We have been going by the specs and only counting the initial lactate. From: Sepsisgroups [mailto:[email protected]] On Behalf Of PAMELA J. ANDERSON Sent: Friday, March 18, 2016 7:56 AM To: Clement, Joseph (DPH) <[email protected]>; [email protected] Subject: Re: [Sepsis Groups] Severe Sepsis with Initial Lactate <4, repeat 3hrs later >4-?Shock or not
"Note, this is an external email and did not originate at Meridian Health". ________________________________ That's what I would do, too - but because the v5.0b updated the spec to include mention of "initial lactate >=4", I'm confused - I've got a QNet pending that addresses this issue & I'll post it when I get a response. Thanks! Pam Pamela Anderson, BSN, RN Clinical Data Abstractor Interim Sepsis Coordinator Loyola University Health System Center for Clinical Excellence Maguire Center | Bldg 105-3909 | Maywood, IL 60153 (O) 708-216-5544 | (F) 708-216-7867 | (E) [email protected]<mailto:[email protected]> NOTE: The information contained in this message may be privileged and confidential and protected from disclosure. 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. If you believe you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank you. Loyola University Health System From: Clement, Joseph (DPH) [mailto:[email protected]] Sent: Thursday, March 17, 2016 4:09 PM To: PAMELA J. ANDERSON; [email protected]<mailto:[email protected]> Subject: Re: [Sepsis Groups] Severe Sepsis with Initial Lactate <4, repeat 3hrs later >4-?Shock or not I would answer Yes to the septic shock question - as long as the shock date/time is within 6 hours of the severe sepsis time, it would count. If anybody believes otherwise I'd love to hear as that's how we've done it. Joseph Clement, MS, RN, CCNS Clinical Nurse Specialist San Francisco General Hospital ph: 415206-6174 pg: 415 327-0220 ________________________________ From: Sepsisgroups <[email protected]<mailto:[email protected]>> on behalf of PAMELA J. ANDERSON <[email protected]<mailto:[email protected]>> Sent: Thursday, March 10, 2016 6:19 AM To: [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] Severe Sepsis with Initial Lactate <4, repeat 3hrs later >4-?Shock or not v5.0b Specs indicate septic shock presentation date and time is determined by persistent hypotension... OR tissue perfusion present as evidenced by INITIAL lactate >=4. Severe sepsis was present @ 09:12, with the initial lactate of 3.6. The repeat done @ 12:01 was 6.7 (30cc/kg was given). Because there was no documentation of "septic shock", and the patient was not hypotensive at the end of the bolus, based on the verbiage from the specs, I would answer, "NO" to the question of whether Septic Shock was present. Any thoughts? Thanks- Pam Pamela Anderson, BSN, RN Clinical Data Abstractor Sepsis Coordinator Loyola University Health System Center for Clinical Excellence 2160 S. First Avenue | Bldg 105-3915 | Maywood, IL 60153 (O) 708-216-5544 | (F) 708-216-7867 | (E) [email protected]<mailto:[email protected]> CONFIDENTIALITY NOTICE** This email communication and any attachments may contain confidential and privileged PHI for the use of the designated recipients named above. Distribution, reproduction or any other use of this transmission by any party other than the intended recipient is prohibited. If you have received this communication in error, please notify the sender immediately. Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.
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