I know that the abstraction guidelines say to abstract the intravenous antibiotics administrations only. Clearly P.O. antibiotics are not considered when abstracting for severe sepsis, but what about IM Rocephin. My patient was from a nursing home getting IM Rocephin for >24 hours prior to severe sepsis presentation here at my hospital. My ER MD documents about the Rocephin and later orders Zosyn. The Zosyn was given after the 3 hour window. I have never given any thought to a situation like this. Has anybody come across this. Should I just stick to IV only like it says or is it worth querying? Thanks
-----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Wednesday, March 09, 2016 5:08 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 195, Issue 5 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. Re: Sepsis as Source of Infection ([email protected]) 2. Re: Code Sepsis Hand-off tool ([email protected]) ---------------------------------------------------------------------- Message: 1 Date: Mon, 7 Mar 2016 18:13:24 +0000 From: <[email protected]> To: <[email protected]>, <[email protected]>, <[email protected]> Subject: Re: [Sepsis Groups] Sepsis as Source of Infection Message-ID: <ad0df4c13cfa31488ec26ba6f72cd5b43b5...@xrdcwpmsghcmd1c.hca.corpad.net> Content-Type: text/plain; charset="iso-8859-1" Thank you. It is my understanding, however, that the question is not if "sepsis" can be utilized as a source of infection, rather if an order for the sepsis order set can be considered as such. Tammy Tammy Lightner RN, MHA, MSPM Director of Performance Improvement Research Medical Center 2316 E Meyer Blvd Kansas City, MO 64132 [email protected] 816- 276-3948 (o)/816-304-5898 ( c ) CONFIDENTIAL - Contains proprietary information.? Not intended for external distribution. -----Original Message----- From: Belfi, Karen [mailto:[email protected]] Sent: Monday, March 07, 2016 12:06 PM To: Heyer, Holly S; Lightner Tammy; [email protected] Subject: [EXTERNAL] Sepsis as Source fo Infection CMS released an "Additional Notes for Abstraction" for Version 5.0b, which stated that sepsis can be used as a source of infection. I've attached it here. Karen Belfi, RN, MSN Quality Outcomes Coordinator Lankenau Medical Center 484-476-8092 Pager: 5240 -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Heyer, Holly S Sent: Monday, March 07, 2016 6:09 AM To: '[email protected]'; [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 194, Issue 9 I think this is a good question, because we have a very recent case that the auditors are marking as a sepsis case with the documentation of "sepsis" as the source of infection. I think I will send a query to Q-Net to determine what their opinion is of this documentation. Holly Heyer Holly Heyer, RN, BSN | Quality Specialist | Quality Department Beaumont Hospital-Taylor | 10000 Telegraph Road | Taylor, MI 48180 (313).295.5040 (office) | [email protected] ????? This document is CONFIDENTIAL.? Its use is for a professional/peer review function which is for the purpose of reducing morbidity and mortality and evaluating and improving the quality of care rendered to patients, and reviewing the necessity and appropriateness of care rendered.? Any records, data, and knowledge collected for or by individuals assigned a professional / peer review function are confidential subject to MCLA 331.531, 331.532, 331.533, 333.20175, 333.21513, 333.21515, 330.1143A and 330.1748(9) and other state and federal laws. -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Thursday, March 03, 2016 4:08 PM To: [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 194, Issue 9 Good afternoon Since clarification came out regarding the ability to use "sepsis" as suspected infection, I would think that an order for a sepsis order set would also indicate as such. Unless, sepsis ordersets could possibly be utilized for other disease processes. I have not seen anything official indicating this, it is only my opinion to add to the discussion. Thank you Tammy Lightner RN, MHA, MSPM Director of Performance Improvement Research Medical Center 2316 E Meyer Blvd Kansas City, MO 64132 [email protected] 816- 276-3948 (o)/816-304-5898 ( c ) ------------------------------ Message: 2 Date: Mon, 7 Mar 2016 18:57:06 +0000 From: <[email protected]> To: <[email protected]>, <[email protected]> Subject: Re: [Sepsis Groups] Code Sepsis Hand-off tool Message-ID: <ad0df4c13cfa31488ec26ba6f72cd5b43b5...