All, There is new language in the 2018 manual concerning Persistent Hypotension.
If there is more than one blood pressure documented, refer to the last two within the hour: If there is a normal blood pressure followed by a low blood pressure, select Value “3.” Trying to understand the rationale for this and understand why this is a bundle failure. In our case, the patient did have septic shock, met all prior bundle requirements and was resuscitated with 30 ml/kg cryst fluid. In my mind, a patient that has septic shock that is actively being fluid resuscitated but continues to be hypotensive should then be considered for vasopressor use and not be considered a failure for the Sepsis bundle. (Pt was on pressors). It seems as if we are being ding-ed based on pt response to treatment. What am I missing? From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Duane, Molly Sent: Monday, March 12, 2018 7:34 PM To: 'Tara Miller'; 'sepsisgroups@lists.sepsisgroups.org' Subject: [External] Re: [Sepsis Groups] Persistent Hypotension Hi Tara, We have requested our nurses to increase VS documentation during each fluid bolus to: Q 15 minutes X2 & Q 30 minutes X2, hoping to improve this documentation. Molly Molly Duane RN, BSN, CCRN Sepsis Program Coordinator Detroit Receiving Hospital Harper-Hutzel Hospital Mobile: 248-709-6218 DRH: 313-966-8087 HUH: 313-745-4340 Email: mdu...@dmc.org ________________________________ From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Tara Miller Sent: Tuesday, March 06, 2018 3:32 PM To: 'sepsisgroups@lists.sepsisgroups.org' Subject: [Sepsis Groups] Persistent Hypotension For the measure element of Persistent hypotension, if only one BP is recorded within the one hour after crystalloid fluid administration and SBP < 90 or MAP < 65, you are to check “persistent hypotension is not assessed.” This would create a fallout for the sepsis core measure. Is anyone else having these issues? We do have a policy for every 1 hr vitals in the ICU setting with Vasopressors or hypotension. Does everyone have a different interval for vital signs? Any assistance to help would be appreciated. Thanks. Tara R Miller, RN Team Leader, Quality Management Mobile Infirmary Medical Center Office: 435-5109 Cell: 605-8270 Confidentiality Notice: This electronic message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this electronic message and/or any attachments is strictly prohibited. This quality assurance document is for the use of Infirmary Health and is prepared and maintained pursuant to Section 22-21-8 of the 1975 Code of Alabama. Prepared in an anticipation of litigation. This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation.
_______________________________________________ Sepsisgroups mailing list Sepsisgroups@lists.sepsisgroups.org http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
