Hi Claudia, At Norton Healthcare we do not screen every patient in the ED. When they are screened, they may be in triage, depending on the criteria met. We utilize an Epic Predictive Analytics tool that triggers a BPA (best practice advisory - popup on the screen guiding practice) based on various weighted criteria (vitals, labs, comorbids, types of medications, etc). When the BPA is triggered, the nurse is to screen the patient. If the screening is positive, the provider is notified. If the screening is negative, then we continue to monitor. The screening 'lives' in the triage navigator so the nurse has the autonomy to screen if s/he so chooses in triage despite having a BPA. We wanted to leave extra room for clinical judgment. Depending on the acknowledgement reason for the BPA, it will lockout for 2 hours. At the 2 hour mark if the BPA criteria is still met, it will trigger the nurse again to screen the patient. If criteria is not met for the BPA then it will not trigger.
We've had great satisfaction from our providers and nurses with the process, and with the BPAs we've seen a reduction in time to treatment and actual sepsis diagnosis in the ED (versus the frequent diagnosis we used to have of 'lactic acidosis, fever of unknown origin...') Hope this helps! Danette Danette Culver, MSN, APRN, ACNS-BC, CCRN-K, RN-BC Clinical Nurse Specialist Norton Healthcare, Louisville KY O: 502.629.4058 C: 812.881.0080 From: Sepsisgroups [mailto:[email protected]] On Behalf Of Orth, Claudia Sent: Monday, January 14, 2019 4:05 PM To: [email protected] Subject: [EXTERNAL] [Sepsis Groups] Sepsis Screening CAUTION: **EXTERNAL EMAIL** Do NOT click links or open attachments unless you recognize the sender and know the content is safe. If you are not sure, please forward the email to [email protected]<mailto:[email protected]> for review. ________________________________ I'm hoping to get an idea of what other facilities are doing about ED Sepsis Screening: 1. Are you screening every patient? 2. Are they screened in Triage or not until they are in a room? 3. If not screening every patient, what are the triggers for screening? 4. Is the screen on paper or electronic? Thank you in advance for being willing to share your expertise and experiences! Best, Claudia Claudia Orth, BSN, RN, CCRN-K Sepsis Coordinator Clinical Quality 1105 Sixth St. Traverse City, MI 49684 (231) 935-5692 voice (231) 935-6629 fax (231) 318-0394 pager [email protected]<mailto:[email protected]> [cid:[email protected]] Website<http://www.munsonhealthcare.org/mmc> I Find a Physician<http://www.munsonhealthcare.org/physician> I Maps<http://www.munsonhealthcare.org/maps> ______________________________________________________________________ This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. Any patient health information must be delivered immediately to intended recipient(s). If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail address or telephone number above and discard this e-mail. Thank you.
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