Here's what the manual says:
Notes for Abstraction:
Only the following situations demonstrate an acceptable delay,
resulting in the blood culture being drawn after an IV antibiotic was
administered.
o Surgical patients who receive a pre-op prophylactic IV
antibiotic and within 24 hours of that antibiotic dose develop severe sepsis
then have a blood culture drawn.
o Within 24 hours prior to severe sepsis presentation, IV
antibiotics were started in the hospital for an infection before severe sepsis
was identified as present or suspected and a blood culture was drawn after the
initial IV antibiotic dose.
o Within 24 hours prior to severe sepsis presentation IV
antibiotics were started prior to arrival to the hospital and a blood culture
was drawn after arrival to the hospital.
o There is physician/APN/PA documentation indicating the IV
antibiotic was started before the blood culture was drawn because waiting for
the blood culture to be drawn would have resulted in a delay of 45 minutes or
more in starting the IV antibiotic.
So it looks like it's trying to help hospitals not fall out when antibiotics
were started prior to severe sepsis, and bc weren't drawn. We have had cases
where the prophylactic antibiotics for surgery made us fall out, as well as
cases where antibiotics were started prior to arrival and we also fell out.
This will help in both of those instances.
Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
484-476-8092
Pager: 5240
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of Clement, Joseph (DPH)
Sent: Tuesday, August 23, 2016 8:02 PM
To: [email protected]
Subject: [EXTERNAL] [Sepsis Groups] SEP-1 Specification Manual for January 2017
Discharges
Hello,
I'm reviewing the updated specification manual 5.2 for SEP-1, that will go into
effect 1/1/17, and I have a few questions - I wonder if others are further
along than me.
https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1228775749207
[] The manual says that MD attestation of reassessment, VS review, skin
assessment, cardiopulmonary exam, and peripheral pulse exams are acceptable. It
also says that "performing, or attesting to performing a physical examination,
perfusion (re-perfusion) assessment, or sepsis (severe sepsis or septic shock)
focused exam is acceptable."
At the risk of asking an obvious question, I just want to make sure I am
getting this right. If the MD signs something that says "I attest to having
performed a severe sepsis re-perfusion exam at XX:XX", then this would meet the
measure requirement?
[] I see that a new element was added "Blood Culture Collection Acceptable
Delay" - but I'm not clear from the manual what constitutes an acceptable
delay. Am I missing something? Can anybody clarify?
Thanks in advance!
Joe
Joseph Clement, MS, RN, CCNS
Clinical Nurse Specialist
San Francisco General Hospital
ph: 628 206-6174
pg: 415 327-0220
office: H5841
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