We are planning to implement a conditional Lactate rule in the next month. We are planning to monitor very closely once rolled out, as there is definite push-back and concerns from some providers.
~Claudia Claudia Orth BSN, RN, CCRN-K Regional Sepsis Coordinator Clinical Quality Munson Medical Center 1105 Sixth Street Traverse City, MI 49684-2386 (231) 935-5692 (Voice) (231) 318-0394 (Pager) [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Amy E. Curley Sent: Monday, April 11, 2016 3:48 PM To: [email protected] Subject: [Sepsis Groups] Reflex Lactates We have approved a nurse driven protocol that is called a "conditional" order in Epic where a new order will be generated for a lactate of 2 or greater. We have chosen to do this 3 hours after initial result. The literature does not support a "hard" re-draw time, and CMS asks for it to be under 6 hours, we just divided it in the middle. Secondly, we have mild push back from providers, but mostly because the MD's remain unaware of the CMS requirements. OR they "already know they are sick" and the lactate will not change course of therapy. Confidential: Protected under New Hampshire's Quality Assurance (QA) statutes (RSA 151:13a and RSA 329:29a). Documents should not be disseminated outside of the Dartmouth-Hitchcock QA structure. All QA documents are to be maintained in secured and segregated QA files (this applies to both electronic and paper storage). IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE: This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.
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