@xrdcwpmsghcmd1c.hca.corpad.net> Content-Type: text/plain; charset="iso-8859-1" It is a separate form. We did add a barcode and it is part of the patient's medical record. Thank you Tammy Tammy Lightner RN, MHA, MSPM Director of Performance Improvement Research Medical Center 2316 E Meyer Blvd Kansas City, MO 64132 [email protected] 816- 276-3948 (o)/816-304-5898 ( c ) CONFIDENTIAL - Contains proprietary information.? Not intended for external distribution. -----Original Message----- From: Maupin, Christina [mailto:[email protected]] Sent: Monday, March 07, 2016 12:51 PM To: Lightner Tammy; [email protected] Subject: [EXTERNAL] RE: Code Sepsis Hand-off tool Hi Tammy, Could you share your hand-off form? Also, Wondering if it is a separate form or integrated with other hand-off tool. Thanks! Chris Christina Maupin, MN, RN, CCNS Clinical Outcomes Specialist Bakersfield Heart Hospital 3001 Sillect Avenue Bakersfield, CA 93308 "Courage is the most important of all the virtues, because without courage you can't practice any other virtue consistently." Maya Angelou -- NOTICE -- This communication, including any attachments, is intended solely for the use of the addressee and may contain information which is privileged, confidential, exempt from disclosure under applicable law or subject to copyright. If you are not an intended recipient, any use, disclosure, distribution, reproduction, review or copying is unauthorized and may be unlawful. If you have received this transmission in error, please notify the sender immediately. Thank you. ________________________________________ From: Sepsisgroups [[email protected]] on behalf of [email protected] [[email protected]] Sent: Friday, March 04, 2016 5:39 PM To: [email protected] Subject: [Sepsis Groups] Code Sepsis We also have it set to where when the ED pages out code sepsis, it goes to the ICU Charge Nurse. She first starts the triage process to secure a bed for the patient. She then goes to ED to facilitate and ensure the bundle components are implemented. We also have a handoff form that the ED staff use to help with the bundle components. This form goes with the patient to the unit. The receiving nurse then takes this form and reviews the chart to make sure nothing is missed. This form also serves as a great handoff tool for oncoming shift. Thank you Tammy Lightner > On Mar 4, 2016, at 7:24 PM, "[email protected]" > <[email protected]> wrote: > > 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.o > rg > > 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. Re: Code Sepsis (Andre Vovan) > 2. Re: Feb. 23rd JAMA article negates severe sepsis and SIRS > (Arnold, Ryan) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Fri, 4 Mar 2016 08:20:21 -0800 > From: Andre Vovan <[email protected]> > To: [email protected] > Cc: [email protected] > Subject: Re: [Sepsis Groups] Code Sepsis > Message-ID: > > <caodvqnvr-obmnr8tqiebfn8laxk1oebjkvk77xkbsdncqcy...@mail.gmail.com> > Content-Type: text/plain; charset="utf-8" > > We have a code sepsis which we have been using for several years now. > Using it notifies the sepsis nurse ( a critical care nurse) to come to > the bedside and help assure that the 3 and 6 hope bundle are since properly. > > Andre Vovan MD MBA >> On Mar 3, 2016 12:27 PM, <[email protected]> wrote: >> >> I too would be very interested in other facility?s processes >> regarding Code Sepsis. >> >> >> >> Karen King, RN MSN >> Quality Management Core Measures Specialist, Lead Lakeview Regional >> Medical Center >> 95 Judge Tanner Boulevard >> Covington, LA 70433 >> >> Office: (985) 867-4467 >> Cell: (985) 788-0585 >> Fax: (985) 867-4263 >> Email: [email protected] >> >> >> >> This email and any files transmitted with it may contain privileged >> or confidential information and may be read or used only by the >> intended recipient. If you are not the intended recipient of the >> email or any of its attachments, please be advised that you have >> received this email in error and that any use, dissemination, >> distribution, forwarding, printing, or copying of this email or any >> attached files is strictly prohibited. If you have received this >> email in error, please immediately purge it and all attachments and >> notify the sender by reply email or contact the sender at the number listed. >> >> >> >> *From:* Sepsisgroups >> [mailto:[email protected]] *On Behalf Of >> *Carter, Anne >> *Sent:* Tuesday, March 01, 2016 10:59 AM >> *To:* [email protected] >> *Subject:* [EXTERNAL] [Sepsis Groups] Sepsis coordinator >> >> >> >> After much trial and error to get on top of the Sepsis core measure, >> our institution would like to institute a ?code sepsis? that alerts >> housewide providers of a potentially septic patient. I have been >> tasked to find out how other institutions have accomplished this who >> do not have an alert in their EMR. Would anyone be willing to share a >> policy, protocol or description of their code sepsis procedure at their >> institution? >> >> Also, do you have a dedicated sepsis coordinator? If so, who do they >> report to and how do they function in that role? I?d love that job >> description as well. >> >> Thanks in advance. >> >> >> >> *Anne Carter