To clarify, does an admission assessment count if it is within 6 hours of the 
fluid or does the provider need to be specific and say "reperfusion exam"?  

Jeanie Bollinger MSN,RN, ACCNS-AG, CCRN-K
Clinical Nurse Specialist
Acute Medicine
Mission Health
509 Biltmore Avenue
Asheville, NC 28801

Office: 828-213-7171
Cell: 828-400-1194

-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of [email protected]
Sent: Thursday, April 26, 2018 2:08 PM
To: [email protected]
Subject: [EXTERNAL] Sepsisgroups Digest, Vol 287, Issue 8

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Today's Topics:

   1. Re: [**External**] Re:  Focused exam (Townsend, Sean, M.D.)


----------------------------------------------------------------------

Message: 1
Date: Wed, 25 Apr 2018 23:23:55 +0000
From: "Townsend, Sean, M.D." <[email protected]>
To: "DHILLON, ROOPINDER" <[email protected]>,
        "'Conaway, Pamela'" <[email protected]>, Fiona Winterbottom
        <[email protected]>, "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] [**External**] Re:  Focused exam
Message-ID:
        
<blupr11mb0097cdef2eff3cf6f4d1a147b6...@blupr11mb0097.namprd11.prod.outlook.com>
        
Content-Type: text/plain; charset="us-ascii"

This is not correct that "the focused exam is still there."  Instead there is a 
new data element "repeat volume status and tissue perfusion assessment 
performed."  You may write nothing at all about an "exam" and pass.  In 
particular, you may right, "tissue perfusion reassessed" or "volume status 
reassessed" and pass.  There's no preference on how you reassess the patient 
and no declaration of the means is required.

That said, if for some reason you like the exam, you may also say "sepsis 
focused exam completed."

Essentially any documentation of a reassessment is sufficient.  That was the 
design intention.

Sean
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of DHILLON, ROOPINDER
Sent: Friday, April 20, 2018 10:55 AM
To: 'Conaway, Pamela' <[email protected]>; Fiona Winterbottom 
<[email protected]>; [email protected]
Subject: [**External**] Re: [Sepsis Groups] Focused exam


WARNING: This email originated outside of the Sutter Health email system!
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The focused exam is still there in July 2018 Specs Manual. They have just 
changed the name to Data Element Name: "Repeat Volume Status and Tissue 
Perfusion Assessment Performed"



-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Conaway, Pamela
Sent: Wednesday, April 18, 2018 7:32 AM
To: Fiona Winterbottom; 
[email protected]<mailto:[email protected]>
Subject: Re: [Sepsis Groups] Focused exam



The focused exam will not be necessary beginning with July 2018 discharges.  
This information can be found on Quality Net in the July 2018 inpatient quality 
reporting specifications.



-----Original Message-----

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Fiona Winterbottom

Sent: Thursday, April 12, 2018 2:12 PM

To: 
[email protected]<mailto:[email protected]>

Subject: [Sepsis Groups] Focused exam



Good Afternoon, I was recently at a large conference where the audience was 
told that the focused exam was no longer necessary.

Could someone clarify this with supporting data of where this can be found?

Thanks

Fiona



-----Original Message-----

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of 
[email protected]<mailto:[email protected]>

Sent: Monday, April 09, 2018 9:22 AM

To: 
[email protected]<mailto:[email protected]>

Subject: Sepsisgroups Digest, Vol 285, Issue 1



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Today's Topics:



   1. Re: Question re: documentation of attestation that focused

      exam was completed (Pamela Green)

   2. Re: Sepsisgroups Digest, Vol 284, Issue 3 (Pender.Linda)

   3. OB patients 
([email protected]<mailto:[email protected]>)





----------------------------------------------------------------------



Message: 1

Date: Thu, 5 Apr 2018 18:21:54 +0000

From: Pamela Green <[email protected]<mailto:[email protected]>>

To: "Duane, Molly" <[email protected]<mailto:[email protected]>>,

                
"[email protected]<mailto:[email protected]>"

                
<[email protected]<mailto:[email protected]>>

Cc: Alesha Collins 
<[email protected]<mailto:[email protected]>>, "Britni N. 
Fannin"

                
<[email protected]<mailto:[email protected]>>, Steven May 
<[email protected]<mailto:[email protected]>>

Subject: Re: [Sepsis Groups] Question re: documentation of attestation

                that focused exam was completed

Message-ID:

                
<cb8b1d4c6616c649be06e4604857ee8605567...@hmhexchange.howardmemorial.com<mailto:cb8b1d4c6616c649be06e4604857ee8605567...@hmhexchange.howardmemorial.com>>



Content-Type: text/plain; charset="us-ascii"



