Some additional potential variables that come to mind: · Pregnancy
· Weekend – versus – weekday · Time of year (new residents, flu season) · Type of practitioner (mid-level, resident, etc…) · Known/unknown source of infection If possible to include program-related variables, the following come to mind: · Nurse-initiated protocol · Electronic screening/alert system (EMR-based) · Code Sepsis protocol · Broad spectrum antibiotic in automated dispensing cabinet · Point of care lactate · Use of non-invasive hemodynamic monitoring equipment · EMS involvement in screening/protocol · Involvement of sepsis coordinator Rhonda Dickman, MSN, RN, CPHQ Clinical Quality Improvement Specialist Tennessee Center for Patient Safety Tennessee Hospital Association Office: 615-401-7404 Cell: 706-570-5700 rdick...@tha.com<mailto:rdick...@tha.com> www.tha.com<http://www.tha.com/> From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Townsend, Sean, M.D. Sent: Tuesday, May 15, 2018 10:07 PM To: sepsisgroups@lists.sepsisgroups.org Subject: [External] [Sepsis Groups] What variables influence compliance? Dear All, I’m working on developing a model to predict compliance with SEP-1. I have a list below of variables that may be of interest, but I’m wondering if you might send me additional variables you think could be related. Just to clarify, SEP-1 excludes transfers, CMO status. 1. Age at admission 2. Sex 3. Ethnicity (Hispanic) 4. Race 5. Initial hypotension (triggers fluid requirement, thus an opportunity to fail to comply) 6. Persistent hypotension (triggers vasopressors, thus an opportunity to fail to comply) 7. Septic shock 8. Lactate > 2 (triggers a repeat lactate, thus another opportunity to fail to comply) 9. Lactate > 4 (triggers shock as well as fluid administration = opportunities to fail to comply) 10. Already on antibiotics prior to time of presentation (makes it easier to comply) 11. Already had blood cultures collected prior to time of presentation (makes it easier to comply) 12. CHF (less likely to comply given known physician behavior) 13. Cardiomyopathy (less likely to comply given known physician behavior) 14. ESRD (less likely to comply given known physician behavior) 15. Morbid Obesity (less likely to comply given known physician behavior) 16. Cirrhosis (less likely to comply given know physician behavior) 17. Admitted during the day (more likely to comply given staff present) 18. Admit type (Emergent, urgent, elective) 19. Presence of an advanced directive 20. Qualification to receive Medicare benefits (disabled, ESRD, old age) 21. Type of insurance (Medicare part D implies more access to drugs, Medicare Part B implies better outpatient care, Medicare part C = better managed care) 22. Surgery during the hospitalization 23. Admit from SNF versus home 24. DRG assigned 25. Primary diagnosis 26. Secondary diagnosis 27. Zip code 28. State Sean
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