Our lab "reflexes" any lactate > 2.0 so that it is re-drawn in 2 hours. This process pre-dates me (I came in Feb. 2017). I don't know if they ever discussed or debated this as a nursing practice issue. Perhaps because this is technically a lab process for our facility?
Laura Soares MSN RN Sepsis & Stroke Program Coordinator 559.788.6067 Office 559.280.2036 Cell "Teamwork is the ability to work together toward a common vision--the ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results"- Andrew Carnegie 465 W. Putnam Ave Porterville, CA 93257 DISCLAIMER: The information contained in this email transmission is confidential and intended for the addressee only. If the reader of this message is not the addressee or addressee's agent, you are hereby advised that any dissemination, distribution or copying of the information is strictly prohibited. The information contained in this email transmission may be protected under the Attorney/Client Privilege and protected from disclosure under California Evidence Code section 1157. If protected by the attorney/client privilege or by California Evidence Code Section 1157, the information contained in this email transmission shall continue to be protected and will not be negated by virtue of sending the information via this email. If you receive this email in error, please call the Information Technology Security Coordinator at (559) 788-6090 (collect if necessary) immediately upon receipt. Thank you for your cooperation. -----Original Message----- From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org Sent: Thursday, January 11, 2018 1:07 PM To: sepsisgroups@lists.sepsisgroups.org Subject: Sepsisgroups Digest, Vol 275, Issue 8 WARNING This message originated outside Sierra View Medical Center. Use caution when opening links or attachments. Send Sepsisgroups mailing list submissions to sepsisgroups@lists.sepsisgroups.org 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 sepsisgroups-requ...@lists.sepsisgroups.org You can reach the person managing the list at sepsisgroups-ow...@lists.sepsisgroups.org When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Re: [External] Sepsisgroups Digest, Vol 275, Issue 3 (Sandy Tobar) ---------------------------------------------------------------------- Message: 1 Date: Tue, 9 Jan 2018 14:49:23 +0000 From: Sandy Tobar <sandra.to...@trinity-health.org> To: "sepsisgroups@lists.sepsisgroups.org" <sepsisgroups@lists.sepsisgroups.org> Subject: Re: [Sepsis Groups] [External] Sepsisgroups Digest, Vol 275, Issue 3 Message-ID: <a55dacbd90bf475eb3e9e36610282...@trinity-health.org> Content-Type: text/plain; charset="iso-8859-1" We had a similar discussion so we have the provider order the initial lactate and a repeat x 1 in 180 minutes after the initial. The subsequent lactate is cancelled if the lactate is <2.0. This eliminates the auto repeat order without a validation by providers because 2 are ordered initially. We have had success with this. Sandy Tobar MSBA, BSN, RN, CPPS Director, Clinical Transformation Sepsis, HAI & Patient Safety Trinity Health sandra.to...@trinity-health.org W? 734-343-1496 20555 Victor Parkway Livonia, MI 48152 trinity-health.org | Facebook | Twitter | LinkedIn -----Original Message----- From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org Sent: Tuesday, January 09, 2018 9:43 AM To: sepsisgroups@lists.sepsisgroups.org Subject: [External] Sepsisgroups Digest, Vol 275, Issue 3 Warning: This email originated from the Internet! DO NOT CLICK links if the sender is unknown, and NEVER provide your password. Send Sepsisgroups mailing list submissions to sepsisgroups@lists.sepsisgroups.org 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 sepsisgroups-requ...@lists.sepsisgroups.org You can reach the person managing the list at sepsisgroups-ow...@lists.sepsisgroups.org When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Automated Lactate Orders (Rutherford, Richard) 2. Re: Antibiotics/ normal saline shortage (Hodge - Garrett, Sara Mical) ---------------------------------------------------------------------- Message: 1 Date: Mon, 8 Jan 2018 22:53:36 +0000 From: "Rutherford, Richard" <richard.rutherf...@ventura.org> To: "sepsisgroups@lists.sepsisgroups.org" <sepsisgroups@lists.sepsisgroups.org> Subject: [Sepsis Groups] Automated Lactate Orders Message-ID: <by2pr09mb0723511ec299b385b3c847249b...