment must be completed within 6 hrs with either a focused exam (including 
VS, cardiopulmonary exam, cap refill, peripheral pulse eval and skin exam) or 
any two of the four: CVP, SV02, bedside cardiovascular ultrasound, passive leg 
raise or fluid challenge.

At our hospital, we have the "shift evaluation" and "shift re-evaluation."  If 
the nurse documents the "shift re-evaluation" they are basically saying nothing 
has changed since the last evaluation.  I'm wondering if that will suffice, or 
if they actually have to do another complete head-to-toe assessment.  Any 
thoughts??

Thanks,
Debbie

Debbie Chambless, MSN, RN, ARNP-C
Sepsis Coordinator
Osceola Regional Medical Center
Kissimmee, Fl 34741
Office: 407-518-3949
Cell: 772-807-0525

~~Recognizing sepsis as a global enemy.  Hoping for global unity in finding a 
solution~~

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