Hello Dr. Townsend and all,

Is anyone else participating in NSQIP? It is the American College of Surgeons 
(ACS) National Surgical Quality Improvement Project (NSQIP). In summary, it is 
reporting on 30 day outcomes post surgically. The charts are reviewed (using 
NSQIP guidelines) for any postoperative occurrence including but not limited to 
Sepsis, and Surgical Site Infections (SSI).
My coworker is doing the abstraction and reporting on NSQIP while I am doing 
abstraction on the CMS Sep-1 measure. I was looking at the NSQIP guidelines 
that define criteria for sepsis and notice how it is not the same as CMS (sirs 
plus a source). NSQIP defines sepsis with 2 SIRS out of 5 (all the same except 
additionally include anion gap acidosis) but also must include documentation of 
a positive blood culture or documentation of purulent discharge from the site.
I believe part of the rationale for Sep-1 is to improve documentation and 
coding of sepsis, severe sepsis and septic shock. I am wondering how to educate 
across our institution to both Medicine and Surgery Departments on the 
definition/criteria for sepsis, severe sepsis and septic shock when they are 
different. How do we align these two national reporting projects?

Thanks for any feedback,
Jennifer

Jennifer Halligan, RN
Quality Review Nurse
San Joaquin General Hospital
Tel: 209-468-7471
Fax: 209-468-7011

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