Can I please get copies of the screening tool for anyone who has incorporated 
Sofa/Q Sofa in their hospital settings?  

Angela Craig APN,MS,CCNS
Clinical Nurse Specialist
Intensive Care Unit
Cookeville Regional Medical Center
931-783-5035

 

-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of [email protected]
Sent: Thursday, February 02, 2017 9:42 AM
To: [email protected]
Subject: Sepsisgroups Digest, Vol 232, Issue 3

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Today's Topics:

   1. Re: SOFA and qSOFA (McFarland, Lori A.)
   2. Re: [**External**]  Question for core measure (Prejean, Evelyn)


----------------------------------------------------------------------

Message: 1
Date: Thu, 26 Jan 2017 13:18:23 +0000
From: "McFarland, Lori A." <[email protected]>
To: "'Karla A. Cleveland'" <[email protected]>,
        "Lewandowski    Susan" <[email protected]>,
        "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] SOFA and qSOFA
Message-ID:
        <f52a25c589e8de4d9cde69f2f4ff0d3adccbc...@smmc-ex10mb03.st-marys.org>
Content-Type: text/plain; charset="utf-8"

Is the SOFA and qSOfA physician driven or nurse driven?- Lori McFarland

________________________________
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Karla A. Cleveland
Sent: Wednesday, January 25, 2017 6:32 AM
To: Lewandowski Susan; [email protected]
Subject: Re: [Sepsis Groups] SOFA and qSOFA

Hi Sue,

Our hospitalist group is routinely using qSOFA in their documentation.  
However, I have not seen the ED physicians using either.


Karla Cleveland BS RN
Sepsis Coordinator
Mercy Health Muskegon
1560 E. Sherman Blvd, Ste 334
Muskegon, MI 49444
231.672.2221
231.672.3965 (FAX)
[email protected]<mailto:[email protected]>
www.MercyHealth.com



From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Lewandowski Susan
Sent: Tuesday, January 24, 2017 12:49 PM
To: [email protected]
Subject: [External] [Sepsis Groups] SOFA and qSOFA

I was curious if any facilities have implemented SOFA and qSOFA? Our facility 
will be implementing both the SOFA and qSOFA in addition to continuing the use 
of SIRS. If these tools are being used, at what frequency is the assessment 
being completed? Also, is SOFA being initiated in the ED upon decision to admit?

Thank you, Sue

Sue Lewandowski RN
Sepsis Coordinator /Nursing Supervisor
Meadville Medical Center
751 Liberty Street
Meadville, Pa 16335
Phone: 814-373-3328
Email: [email protected]<mailto:[email protected]>
[Description: MMC%20logo%20and%20tagline%20email]


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Message: 2
Date: Thu, 26 Jan 2017 13:27:45 +0000
From: "Prejean, Evelyn" <[email protected]>
To: "Merwin, Courtney C." <[email protected]>, "Barnes-Daly, Mary Ann"
        <[email protected]>,    Crowley Amy
        <[email protected]>,
        "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] [**External**]  Question for core measure
Message-ID:
        
<dm5pr10mb148229496b75853c89fa0e03f7...@dm5pr10mb1482.namprd10.prod.outlook.com>
        
Content-Type: text/plain; charset="us-ascii"

I have the same questions.  This is getting more confusing to me.  Thanks y'all 
for sharing, at least I know I'm not alone.  Ep

Evelyn Prejean  MSN

PI Nurse Analyst

University Medical Center New Orleans | Proud Member of LCMC Health

2000 Canal Street | New Orleans, LA 70112

OFFICE (504)702-2920

[email protected]<mailto:[email protected]> | 
www.UMCNO.org<http://www.umcno.org/>

[https://lcmchealth.blob.core.windows.net/logos/emailSignature_UMC_v2.png]





From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Merwin, Courtney C.
Sent: Tuesday, January 24, 2017 3:06 PM
To: Barnes-Daly, Mary Ann <[email protected]>; Crowley Amy 
<[email protected]>; [email protected]
Subject: Re: [Sepsis Groups] [**External**] Question for core measure

Mary Ann,

Not sure if I followed your clarification.

If Severe sepsis criteria are not met, BUT there is MD documentation of "Severe 
Sepsis", then you choose "1" for severe sepsis present.
Same for Septic shock: even if the criteria are not met, BUT there is MD 
documentation of "Septic Shock", then you also choose "1" for severe sepsis and 
septic shock present.

Isn't that correct??

Courtney Merwin BS, RRT
Clinical Quality Analyst
East Jefferson General Hospital
4200 Houma Blvd.
Metairie, LA  70006
504-503-5968
[email protected]<mailto:[email protected]>




From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Barnes-Daly, Mary Ann
Sent: Saturday, January 14, 2017 12:24 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


WARNING: This email originated outside of the Sutter Health email system!
DO NOT CLICK links if the sender is unknown and never provide your User ID or 
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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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