I try to give them as much time as possible so using the triage time buys them 
a few minutes as it is normally the first recognition as we have a screening 
built into our triage.  If for some reason they are screened incorrectly, but 
the MD notes it then I use the time the md sees the patient as that is what 
they record.
Hope this helps !

Abstraction notes:
If severe sepsis is present on arrival to the Emergency Department or severe 
sepsis is identified in triage, the Severe Sepsis Presentation Time is the time 
the patient was triaged in the Emergency Department. If more than one triage 
time is documented (e.g., "Triage started" and "Triage completed") use the 
later time reflecting triage is completed.

If a suspected infection, severe sepsis or septic shock is in an ED physician 
note without a specific time documented within the note use the time the note 
was started or opened.
From: Bly, Lori [mailto:[email protected]]
Sent: Thursday, January 26, 2017 6:51 AM
To: 'Belfi, Karen'; Gibbs, Katie; 'Barnes-Daly, Mary Ann'; Crowley Amy; 
[email protected]
Subject: RE: [Sepsis Groups] [**External**] Question for core measure

I believe we use arrival time  - Our arrival time is earlier than triage time

Lori Bly, RN
Quality Management Department
ACMH Hospital
One Nolte Drive
Kittanning, PA 16201
Extension: 8459

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From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Belfi, Karen
Sent: Tuesday, January 24, 2017 2:34 PM
To: Gibbs, Katie; 'Barnes-Daly, Mary Ann'; Crowley Amy; 
[email protected]<mailto:[email protected]>
Subject: Re: [Sepsis Groups] [**External**] Question for core measure

I believe you would look for when the pt was admitted, which is later in the ED 
visit-when the order to admit is actually written (or whatever you use at your 
hospital).
If it were documented as present on arrival, you would use the triage time.

From: Gibbs, Katie [mailto:[email protected]]
Sent: Tuesday, January 24, 2017 2:33 PM
To: Belfi, Karen; 'Barnes-Daly, Mary Ann'; Crowley Amy; 
[email protected]<mailto:[email protected]>
Subject: [EXTERNAL] RE: [Sepsis Groups] [**External**] Question for core measure

Thank you for the clarification!

Also, Looking at the Additional Notes for Abstraction 5.2a under Severe Sepsis 
Presentation date it states "For Physician/APN/PA documentation of severe 
sepsis indicating "present on admission" or "admitted with", use the date and 
time of admission to the hospital.

If the patient is admitted through the ED, even if the provider indicated 
present on admission wouldn't the time be triage time????

From: Belfi, Karen [mailto:[email protected]]
Sent: Tuesday, January 24, 2017 2:27 PM
To: Gibbs, Katie; 'Barnes-Daly, Mary Ann'; Crowley Amy; 
[email protected]<mailto:[email protected]>
Subject: RE: [Sepsis Groups] [**External**] Question for core measure

That is correct, Katie. If the provider documents septic shock, they do not 
need to document severe sepsis. You would use septic shock time for both.
And if the patient meets criteria, you don't need the provider to document it.


From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Gibbs, Katie
Sent: Monday, January 23, 2017 9:47 AM
To: 'Barnes-Daly, Mary Ann'; Crowley Amy; 
[email protected]<mailto:[email protected]>
Subject: [EXTERNAL] Re: [Sepsis Groups] [**External**] Question for core measure

I am sorry this still seems unclear to me.
If the provider documents septic shock then obviously the patient has severe 
sepsis. Why would the provider need to document severe sepsis and septic shock?

Also, from the description below, then if a patient meets all criteria for 
severe sepsis and the provider only documented sepsis then it should be 
answered no?

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Barnes-Daly, Mary Ann
Sent: Saturday, January 14, 2017 1:24 PM
To: Crowley Amy; 
[email protected]<mailto:[email protected]>
Subject: Re: [Sepsis Groups] [**External**] Question for core measure

Yes Amy, you are correct - that means if what IS documented does not meet 
criteria, or if:

1.     Nothing is documented - not done

2.     Done but not documented - not done
All = fallout

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| [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 Crowley Amy
Sent: Thursday, January 12, 2017 2:26 PM
To: 
[email protected]<mailto:[email protected]>
Subject: [**External**] [Sepsis Groups] Question for core measure


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I just abstracted a pt with this exact scenario. The wording below of "if 
criteria is not documented" confuses me. What if the criteria is not met AT 
ALL? Not documented or met? Is that not the same thing? The criteria being met 
within 6 hours is the ENTIRE premise for being able to say that the pt had 
severe sepsis, EVEN IF the provider documents septic shock when the pt doesn't 
really have it... Maybe I'm not thinking straight or I'm not getting something, 
but it doesn't make sense to me.. Thoughts? I am highlighting with green.

I do not want to have to say yes to pt's such as these when the severe sepsis 
criteria was never met during the entire pt stay. The only thing they had was a 
source that grew out from an infected dialysis catheter. The pt was never on 
any pressors or had any organ dysfunction.

Severe Sepsis Present
Documentation of the presence of severe sepsis.

Was severe sepsis present?
Allowable Values
1 (Yes)

Severe Sepsis was present.

2 (No)

Severe Sepsis was not present, or Unable to Determine.


One of the rules for abstraction:
"If criteria for severe sepsis are not documented and there is not 
physician/APN/PA documentation of severe sepsis, but there is physician/APN/PA 
documentation of septic shock, choose Value "1."


In addition: this is the criteria for septic shock:
Septic Shock Present
Documentation of the presence of septic shock.

Is there documentation of the presence of septic shock?
Allowable Values
1 (Yes)

[cid:[email protected]]There is documentation of Septic Shock.

2 (No)

There is no documentation of Septic Shock, or unable to determine.

Notes for Abstraction

 *   The criteria for determining that Septic Shock is present are as follows: 
( Is it just the documentation of OR does a and b below have to be met??)

    *   There must be documentation of severe sepsis present. ( my pt did not 
have the criteria met nor was severe sepsis documented)
AND

    *   Hypotension persists in the hour after the conclusion of the 30 mL/kg 
Crystalloid Fluid Administration<javascript:void(0);>, evidenced by

       *   systolic blood pressure (SBP) < 90, or

       *   mean arterial pressure < 65 or

       *   a decrease in systolic blood pressure (SBP) by > 40 mmHg.
Physician/APN/PA documentation must be present in the medical record indicating 
a >40 mmHg decrease in SBP has occurred and is related to infection, severe 
sepsis or septic shock and not other causes.
OR
Tissue hypoperfusion is present evidenced by

       *   Initial Lactate level is >= 4 mmol/L



My pt had documentation of septic shock, but no severe sepsis or any criteria 
for it, like I have said. In my opinion, these two rules for severe and shock 
are contradictory.


Amy Crowley
Sepsis Coordinator
Medical City Denton
3535 South I-35E
Denton, Texas 76210
P: 940-384-3254
C: 214-801-2950
DentonRegional.com

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