Hi Angela, At our facility we tend to struggle with the number of lactic acid levels drawn on some of our patients. We base whether to draw these on specific alerts that trigger which follows the 3-hour rule for time zero. They also generally have these drawn during morning labs. Some patients tend to have more than 1 drawn in a day for these reasons. As for blood cultures, I understand the reluctance for drawing another but I view it as beneficial for the patient, as well as meeting the standard. The standards are there because they are evidence-based and we know that there is always a potential that a patient could develop sepsis fairly quickly. This would make a set of blood cultures 48 or 72 hours ago appear negative but a more recent set return positive. I view it as meeting the standard is what is also right for the patient.
Hope this helps. Thanks, Michael Foley RN, BSN, MBA Sepsis Coordinator/Clinical Specialist Medstar Washington Hospital Center O: 202-877-2089 | C: 740-424-3186 -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Monday, July 17, 2017 9:22 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 254, 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=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT4oEnIs-gdg&m=XNlj6U7fg3qw3fOpzPRBQhszFq58f3_e-AZd51abbgg&s=_ADMyyqqRXwBrb-EW7PQUTrHgX9hNdNtaZ0dw30bS6E&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. Blood Culture Collection (Angela Craig) 2. Re: Sepsisgroups Digest, Vol 253, Issue 6 (William Haik) 3. Re: CMS Updates [External] (Cox, Debra M. (RN)) ---------------------------------------------------------------------- Message: 1 Date: Tue, 11 Jul 2017 16:57:31 -0500 From: Angela Craig <[email protected]> To: Suriving Sepsis Campaign Listserve <[email protected]> Subject: [Sepsis Groups] Blood Culture Collection Message-ID: <343E31412FC9094487B54371286ADDA06D54D6D027@D109EXCHMB.crmchealth.hospital> Content-Type: text/plain; charset="utf-8" When the CMS requirements rolled out in 2015 our hospital decided to change to getting blood cultures if they had not been obtained within 48 hours instead of 72 if they screen positive for sepsis. I find that we get a lot of repeat cultures and I was wondering if anyone had evidence that we should or should not be getting these this frequently. We are trying to meet the standard and not "fall out" but I want to do what's right for the patient not just meet a standard. Any feedback is appreciated. Angela Craig APN,MS,CCNS Clinical Nurse Specialist Intensive Care Unit Cookeville Regional Medical Center 931-783-5035 This email message has been delivered safely and archived online by Mimecast. For more information please visit https://urldefense.proofpoint.com/v2/url?u=http-3A__www.mimecast.com&d=DwICAg&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT4oEnIs-gdg&m=XNlj6U7fg3qw3fOpzPRBQhszFq58f3_e-AZd51abbgg&s=PerWaGzlU8hIpW1shJTJD7j_09XBEgXUFFiP8CjIVRI&e= -------------- 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_20170711_4a036cd4_attachment-2D0001.htm&d=DwICAg&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT4oEnIs-gdg&m=XNlj6U7fg3qw3fOpzPRBQhszFq58f3_e-AZd51abbgg&s=1hrXTm6s2bl8RXGsGXd3anfk1WRcjJj6BiEGJ3VoSjQ&e= > ------------------------------ Message: 2 Date: Sun, 9 Jul 2017 13:26:08 -0500 From: William Haik <[email protected]> To: [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 253, Issue 6 Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" I spoke with CMS about 6 months ago and at that time they had no plans to change William E. Haik, M.D., F.C.C.P., C.D.I.P. AHIMA Approved ICD-10-CM/PCS Trainer Office: (850) 863-2110 Cell: (850) 803-5854 Fax: (850) 864-4438 > On Jul 9, 2017, at 1:00 PM, [email protected] wrote: > > 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=RvBXVp2Kc > -itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT > 4oEnIs-gdg&m=XNlj6U7fg3qw3fOpzPRBQhszFq58f3_e-AZd51abbgg&s=_ADMyyqqRXw > Brb-EW7PQUTrHgX9hNdNtaZ0dw30bS6E&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: CMS Updates (Mary Draper) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Wed, 5 Jul 2017 21:23:43 +0000 > From: Mary Draper <[email protected]> > To: 'Jamie Natkowski' <[email protected]>, > "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] CMS Updates > Message-ID: > > <bn1pr08mb1070e93eeb4fa003d9cd39d90...