I also just want to be clear regarding the new focused exam. The spec manual states for each of the focused exam elements:
"Documentation indicating a physician/APN/PA has performed, or attested to performing a physical examination, perfusion (re-perfusion) assessment, or sepsis (severe sepsis or septic shock) focused exam is acceptable." So does any physical exam documented within the 6 hr. window suffice, or must it be specifically called a perfusion or sepsis exam? For instance, the patient presents and the bundles are initiated in the ED. The admitting physician assesses the patient a couple hours later after fluid, etc. and documents a physical assessment in the H&P (within the 6 hr. window), but neglects to specifically document cap refill/perfusion. Would this meet the requirement? Even if it is not called a perfusion or sepsis focused exam? Just want to be sure before we communicate with our docs. Kristen Christiansen, RN BSN Clinical Outcomes Coordinator Patient Safety and Performance Excellence Longmont United Hospital (303) 651-5347 [email protected] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Monday, February 06, 2017 7:26 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 233, Issue 5 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.sepsisgroups.org_listinfo.cgi_sepsisgroups-2Dsepsisgroups.org&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=DEondeL0nzt1x8dhiCtj7owWuk8PF_24AuoJZJ-DHVY&e= or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Re: [**External**] Focused exam 2017 (Osburn, Jennifer R. RN) 2. Re: [EXTERNAL] Re: [**External**] Focused exam 2017 (Townsend, Sean, M.D.) 3. Proper link to SSC guidelines manuscript (Lori Harmon) ---------------------------------------------------------------------- Message: 1 Date: Mon, 6 Feb 2017 13:24:25 +0000 From: "Osburn, Jennifer R. RN" <[email protected]> To: "'Townsend, Sean, M.D.'" <[email protected]> Cc: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] [**External**] Focused exam 2017 Message-ID: <61eb11df76bc404baa706e7a14a9dbc5dca2b...@smmc-ex10mb03.st-marys.org> Content-Type: text/plain; charset=UTF-8 For clarification: For the RN exam, does the RN need to document all individual elements that are required in the focused exam? The MD needs to sign the RN exam within the time window beginning at the crystalloid fluid administration date and time and ending six hours after the presentation of septic shock date and time? Thanks Jennifer Osburn, RN, BSN Performance Improvement St. Mary's Medical Center 304-526-1506 [email protected] Important Notice: This e-mail message and any attachments are from the above sender at St. Mary's Medical Center and are intended solely for the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law.? If you are not the intended recipient of this communication or the employee or agent responsible for delivering the message to the intended recipient, or if it has been sent to you in error, please notify the sender immediately.? Do not examine, review, use, disclose, deliver, distribute, reproduce or take any action in reliance on it and immediately delete the message and any attachments. -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Townsend, Sean, M.D. Sent: Friday, February 03, 2017 2:28 AM To: Tish Poserina Cc: [email protected] Subject: Re: [Sepsis Groups] [**External**] Focused exam 2017 You no longer need to document the individual elements in the record. A provider may simple write that a focused exam was performed or reviewed. Yes, they can review a nurse's exam now. On Feb 2, 2017, at 7:42 AM, Tish Poserina <[email protected]<mailto:[email protected]>> wrote: 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 Password. Can I get a clarification re focused assessment? Most recently, if a physician documents "a sepsis exam" or "perfusion exam" completed, would that prompt the abstractor to say "yes" to the components required for a focused exam? And if so, would that still mean the components must be documented individually in the record? I may be mis-interpreting the latest CMS update. Thank you Tish Poserina RN, MSN-Ed, CCRN-CMC, CNRN Sepsis Coordinator St Mary Medical Center 1201 Langhorne-Newtown Road Langhorne, PA [email protected]<mailto:[email protected]> Contact: 215-710-4347 Spectralink: 215-710-7644 <image001.png><image002.png> Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> https://urldefense.proofpoint.com/v2/url?u=https-3A__na01.