Hi, I agree as well that this should be brought to CMS. We have also discovered that the MAP is also calculated differently based on whether the EMR is calculating it our the monitor. Requiring 2 consecutive BP that are low prior to meeting the fluid bolus requirements, makes sense clinically--typically one isolated low BP would not be treated, but first validated for accuracy.
Pat Pat Posa RN, BSN, MSA, FAAN Quality Excellence Leader St. Joseph Mercy Health System Ann Arbor, MI cell:248.890.0044 Office: 734.712.3604 On Fri, Apr 14, 2017 at 11:45 AM, Barnes-Daly, Mary Ann, MS, RN, CCRN, DC < [email protected]> wrote: > Yes, I have feedback that occurs and it is problematic. > > > > We need to bring this to CMS. > > I would suggest that in the same way 2 consecutive BPs are required to > identify SEPTIC SHOCK after fluids, the same should be true to signify the > onset of hypotension. > > > > *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 <(916)%20200-5604>*| [email protected] > <[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 *Nelson, Kathy > *Sent:* Friday, April 07, 2017 12:43 PM > *To:* [email protected] > *Subject:* [**External**] [Sepsis Groups] One low MAP can trigger Severe > Sepsis presentation > > > > *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. > > > > Question posed by our physician leadership: > > > > Is anyone else having a problem with their CMS bundles when it comes to a > low MAP. Our EMR captures every vital sign and if the auto-calculated MAP > falls only momentarily to 64, it will trigger our data abstractors to > establish a diagnosis of hypotension and put the patient into the severe > sepsis category without necessarily having any of the other organ > dysfunction criteria for the diagnosis. This results in a fall out on the > bundle and makes us non-compliant from CMS data collection purposes. Has > anyone else had a similar EMR issue and if so, how did you deal with it? > > > > Thanks! > > > > *Kathy Nelson**, **MBA, CPHQ, RHIA* > > Public Data Manager > > Advocate Health Care > > Center for Health Information Services (CHIS) > > > > 3075 Highland Parkway, Suite 600 > > Downers Grove, IL 60515 > > P: 630- 929-6782 <(630)%20929-6782> (Internal: 55-6782) > > [email protected] > > > > This e-mail, and any attachments thereto, is intended only for use by the > addressee(s) named herein and may contain legally privileged and/or > confidential information. If you are not the intended recipient of this > e-mail (or the person responsible for delivering this document to the > intended recipient), you are hereby notified that any dissemination, > distribution, printing or copying of this e-mail, and any attachments > thereto, is strictly prohibited. If you have received this e-mail in error, > please respond to the individual sending the message and permanently delete > the original and any copy of any e-mail and any printout thereof. > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > >
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