@by2pr09mb0723.namprd09.prod.outlook.com> Content-Type: text/plain; charset="iso-8859-1" Hello All, We are having a debate in our organization about whether automatic lactate orders violate nursing standard of practice. Currently if a patient in ED or on floor screens in for sepsis, the nurse follows hospital protocol and orders a lactate which is then routed to the attending physician for cosignature (after drawn). We also have an automated order to repeat lactate at 4 hours for admitted patients with an initial lactate>2. I believe our initial lactate order in ER is covered by Standardized Nursing Procedures. We are having more debate around the initial lactate ordered on inpatients and the automated second lactate on all patients with lactate>2 without a prior physician order. I am interested in knowing if other hospitals use our approach, and if so is nursing leadership feeling comfortable that nursing standards of practice are not being violated. Thanks, Rick Rutherford -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20180108/38db5cac/attachment-0001.html> ------------------------------ Message: 2 Date: Wed, 3 Jan 2018 17:41:33 +0000 From: "Hodge - Garrett, Sara Mical" <sara.hodge-garr...@harrishealth.org> To: 'Angela Craig' <acr...@crmchealth.org>, 'Tara Miller' <tara.mil...@infirmaryhealth.org>, "sepsisgroups@lists.sepsisgroups.org" <sepsisgroups@lists.sepsisgroups.org> Subject: Re: [Sepsis Groups] Antibiotics/ normal saline shortage Message-ID: <246a1a4685bd471a8005998500912...@harrishealth.org> Content-Type: text/plain; charset="utf-8" In Houston, many of the hospitals are being affected by the saline shortage. In order to be proactive, we are doing IVP medications as well. Sara M. Hodge-Garrett, MSN, RN, MSCRN, CPHQ Quality Manager Ben Taub Hospital Quality Programs HARRIS HEALTH SYSTEM 1504 Taub Loop | Houston, TX 77030 | phone 713.873.4452 sara.hodge-garr...@harrishealth.org<mailto:sara.hodge-garr...@harrishealth.org> CONFIDENTIALITY NOTICE: If you have received this e-mail in error, please immediately notify the sender by return e-mail and delete this e-mail and any attachments from your computer system. To the extent the information in this e-mail and any attachments contain protected health information as defined by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), PL 104-191; 45 CFR Parts 160 and 164; or Chapter 181, Texas Health and Safety Code, it is confidential and/or privileged. This e-mail may also be confidential and/or privileged under Texas law. The e-mail is for the use of only the individual or entity named above. If you are not the intended recipient, or any authorized representative of the intended recipient, you are hereby notified that any review, dissemination or copying of this e-mail and its attachments is strictly prohibited. From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Angela Craig Sent: Tuesday, January 02, 2018 11:34 AM To: 'Tara Miller'; sepsisgroups@lists.sepsisgroups.org Subject: Re: [Sepsis Groups] Antibiotics/ normal saline shortage We are starting to give IVP antibiotics for these instances. Yes we are feeling this in TN as well. Angela Craig APN,MS,CCNS Clinical Nurse Specialist Intensive Care Unit Cookeville Regional Medical Center 931-783-5035 From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Tara Miller Sent: Tuesday, January 02, 2018 9:16 AM To: sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org> Subject: [Sepsis Groups] Antibiotics/ normal saline shortage Is anyone else having issues with no spike bags or normal saline bags available for mixing antibiotics? Our hospital and pharmacy are completely out of most saline bags. We are mixing all antibiotics manually. Have you heard of CMS allowing IM/IO antibiotics due to this shortage? Thanks. 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If protected by the attorney/client privilege or by California Evidence Code Section 1157, the information contained in this email transmission shall continue to be protected and will not be negated by virtue of sending the information via this email. If you receive this email in error, please call the Information Technology Security Coordinator at (559) 788-6090 (collect if necessary) immediately upon receipt. Thank you for your cooperation. _______________________________________________ Sepsisgroups mailing list Sepsisgroups@lists.sepsisgroups.org http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
