Does anyone have a national average or specific to their facility cases of
sepsis with undiagnosed organism.
Erin Parker RN, BSN, CIC, ACM
Infection Preventionist, Epidemiology
Ascension | Genesys
One Genesys Parkway
Grand Blanc, MI 48439
Ascension.org/Michigan
T: 810.606.5093
F: 810-606-5495
M: [email protected]<mailto:[email protected]>
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of Rhonda Dickman
Sent: Wednesday, May 16, 2018 5:49 PM
To: Townsend, Sean, M.D. <[email protected]>;
[email protected]
Subject: Re: [Sepsis Groups] [External] What variables influence compliance?
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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
[email protected]<mailto:[email protected]>
www.tha.com<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.tha.com_&d=DwMGaQ&c=Rm3hRyxmymJgpBTCyRDm7Q&r=8-E7F-O-Pm6NE44jMi1aQwcxddU1g1ah_mGZhj_sXTE&m=gAT7v8nDnrbaAwJW0swwLrek9qrqXrKWaXYLi1Iv9FA&s=T9MaybbXiKvey_j_bb6s_xfxF36ieeiG-y3JXVh4p3k&e=>
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of Townsend, Sean, M.D.
Sent: Tuesday, May 15, 2018 10:07 PM
To:
[email protected]<mailto:[email protected]>
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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