@bn1pr08mb107.namprd08.prod.outl > ook.com> > > Content-Type: text/plain; charset="utf-8" > > The last I saw was there wouldn?t be any updates until January of 2018. > > 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]> > [cid:[email protected]] > ?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 > > From: Sepsisgroups > [mailto:[email protected]] On Behalf Of > Jamie Natkowski > Sent: Saturday, July 01, 2017 1:24 PM > To: [email protected] > Subject: [Sepsis Groups] CMS Updates > > Forgive me if this has already been addressed: > Does anyone know when the next set of CMS updates will come out for sep-1? > Curious if they will reflect the 2016 SCCM/SSC guidelines. > Thanks! > -------------- next part -------------- An HTML attachment was > scrubbed... > URL: > <https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.sepsisgroup > s.org_pipermail_sepsisgroups-2Dsepsisgroups.org_attachments_20170705_6 > 25b60d5_attachment.htm&d=DwICAg&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj > 8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT4oEnIs-gdg&m=XNlj6U7fg3qw3f > OpzPRBQhszFq58f3_e-AZd51abbgg&s=TGPX2rVw6DH4lUKcU_dj4WzRVQwTnHV9mP44V- > o_HUI&e= > > -------------- next part -------------- A non-text attachment was > scrubbed... > Name: image001.png > Type: image/png > Size: 31953 bytes > Desc: image001.png > URL: > <https://urldefense.proofpoint.com/v2/url?u=http-3A__lists.sepsisgroup > s.org_pipermail_sepsisgroups-2Dsepsisgroups.org_attachments_20170705_6 > 25b60d5_attachment.png&d=DwICAg&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj > 8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT4oEnIs-gdg&m=XNlj6U7fg3qw3f > OpzPRBQhszFq58f3_e-AZd51abbgg&s=g0gRDuqza-zfU8d7oyi3WQLmAutHWAWVFWTNCy > -9FQ0&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=RvBXVp2Kc > -itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT > 4oEnIs-gdg&m=XNlj6U7fg3qw3fOpzPRBQhszFq58f3_e-AZd51abbgg&s=_ADMyyqqRXw > Brb-EW7PQUTrHgX9hNdNtaZ0dw30bS6E&e= > > > ------------------------------ > > End of Sepsisgroups Digest, Vol 253, Issue 6 > ******************************************** -------------- 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_20170709_3b5c14c4_attachment-2D0001.htm&d=DwICAg&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT4oEnIs-gdg&m=XNlj6U7fg3qw3fOpzPRBQhszFq58f3_e-AZd51abbgg&s=p7PfseYdfrEITIzuqim7JMV9A-WKmTW0-bgC3YMAedA&e= > ------------------------------ Message: 3 Date: Mon, 10 Jul 2017 13:43:29 +0000 From: "Cox, Debra M. (RN)" <[email protected]> To: 'Mary Draper' <[email protected]>, 'Jamie Natkowski' <[email protected]>, "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] CMS Updates [External] Message-ID: <[email protected]> Content-Type: text/plain; charset="utf-8" The next version starting Jan 2018 are on the https://urldefense.proofpoint.com/v2/url?u=http-3A__Qualitynet.org&d=DwICAg&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=j7MLZhtia4fb_PGZfl9Gc6ysG25G_i7hT4oEnIs-gdg&m=XNlj6U7fg3qw3fOpzPRBQhszFq58f3_e-AZd51abbgg&s=GwhLzQIYONLV4qdE6X9HdhIAMongG4EK0cNqEH8gE4s&e= website. From: Sepsisgroups [mailto:[email protected]] On Behalf Of Mary Draper Sent: Wednesday, July 05, 2017 5:24 PM To: 'Jamie Natkowski'; [email protected] Subject: Re: [Sepsis Groups] CMS Updates [External] Be aware: [This message came from outside of Spartanburg Regional Network] The last I saw was there wouldn?t be any updates until January of 2018. 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]> [cid:[email protected]] ?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 From: Sepsisgroups [mailto:[email protected]] On Behalf Of Jamie Natkowski Sent: Saturday, July 01, 2017 1:24 PM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] CMS Updates Forgive me if this has already been addressed: Does anyone know when the next set of CMS updates will come out for sep-1? Curious if they will reflect the 2016 SCCM/SSC guidelines. Thanks! -------------- next part -------------- An HTML attachment was scrubbed... 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