This change is effective in the July 2016 update! Page 1-84 of the data dictionary: If the crystalloid fluid order is equivalent to 30 mL/kg, the IV route is indicated, and a specific time over which the IV fluids are to be given or a rate is not in the order, but the terms "bolus" or "wide open" are included in the order, this is acceptable. The terms "bolus" and "wide open" imply the fluids will be administered rapidly and are acceptable in place of a specific rate or infusion duration.
-----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Monday, February 01, 2016 2:09 PM To: [email protected] Subject: [EXTERNAL] Sepsisgroups Digest, Vol 190, Issue 1 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. IVF Administration (Robert Hattabaugh) 2. Re: Bundle compliance rates (Townsend, Sean, M.D.) ---------------------------------------------------------------------- Message: 1 Date: Fri, 29 Jan 2016 18:26:59 +0000 From: Robert Hattabaugh <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] IVF Administration Message-ID: <81a2f6f8e4eac5449d2bbd27d8cd9e1104392...@jmhexchange2010.jmhdomain.org> Content-Type: text/plain; charset="us-ascii" I wanted to see if anyone has heard anything about CMS possibly changing the language, in July 2016, regarding Crystalloid Fluid administration orders. I was recently told, that the current language, for the IVF order requiring it to specify either duration or rate; will be relaxed to include "bolus" as being allowable. I had not heard of that happening and wanted to see if anyone else had heard it. Thank You Robert Hattabaugh MSN, RN, ACNS-BC, CMSRN Adult Health Clinical Nurse Specialist Johnson Memorial Hospital 317-346-3959 (office) 317-346-3013 (fax) [email protected] -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20160129/4bebee6e/attachment.html> -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.gif Type: image/gif Size: 1089 bytes Desc: image001.gif URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20160129/4bebee6e/attachment-0001.gif> ------------------------------ Message: 2 Date: Thu, 28 Jan 2016 13:23:23 -0800 From: "Townsend, Sean, M.D." <[email protected]> To: "Nielsenshultz, Yara" <[email protected]> Cc: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Bundle compliance rates Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" At my institutions we have seen 55% compliance on average (20+ hospitals). Most success come with severe sepsis. Still a lot of work to do for shock. On Jan 28, 2016, at 12:38 PM, Nielsenshultz, Yara <[email protected]> wrote: Back in October, Dr. Townsend stated he expected a bundle compliance rate of 30-50% (see below). Does this estimate seem congruent with your experience with this measure? We're seeing a wide range in compliance rates at our various locations. Thank you, YARA NIELSENSHULTZ, RN, BSN, MS Clinical Quality Manager EmCare, North Division Direct: (215) 442-5122 [email protected] www.EmCare.com -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Townsend, Sean, M.D. Sent: Saturday, October 03, 2015 1:29 AM To: Brown, Sheree Cc: [email protected] Subject: Re: [Sepsis Groups] Bundle compliance rates I expect that compliance will be very low, 30% at best for most facilities. Some facilities will be 15-20%. This I also will reach 50% by 6-12 months experience with this metric, but getting there will not be easy. Remember, however, CMS will report performance as a benchmark with deciles of performance. If 30% is the best anyone can do, that will be P90. That said, changes will be sharp -- P50 may be 27%. All metrics accomplish one thing -- they focus facilities on improving the metric. This will create conversations, meetings, collaborations, arguments, disagreements, settlements, etc. And it's all good -- it means people will improve. Probably with pain as well as pleasure in accomplishment. This is a tough measure. Very very tough. But if you focus your energies on the patient and trying to work with it, it will pay off. The first SSC paper I think is most illustrative. Compliance went from low 30's to mid 30's on an all or nothing basis, but mortality dropped 7%. So, small gains with this measure result in tangible benefits. It just doesn't "feel" good while it's happening. See: Levy MM, Dellinger RP, Townsend SR et al, The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis, Crit Care Med. 2010 Feb;38(2):367-74. doi: 10.1097/CCM.0b013e3181cb0cdc. On Oct 2, 2015, at 12:50 PM, Brown, Sheree <[email protected]<mailto:[email protected]>> wrote: Does anyone know if CMS has established an expected minimal rate of compliance with the Sep-1 measure? Or if not, is there is a reported compliance rate with the SSC 3 hr and 6 hr bundles? Thanks, Sheree Sheree Brown MSN, RN, CNL Manager, Performance Excellence Phone: 517 205-4209 ext. 4209 Pager: 517 534-0127 Fax: 517 788-4715 [email protected]<allegiancehealth.org> [cid:[email protected]] _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[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 ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 190, Issue 1 ******************************************** -------------------------------------------------------------------------- Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally privileged or protected. 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