MS, ACNS-BC, CEN* >> >> *Coordinator* >> >> *Outcomes Management* >> >> *Riverview Medical Center* >> >> *732-450-2735 <732-450-2735>* >> >> *[email protected]* <[email protected]> >> >> >> >> >> >> ?This document and the information attached is Patient Safety Work >> Product & as such, is privileged and confidential pursuant to the >> N.J. Patient Safety Act and the Federal Patient Safety & Quality >> Improvement Act of 2005 and should not be further disclosed except as >> permitted by law.? >> >> >> >> Please note that the information contained in this message and any >> files transmitted with it are privileged and confidential and are >> protected from disclosure under the law, including the Health >> Insurance Portability and Accountability Act (HIPAA). If the reader >> of this message is not the intended recipient, or an employee or >> agent responsible for delivering this message to the intended >> recipient, you are hereby notified that any dissemination, >> distribution or copying of this communication is strictly prohibited >> and may subject you to criminal or civil penalties. If you have >> received this communication in error, please notify the sender by >> replying to the message and delete the material from any computer. >> Thank you, Hoag Memorial Hospital Presbyterian and its Affiliates >> >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups. >> org > -------------- next part -------------- An HTML attachment was > scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org > /attachments/20160304/fecc41dc/attachment.htm> > > ------------------------------ > > Message: 2 > Date: Fri, 4 Mar 2016 16:29:58 +0000 > From: "Arnold, Ryan" <[email protected]> > To: 'June Curry' <[email protected]>, > "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] Feb. 23rd JAMA article negates severe > sepsis and SIRS > Message-ID: <[email protected]> > Content-Type: text/plain; charset="us-ascii" > > You are correct June, and in fact, a mandatory 2/4 SIRS criteria has been > removed from the definition of sepsis since the 2001 Sepsis Definitions > Conference (Levy CCM 2003). This was further bolstered by the Kaukonen > article in NEJM 2015 showing persistently elevated mortality in sepsis > patients with 0/4 and 1/4 SIRS criteria. Why CMS would require this > non-standard criteria for review is unclear, but clearly omits patients whom > clinically meet severe sepsis (now just "sepsis") criteria. > > As you probably saw from Lori Harmon's email from SSC, they have responded > promptly and adjusted their definitions to align with this landmark article, > with no mention of any number of SIRS criteria required for sepsis diagnosis. > We can only hope that CMS follows suit. > > Ryan > > _______________________________ > Ryan Arnold, MD > Director of Research, Department of Emergency Medicine Clinical > Investigator, Value Institute Christiana Care Health System > > From: Sepsisgroups > [mailto:[email protected]] On Behalf Of June > Curry > Sent: Monday, February 29, 2016 2:15 PM > To: [email protected] > Subject: [Sepsis Groups] Feb. 23rd JAMA article negates severe sepsis > and SIRS > > Dr. Townsend, > > A number of our physicians have brought to our attention an article > published by JAMA on Feb. 23rd titled, "The third international consensus > definitions for sepsis and septic shock". It is their understanding that > this article negates severe sepsis and SIRS. Our physicians are wanting to > know when CMS will address these changes and how/when they will affect the > current SEP-1 measure. I would appreciate any information you can share that > I can pass along to our providers. > > Thanks! > > _________________________ > June R. Curry, RHIA > Manager, Evidence Based Care > Process Improvement and Innovation > > [cid:[email protected]]<http://www.methodisthealth.org/> > > 1211 Union Ave. Rm 604 > Memphis, TN 38104 > > mobile 901-568-9431 | email > [email protected]<mailto:[email protected]> > > > > -------------- next part -------------- An HTML attachment was > scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org > /attachments/20160304/bd102662/attachment.htm> > -------------- next part -------------- A non-text attachment was > scrubbed... > Name: image001.jpg > Type: image/jpeg > Size: 2248 bytes > Desc: image001.jpg > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org > /attachments/20160304/bd102662/attachment.jpg> > > ------------------------------ > > Subject: Digest Footer > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg > > > ------------------------------ > > End of Sepsisgroups Digest, Vol 194, Issue 15 > ********************************************* > _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient (s) and may contain confidential and privileged information. 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