Hi Dr. Townsend and all,

Many abstractors are questioning how to abstract for the SEP-1 data element 
persistent hypotension if there is only ONE BP documented in the hour following 
crystalloid fluids completion. The answer, I believe is selecting "allowable 
value 3" which includes "unable to determine". I think (not sure as I need to 
review the category assignments again) that value 3 may fail the measure. Again 
NOT sure. But in the meantime while I review, I would still like to ask my 
question.

1)       WHY did the CMS change this data element to TWO BPs instead of one? 
The reason I ask is because sometimes there is only ONE BP documented in the 
record before a vasopressor is started. Is it a clinical reason, i.e., is it 
not appropriate to go to vasopressor and/or determine shock) based on ONE BP? 
Or something else? I just need a little help as to how and why this data 
element was written the way it was for the measure? I just need to understand 
the background so I can assist the physicians.


Thanks everyone for your help,

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

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