We use the inter-professional plans of care that are offered in our EMR's. We have done an analysis of our sepsis population and it appears that IPOC's are one variable that has an impact on severity progression, LOS and patient outcomes as well as readmissions. Especially if there is a delay in implementation beyond 4 hours of the identification of sepsis
Sandy Tobar RN, BSN, MSBA Director, Clinical Transformation Sepsis, HAI & Patient Safety Trinity Health [email protected] W 734-343-1496 20555 Victor Parkway Livonia, MI 48152 trinity-health.org | Facebook | Twitter | LinkedIn -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Thursday, April 13, 2017 6:52 PM To: [email protected] Subject: [External] Sepsisgroups Digest, Vol 242, Issue 3 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org 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. Sepsis Clinical Pathways and nursing care plans (Engleman, Anne) 2. Re: Septic shock question (Belfi, Karen) 3. Re: Initial lactate vs repeat lactate result (Cynthia Wells) ---------------------------------------------------------------------- Message: 1 Date: Thu, 6 Apr 2017 18:55:44 +0000 From: "Engleman, Anne" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Sepsis Clinical Pathways and nursing care plans Message-ID: <09d1158b26ef3d428ec4b6f30faf73847460a...@tenhdcthmb10-04.tenethealth.net> Content-Type: text/plain; charset="us-ascii" Hello everyone, I am wondering if anyone has developed clinical pathways or nursing care plans for sepsis patients and would be willing to share what they have. In addition, to share if they are effective with inpatient sepsis cases and compliance with the CMS metrics. I appreciate any and all feedback. Our Sepsis Committee members would like to explore this as an option in our facility. Regards, Anne Anne Engleman RN, MSN Quality Manager Quality Management Department JFK Memorial Hospital 47-111 Monroe Street Indio, CA 92201 Phone: (760) 775-8086 Email: [email protected]<mailto:[email protected]> This email and any attached files may contain Privileged or Confidential information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender. -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20170406/6b949107/attachment-0001.htm> ------------------------------ Message: 2 Date: Wed, 5 Apr 2017 06:37:03 -0400 From: "Belfi, Karen" <[email protected]> To: "Gibbs, Katie" <[email protected]>, "'Mills, Mary'" <[email protected]>, "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Septic shock question Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" In the current specification manual (Version 5.2a), it states: Crystalloid fluid volumes ordered that are within 10% lower than the actual volume calculated by weight are acceptable. So if a patient needs 2200, they can get as little as 1980. (10% of 2200 is 220; 2200 -220 is 1980). -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Gibbs, Katie Sent: Thursday, March 30, 2017 3:19 PM To: 'Mills, Mary'; [email protected] Subject: [EXTERNAL] Re: [Sepsis Groups] Septic shock question Mary, Can you clarify the 10%. And where to find that in the spec manual? Thanks! -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Mills, Mary Sent: Tuesday, March 21, 2017 5:28 PM To: [email protected] Subject: [Sepsis Groups] Septic shock question For CMS , you have to have severe sepsis before you have septic shock. When you say no source identified, are you saying that there is no documentation of a suspected infection within the 6 hr window criteria? If that is the case, then you can't meet all the criteria components for severe sepsis. Is there a reason the white count was so low documented in the note (recent chemo, etc)? If there is and the provider has documented it as such, you can't use that white count as your 2nd SIRS. In terms of just good patient care and reality, yes, this pt clinically is in septic shock. Per the most recent specs manual, a decrease of 10% of the 30mL/kg of crystalloids is acceptable, but that would be 1978.56. Not enough I hope this help :-) Sepsis, she is a nasty little bugger :-) Mary Mills RN, BSN, CPHQ, CPPS Centegra Health System ________________________________________ From: Sepsisgroups [[email protected]] On Behalf Of [email protected] [[email protected]] Sent: Tuesday, March 21, 2017 2:10 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 239, Issue 1 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=qqcbk_QeabW4Z7GBhIMNtn_B7aQjktEuWNmUvrzri9o&r=9XT3K_nIvIIF-7Bh2TiB0g&m=FXqwy-DHLddNT3CTdViX75Bd_MMGSCRinSMCq2AUalc&s=9xfcZwmWnIfVa-kgQ98natbkaoxEpp6Rsn5IJpE2iUs&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. Septic shock question (Davis, Diana) ---------------------------------------------------------------------- Message: 1 Date: Mon, 20 Mar 2017 17:58:40 +0000 From: "Davis, Diana" <[email protected]> To: "'[email protected]'" <[email protected]> Subject: [Sepsis Groups] Septic shock question Message-ID: <bn6pr13mb0947c73172d6a1fa8e0a6bc8a2...@bn6pr13mb0947.namprd13.prod.outlook.com> Content-Type: text/plain; charset="utf-8" Septic shock To everyone: Hoping to get some clarification re: potential septic shock pt. 1207- B/P- 84/57 P- 135. Lactate at 1430- 4.8- lactate at 1810- 4.3 WBC- 0.1 at 1621 Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this No source identified Will this patient meet septic shock due to lactate level? We cannot come to conclusion 100%- so looking for help from everyone. I say yes. Thank you. Diana Davis, Quality Outcomes Coordinator CMH Regional Health System 937-382-9315 Diana Davis, Quality Outcomes Coordinator CMH Regional Health System 937-382-9315 Disclaimer The information transmitted via this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/or proprietary information. Any use, review, retransmission, dissemination or other use of, or pursuing of any action in reliance upon this information by persons or entities other than the intended recipient is strictly prohibited. If you are the recipient of this e-mail transmission in error, please reply to the sender and delete the material from any computer. Thank you This email has been scanned for viruses and malware, and may have been automatically archived by Mimecast Ltd, an innovator in Software as a Service (SaaS) for business. Providing a safer and more useful place for your human generated data. Specializing in; Security, archiving and compliance. 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Thank you. _______________________________________________ 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=qqcbk_QeabW4Z7GBhIMNtn_B7aQjktEuWNmUvrzri9o&r=9XT3K_nIvIIF-7Bh2TiB0g&m=FXqwy-DHLddNT3CTdViX75Bd_MMGSCRinSMCq2AUalc&s=9xfcZwmWnIfVa-kgQ98natbkaoxEpp6Rsn5IJpE2iUs&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=qqcbk_QeabW4Z7GBhIMNtn_B7aQjktEuWNmUvrzri9o&r=9XT3K_nIvIIF-7Bh2TiB0g&m=FXqwy-DHLddNT3CTdViX75Bd_MMGSCRinSMCq2AUalc&s=9xfcZwmWnIfVa-kgQ98natbkaoxEpp6Rsn5IJpE2iUs&e= ------------------------------ Message: 3 Date: Wed, 5 Apr 2017 12:46:34 +0000 From: Cynthia Wells <[email protected]> To: Mary Draper <[email protected]> Cc: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Initial lactate vs repeat lactate result Message-ID: <[email protected]> Content-Type: text/plain; charset="utf-8" It depends on which lactate is "drawn" closer to time zero. The lactate used to establish time zero is not always the "initial lactate" data element. Cindy Sent from my iPhone On Apr 4, 2017, at 6:20 PM, Mary Draper <[email protected]<mailto:[email protected]>> wrote: I have a patient that met the SIRS criteria with a possible infection though etiology unknown and had an initial lactate of 2.2. This ruled the patient in for severe sepsis. No hypotension. The repeat lactate 4 hours later is > 4. Patient is still not hypotensive. Does this then qualify the patient for septic shock? I thought we used the ?initial? episode?s lactate not the repeat result. Appreciate your 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]> <image003.png> ?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 _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20170405/eb455ba5/attachment.htm> -------------- next part -------------- A non-text attachment was scrubbed... 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