Time zero is not necessarily triage time. It is based on MD/PA/NP documentation 
of severe sepsis or septic shock OR if the patient meets the criteria whichever 
is first.

For the IP case, we need to see the same documentation, either by 
physician/NP/PA or look to see if the patient has the three necessary criteria. 
If we use the criteria, the clock starts with the last criteria met (for 
example, if the lactate result was last, that is when the clock starts.) If the 
criteria is met prior to the MD documentation then again we need to take the 
time of the last criteria. If MD documentation occurs first....then that is 
when the clock starts.

We are developing a "code sepsis" process that we hope will help us identify 
"time zero" in the IP. We are working with the clinical staff on the units in 
order to assist them in early identification of sepsis.

Thank you, Kim

Kim Izard, BS, RN
Supervisor Clinical Outcomes/Core Measures
SSM Health - St. Louis Network
1015 Corporate Square Drive Suite 240
Creve Coeur, MO 63132
Office - 314-989-2137
Cell - 618-670-3616
[email protected]<mailto:[email protected]>

[cid:[email protected]]

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From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Parker, Erin
Sent: Monday, June 01, 2015 2:36 PM
To: [email protected]
Subject: [Sepsis Groups] CMS Guidelines

I understand that time zero for ED is triage, but confused with SEP-1 when does 
the clock start if a person is in the ICU/Floor?

Erin K. Parker RN, BSN, ACM | Infection Control | Sepsis Coordinator
Genesys Regional Medical Center |  One Genesys Parkway | Grand Blanc, MI 48439
Phone: 810.606.5093| Fax: 810-606-5495 | 
[email protected]<mailto:[email protected]> | 
www.genesys.org<http://www.genesys.org/>


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