I have been told that to meet the requirement the entire 30ml/kg must be infused, or is it ordered? I agree with the clinician being able to determine that the patient needs less volume as long as it is documented. But want to know the exact metric parameters.
Theresa Murray RN, MSN, CCRN, CCNS Critical Care Clinical Nurse Specialist Community Health Network 1500 N. Ritter Ave Indianapolis Indiana 46219 1-317-355-4258 office 1-317-351-7860 fax 1-317-904-7212 pager 1-317-627-9350 Mobile [email protected] -----Original Message----- From: Bruce Ushkow, MD, FACEP [mailto:[email protected]] Sent: Wednesday, January 20, 2016 2:05 PM To: Krall, Eva <[email protected]>; Murray, Theresa <[email protected]>; Prabhakar, Brenda <[email protected]>; Angela Craig <[email protected]>; 'Townsend, Sean, M.D.' <[email protected]>; Cobb, Amy L. <[email protected]> Cc: Sullivan-Wright, Dawn M. <[email protected]>; [email protected]; Gieselman, Morris <[email protected]> Subject: Re: [Sepsis Groups] Repeat volume assessment and tissue perfusion CMS requirements Agree with you completely it is not the abstractor's job to determine the "appropriate" amount of resuscitation fluid. It is in incumbent on the clinician to document clearly, specifically why < 30 mL/Kg was infused. If documenting rationale meets the measure - excellent for both patient care and the abstraction. Thank you for the comment. I too would appreciate direction in this area for our abstractors. For our patients, Bruce Ushkow, MD, MS, FACEP Director, Emergency Critical Care Samaritan Hospital, Troy NY ________________________________________ From: Krall, Eva <[email protected]> Sent: Wednesday, January 20, 2016 1:53 PM To: Bruce Ushkow, MD, FACEP; Murray, Theresa; Prabhakar, Brenda; Angela Craig; 'Townsend, Sean, M.D.'; Cobb, Amy L. Cc: Sullivan-Wright, Dawn M.; [email protected]; Gieselman, Morris Subject: RE: [Sepsis Groups] Repeat volume assessment and tissue perfusion CMS requirements I do not feel the chart abstractors should be the ones deciding if the correct volume was given, given the patient situation. I thought the measure was not met if 30ml/kg is not given and the provider has not documented rationale for not giving the full amt. Be anxious to hear feedback Eva "Bunny" Krall RN MSN ACNS-BC CMSRN CDE Clinical Nurse Specialist, Quality and Patient Safety Patient Experience Division Palomar Health 2185 Citracado Parkway Escondido, CA 92029 442-281-4268 [email protected] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Bruce Ushkow, MD, FACEP Sent: Thursday, January 14, 2016 3:58 PM To: Murray, Theresa; Prabhakar, Brenda; Angela Craig; 'Townsend, Sean, M.D.'; Cobb, Amy L. Cc: Sullivan-Wright, Dawn M.; [email protected]; Gieselman, Morris Subject: Re: [Sepsis Groups] Repeat volume assessment and tissue perfusion CMS requirements If I may expand the key question posed by Ms. Murray: Per SEP-1, CMS, may chart abstractors give credit for less than 30 mL/Kg intentionally not being infused in "at risk"of fluid overload patients? Based on clinical judgement or better yet judgement linked with objective measures as bedside Cardiovascular Ultrasound as per Surviving Sepsis? For our patients, Bruce Ushkow, MD, MS, FACEP Director, Emergency Critical Care Samaritan Hospital, Troy NY ________________________________________ From: Sepsisgroups <[email protected]> on behalf of Murray, Theresa <[email protected]> Sent: Wednesday, January 13, 2016 1:09 PM To: Prabhakar, Brenda; Angela Craig; 'Townsend, Sean, M.D.'; Cobb, Amy L. Cc: Sullivan-Wright, Dawn M.; Gieselman, Morris; [email protected] Subject: Re: [Sepsis Groups] Repeat volume assessment and tissue perfusion CMS requirements At our shop we are talking about the volume resuscitation. Does it have to be the entire 30ml/kg, or can the clinician treat the hypotension with volume to the point of normotension especially in a renal or CHF patent and still get credit for the metric? I have heard different responses. Thanks in advance for the info Theresa Murray RN, MSN, CCRN, CCNS Critical Care Clinical Nurse Specialist Community Health Network 1500 N. Ritter Ave Indianapolis Indiana 46219 1-317-355-4258 office 1-317-351-7860 fax 1-317-904-7212 pager 1-317-627-9350 Mobile [email protected] Cookeville Regional Medical Center 931-783-5035 This email message has been delivered safely and archived online by Mimecast. For more information please visit http://www.mimecast.com _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org CONFIDENTIALITY NOTE: This e-mail contains information that may be privileged, confidential and subject to legal restrictions and penalties regarding its unauthorized disclosure or other use. 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