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Flists.sepsisgroups.org-252Flistinfo.cgi-252Fsepsisgroups-2Dsepsisgroups.org-26data-3D02-257C01-257Ctownsesr-2540sutterhealth.org-257C5f3311c29a464ba89ed008d44b82182d-257Caef453eadaa243e0be62818066e9ff63-257C0-257C0-257C636216469504206180-26sdata-3DuocZIzt5OaYldoamWTbQvgkRBQMAM2yJc2kgxUOV7uk-253D-26reserved-3D0&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=jtjHWCHuVFwR_Abt4nKBXpgNUf7nyfY5eEGwIorKLMQ&e= _______________________________________________ Sepsisgroups mailing list [email protected] https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.sepsisgroups.org_listinfo.cgi_sepsisgroups-2Dsepsisgroups.org&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=DEondeL0nzt1x8dhiCtj7owWuk8PF_24AuoJZJ-DHVY&e= Important Notice: This e-mail message and any attachments are from the above sender at St. Mary?s Medical Center and are intended solely for the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the intended recipient of this communication or the employee or agent responsible for delivering the message to the intended recipient, or if it has been sent to you in error, please notify the sender immediately. Do not examine, review, use, disclose, deliver, distribute, reproduce or take any action in reliance on it and immediately delete the message and any attachments. ------------------------------ Message: 2 Date: Fri, 3 Feb 2017 12:54:55 -0800 From: "Townsend, Sean, M.D." <[email protected]> To: "Swash, Pat" <[email protected]> Cc: Tish Poserina <[email protected]>, "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] [EXTERNAL] Re: [**External**] Focused exam 2017 Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" If you write that a focused physical exam was reviewed that will pass. The doctor does not have to perform the exam. On Feb 3, 2017, at 12:47 PM, Swash, Pat <[email protected]> wrote: Hi Dr. Townsend, The guidelines state use Physician/APN/PA documentation only for Examine findings so are you saying they can refer to Nurses examine documentation? Can you please clarify? Thanks Pat Pat Swash Quality Outcomes Coordinator Bryn Mawr Hospital [email protected] 484-337-3388 FAX-484--337-3729 T Together E Everyone A Achieves M More This communication,including any attachments,may contain privileged,proprietary or otherwise confidential information. If the reader of this communication is not the intended recipient,or you have received this communication in error, please notify sender immediately and promptly delete this e-mail without retaining a copy or saving in any manner. The unauthorized use,dissemination,distribution or reproduction of this e-mail,including attachments,is prohibited and may be unlawful. -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Townsend, Sean, M.D. Sent: Friday, February 03, 2017 2:28 AM To: Tish Poserina Cc: [email protected] Subject: [EXTERNAL] Re: [Sepsis Groups] [**External**] Focused exam 2017 You no longer need to document the individual elements in the record. A provider may simple write that a focused exam was performed or reviewed. Yes, they can review a nurse's exam now. On Feb 2, 2017, at 7:42 AM, Tish Poserina <[email protected]<mailto:[email protected]>> wrote: 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 Password. Can I get a clarification re focused assessment? Most recently, if a physician documents "a sepsis exam" or "perfusion exam" completed, would that prompt the abstractor to say "yes" to the components required for a focused exam? And if so, would that still mean the components must be documented individually in the record? I may be mis-interpreting the latest CMS update. Thank you Tish Poserina RN, MSN-Ed, CCRN-CMC, CNRN Sepsis Coordinator St Mary Medical Center 1201 Langhorne-Newtown Road Langhorne, PA [email protected]<mailto:[email protected]> Contact: 215-710-4347 Spectralink: 215-710-7644 <image001.png><image002.png> Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__na01.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Flists.sepsisgroups.org-252Flistinfo.cgi-252Fsepsisgroups-2Dsepsisgroups.org-26data-3D02-257C01-257Ctownsesr-2540sutterhealth.org-257C5f3311c29a464ba89ed008d44b82182d-257Caef453eadaa243e0be62818066e9ff63-257C0-257C0-257C636216469504206180-26sdata-3DuocZIzt5OaYldoamWTbQvgkRBQMAM2yJc2kgxUOV7uk-253D-26reserved-3D0%26d%3DDwICAg%26c%3Dqqcbk_QeabW4Z7GBhIMNtn_B7aQjktEuWNmUvrzri9o%26r%3D-hEbX7avgdNFCwMzWcM-4w%26m%3DtS_LgxA3hR0TQfoMtzim5w3npeP2n4mjyGYTgkP4Be8%26s%3DijW-sbIoOGfv272p7BifY_gmgRElMw5Tr-knsLFxViM%26e&data=02%7C01%7CTownseSR%40sutterhealth.org%7C00fd09755baa46d2285408d44c75dfad%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636217516598027302&sdata=6TSpVDzr58vSaO6v0WqtyPV6GAgUZ2lWCRQAgyEOfis%3D&reserved=0= _______________________________________________ Sepsisgroups mailing list [email