Good  afternoon everyone,

We are having a difficult time getting the appropriate documentation to meet 
the bundle compliance even though everything is done correctly! Use of our 
Sepsis  Screening and Evaluation Documentation tool is hit and missed although 
I can see by the labs and treatment protocol that they are doing it.  On the IP 
side it  is the issue with getting them to document to the Sepsis Shift Screen 
and Focus reassessment. With the physicians if they are here when patient is 
admitted to the floor they usually do an admit note that includes a focused 
reassessment so we will catch those.  If it is after hours we are hoping to 
hold the ER physicians accountable to documenting a focused reassessment prior 
to moving patient to PCU or ICU.  I would be open to suggestions for better 
documentation compliance also. Pam Pam



From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Duane, Molly

Sent: Thursday, April 05, 2018 11:18 AM

To: 
[email protected]<mailto:[email protected]>

Subject: [Sepsis Groups] Question re: documentation of attestation that focused 
exam was completed



Hello All,

I was wondering if your physicians were using the attestation statement instead 
of documenting the specific focused exam components. If so, how is that going? 
How did you implement this?



We had a miss this month: even though the physician documented in his note the 
specific amount of fluid that was given, followed with "after these 
interventions the patient was reassessed", we missed because the attestation 
did not have a specific time included. The time the note was opened/started was 
used. This was an ED note, started at the beginning of the pt's visit, so that 
was prior to fluids being given.



It is frustrating to see that the correct care is being given, yet we are 
missing on documentation technicalities.

Does anyone have suggestions?

Thanks,

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: 
[email protected]<mailto:[email protected]<mailto:[email protected]%3cmailto:[email protected]>>





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Message: 2

Date: Thu, 5 Apr 2018 20:35:43 +0000

From: Pender.Linda 
<[email protected]<mailto:[email protected]>>

To: 
"[email protected]<mailto:[email protected]>"

                
<[email protected]<mailto:[email protected]>>

Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 284, Issue 3

Message-ID:

                
<sn6pr11mb2765422ef07f4d6a862b7feff6...@sn6pr11mb2765.namprd11.prod.outlook.com<mailto:sn6pr11mb2765422ef07f4d6a862b7feff6...@sn6pr11mb2765.namprd11.prod.outlook.com>>



Content-Type: text/plain; charset="iso-8859-1"



Molly,

We had the same issue with physicians documenting everything that occurred for 
hours within the note they started at the time of admission. We requested for 
the physicians to add a date and time of their re-assessments. This has 
surprisingly worked for us since we were able to show failures due to the 
technicalities.



Linda G. Pender RRT-NPS

Sepsis Coordinator

Patient Care Services  Administration

Navicent Health

phone: 478-633-6806  pager: 4444

KNOW Sepsis: Inside & Out



Confidential Quality Improvement: Not for Disclosure

Email: [email protected]<mailto:[email protected]>





-----Original Message-----

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of 
[email protected]<mailto:[email protected]>

Sent: Thursday, April 05, 2018 4:07 PM

To: 
[email protected]<mailto:[email protected]>

Subject: Sepsisgroups Digest, Vol 284, Issue 3



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Today's Topics:



   1. Question re: documentation of attestation that focused exam

      was completed (Duane, Molly)





----------------------------------------------------------------------



Message: 1

Date: Thu, 5 Apr 2018 12:17:56 -0400

From: "Duane, Molly" <[email protected]<mailto:[email protected]>>

To: 
"[email protected]<mailto:[email protected]>"

<[email protected]<mailto:[email protected]>>

Subject: [Sepsis Groups] Question re: documentation of attestation that focused 
exam was completed

Message-ID:

<[email protected]<mailto:[email protected]>>

Content-Type: text/plain; charset="us-ascii"



Hello All,

I was wondering if your physicians were using the attestation statement instead 
of documenting the specific focused exam components. If so, how is that going? 
How did you implement this?



We had a miss this month: even though the physician documented in his note the 
specific amount of fluid that was given, followed with "after these 
interventions the patient was reassessed", we missed because the attestation 
did not have a specific time included. The time the note was opened/started was 
used. This was an ED note, started at the beginning of the pt's visit, so that 
was prior to fluids being given.



It is frustrating to see that the correct care is being given, yet we are 
missing on documentation technicalities.

Does anyone have suggestions?

Thanks,

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: 
[email protected]<mailto:[email protected]<mailto:[email protected]%3cmailto:[email protected]>>







This message (including any attachments) is confidential and intended solely 
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Message: 3

Date: Sat, 07 Apr 2018 01:25:43 +0300

From: [email protected]<mailto:[email protected]>

To: Sepsis List Serve 
<[email protected]<mailto:[email protected]>>

Subject: [Sepsis Groups] OB patients

Message-ID: 
<[email protected]<mailto:[email protected]>>

Content-Type: text/plain; charset="utf-8"





Hello All,



We are initiating protocols to screen and treat obstetrical patients for 
Sepsis. Are your hospitals using the same protocols as for medical and surgical 
patients? ?If not, would you be willing to send me examples of protocols 
specific to obstetrics?



Thank you,



Rick Rutherford, MD

Ventura County Medical Center







Sent from myMail for iOS

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