Stanford has two protocols covering RNs for drawing lactates. They are both
standardized procedures (protocols) ordered as "per protocol without cosign."
1. Standardized procedure (protocol) for the bedside RN to order a stat lactate
when their patient screens positive for sepsis
2. Standardized procedure (protocol) for the Rapid Response RN to order an
initial lactate AND a repeat lactate if the initial was elevated > 2 mmol/L
a. This protocol includes additional elements of the 3 hour bundle
Christine Aceves, MSN, RN, CNL, CEN
Sepsis Program Manager
Nursing Quality
Stanford Health Care
300 Pasteur Dr., HG021A MC 5221 Stanford, CA 94305
O: 650.498.0971 C: 650.483.2248
[email protected]
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-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of [email protected]
Sent: Thursday, June 02, 2016 2:31 PM
To: [email protected]
Subject: Sepsisgroups Digest, Vol 207, Issue 2
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Today's Topics:
1. Re: [External] Nursing Lactate Protocol Information
(Titano, Janice)
2. ED provider notes (Mary Draper)
----------------------------------------------------------------------
Message: 1
Date: Thu, 2 Jun 2016 11:12:10 +0000
From: "Titano, Janice" <[email protected]>
To: Mary Draper <[email protected]>, "Barnes-Daly, Mary
Ann" <[email protected]>
Cc: "Sullivan, Mary Cook" <[email protected]>,
"[email protected]"
<[email protected]>
Subject: Re: [Sepsis Groups] [External] Nursing Lactate Protocol
Information
Message-ID:
<bn3pr0401mb11870ddc8c9575f2e168577f85...@bn3pr0401mb1187.namprd04.prod.outlook.com>
Content-Type: text/plain; charset="utf-8"
Mary Ann, this is very progressive work that your team at Sutter Health is
doing. I?m trying to work in this type of forward thinking into my client
sites so that the patient gets the right care at the right time. Kudos!
Janice Titano RN, MSN/MBA, CEN, CCRN
Director of Clinical Services
EmCare, Inc.
100 Witmer Road, Suite 220
Horsham, PA 19044
215-356-3665
[email protected]
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of Mary Draper
Sent: Friday, May 27, 2016 5:53 PM
To: Barnes-Daly, Mary Ann
Cc: Sullivan, Mary Cook; [email protected]
Subject: Re: [Sepsis Groups] [External] Nursing Lactate Protocol Information
Good to know we are all on the same page!!
Mary Draper RN BSN
QI Coordinator
Quality Management
Office (925) 674-2045<tel:(925)%20674-2045> Cell (925)
451-8792<tel:(925)%20451-8792> Fax (925) 674-2373<tel:(925)%20674-2373>
[email protected]<mailto:[email protected]>
On May 27, 2016, at 2:07 PM, Barnes-Daly, Mary Ann
<[email protected]<mailto:[email protected]>> wrote:
MARY!!!!! Hello Friend;
All Sutter Health hospitals have the opportunity to use a nursing SP for
initiation of the severe sepsis bundle (1L bolus if hypotension present)
Slightly different for ED and inpatient (RRT uses) Not all affiliates use
either or both , but most do.
And as of July 12, we have automated repeat lactates for any value >1.9.
Thanks,
MARY ANN BARNES-DALY MS RN CCRN DC | Clinical Performance Improvement
Consultant Quality & Clinical Effectiveness Team | Office of Patient Experience
Sutter Health -2200 River Plaza Drive, Sacramento, CA 95833 Mobile
916.200.5604| Office 916.286.6717 |
[email protected]<mailto:[email protected]>
?You never change things by fighting the existing reality. To change something,
build a new model that makes the existing model obsolete.? ~R.
Buckminster Fuller
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of Sullivan, Mary Cook
Sent: Wednesday, May 25, 2016 11:32 AM
To:
[email protected]<mailto:[email protected]>
Subject: [External] [Sepsis Groups] Nursing Lactate Protocol Information
Good Morning,
For facilities that use a Nursing procedure to collect lactate
specimens, how does your institution verify or co-sign the order of the
lactate? Is anyone using a completely independent nursing standard procedure
or protocol that providers do not verify or authenticate?
Thank you in advance!
Mary Cook Sullivan RN, MS, CNS
Sepsis Project Manager
Quality Improvement Department
Division of Patient Safety and Quality Services UCSF Medical Center
350 Parnassus, Suite 706, San Francisco, CA 94117
[email protected]<mailto:[email protected]>
Office: 415 353 3978
Pager: 415 443 3930
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Message: 2
Date: Thu, 2 Jun 2016 12:14:10 -0700
From: Mary Draper <[email protected]>
To: "'[email protected]'"
<[email protected]>
Subject: [Sepsis Groups] ED provider notes
Message-ID:
<[email protected]>
Content-Type: text/plain; charset="us-ascii"
I have an interesting situation where the ED provider of record on the day of
arrival to the ED (2/12) didn't dictate his note until (2/14 or date/time the
service as on 2/12). With this discrepancy in dates yet it is clear from the
orders, etc that he cared for this patient on 2/12 what do you all think about
using his PE to meet the 6 hr bundle compliance?
Appreciate any feedback, thanks.
Mary Draper RN BSN
Coordinator Quality Improvement
Peer Review Support CV/CT
Quality Management JMH
Office (925) 674-2045
Cell (925) 451-8792
Fax (925) 674-2373
[email protected]<mailto:[email protected]>
[cid:[email protected]]
"O, let us always have a mountain within our soul, with a peak so high that we
never quite reach the top...
For then we will always strive for greater things and will not be content
with merely climbing hills." Ardath Rodale
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