protected] https://urldefense.proofpoint.com/v2/url?u=https-3A__na01.safelinks.protection.outlook.com_-3Furl-3Dhttps-253A-252F-252Furldefense.proofpoint.com-252Fv2-252Furl-253Fu-253Dhttp-2D3A-5F-5Flists.sepsisgroups.org-5Flistinfo.cgi-5Fsepsisgroups-2D2Dsepsisgroups.org-2526d-253DDwICAg-2526c-253Dqqcbk-5FQeabW4Z7GBhIMNtn-5FB7aQjktEuWNmUvrzri9o-2526r-253D-2DhEbX7avgdNFCwMzWcM-2D4w-2526m-253DtS-5FLgxA3hR0TQfoMtzim5w3npeP2n4mjyGYTgkP4Be8-2526s-253Dmn0fcWPG9sl8hltYCP0thH4SD-5FK-5FB4phP8lWhZSiKzE-2526e-26data-3D02-257C01-257CTownseSR-2540sutterhealth.org-257C00fd09755baa46d2285408d44c75dfad-257Caef453eadaa243e0be62818066e9ff63-257C0-257C0-257C636217516598027302-26sdata-3D5DmCuXphNfxXKtkOsFPsNkYCrrndIXT2zxj3KTfCGvQ-253D-26reserved-3D0-3D&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=-RcpeLwu8twbs2s4zC2613mgo7KbKUiKwfrZPOE-BK4&e= ------------------------------ Message: 3 Date: Mon, 6 Feb 2017 14:25:08 +0000 From: Lori Harmon <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Proper link to SSC guidelines manuscript Message-ID: <dm5pr11mb186899b8a4faf0c9de21b4eacb...@dm5pr11mb1868.namprd11.prod.outlook.com> Content-Type: text/plain; charset="iso-8859-1" All, Perhaps placing the link in this email will take you directly to the guideline rather than solely the resources. Best, Lori ICM: https://urldefense.proofpoint.com/v2/url?u=http-3A__link.springer.com_article_10.1007_s00134-2D017-2D4683-2D6&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=JtfbR9I0v61MJrcSvlokORVXTwyF9e3nIY-JCzShKDc&e= Surviving Sepsis Campaign ... - link.springer.com<https://urldefense.proofpoint.com/v2/url?u=http-3A__link.springer.com_article_10.1007_s00134-2D017-2D4683-2D6&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=JtfbR9I0v61MJrcSvlokORVXTwyF9e3nIY-JCzShKDc&e= > link.springer.com Rhodes, A., Evans, L.E., Alhazzani, W. et al. Intensive Care Med (2017). doi:10.1007/s00134-017-4683-6 A consensus committee of 55 international experts representing ... CCM: https://urldefense.proofpoint.com/v2/url?u=http-3A__journals.lww.com_ccmjournal_Abstract_publishahead_Surviving-5FSepsis-5FCampaign-5F-5F-5FInternational.96723.aspx&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=-EhR-DnYamYyDXTtlNL1v3U_tUeSVJ7VYObmgrwzfBM&e= Surviving Sepsis Campaign: International Guidelines for ...<https://urldefense.proofpoint.com/v2/url?u=http-3A__journals.lww.com_ccmjournal_Abstract_publishahead_Surviving-5FSepsis-5FCampaign-5F-5F-5FInternational.96723.aspx&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=-EhR-DnYamYyDXTtlNL1v3U_tUeSVJ7VYObmgrwzfBM&e= > journals.lww.com Objective: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." Design: A consensus committee of 55 ... -------------- next part -------------- An HTML attachment was scrubbed... URL: <https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.sepsisgroups.org_pipermail_sepsisgroups-2Dsepsisgroups.org_attachments_20170206_78aaa7e5_attachment.htm&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=iO5rztb2kQKbA2j6LWdKVe-Hp3qAryGB0TuTYfdBcfQ&e= > ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.sepsisgroups.org_listinfo.cgi_sepsisgroups-2Dsepsisgroups.org&d=DwICAg&c=Pwu_a0G_ObmG9m2oOJ2UZcJw-xcSMajL85khUUJ_xq4&r=_UCiX2JWJadT7C8pwlS5ippiR7GYIzInWiTHhFPVobdFj073KKvpto1vZgJdxXYY&m=4A3Vj0qeCS-i5oGO8isMf36fBn9amSg61p5jnv-68P8&s=DEondeL0nzt1x8dhiCtj7owWuk8PF_24AuoJZJ-DHVY&e= ------------------------------ End of Sepsisgroups Digest, Vol 233, Issue 5 ******************************************** ************************************* TLS Secure ************************************* This email was sent securely using Transport Layer Security (TLS) Encryption. Please ensure your email systems support TLS before replying with any confidential information. ------------------------------------------------------------------------------------------------ This communication is for the use of the intended recipient only. It may contain information that is privileged and confidential. If you are not the intended recipient of this communication, any disclosure, copying, further distribution or use thereof is prohibited. If you have received this communication in error, please advise me by return e-mail or by telephone and delete/destroy it. ***************************************************************************************** ***************************************************************************** This communication is for the use of the intended recipient only. It may contain information that is privileged and confidential. If you are not the intended recipient of this communication, any disclosure, copying, further distribution or use thereof is prohibited. If you have received this communication in error, please advise me by return e-mail or by telephone and delete/destroy it. ***************************************************************************** _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
