They said that since the antibiotics were being used to calculate the 30 mL/kg that it is now multiple orders.
From: Maykel, Julie [mailto:[email protected]] Sent: Monday, March 25, 2019 5:32 PM To: Belfi, Karen; [email protected] Subject: [EXTERNAL] RE: [External Email] [Sepsis Groups] Crystalloid fluids This message originated from outside MLHS systems. Any attachments or links should be carefully considered before proceeding. Messages from our business partners still need to be reviewed and should not be opened if suspicious. Please contact the IT Service Desk at 484-596-4357 with any questions or forward a questionable email to [email protected] ________________________________ Hi Karen, Here is an excerpt from the Specification Manual, page 1-63 of the Alphabetical Data Dictionary for DCs 01-01-19 through 06-30-19 : [cid:[email protected]] Based on the second bullet point - if the initial order was to administer 3 L, I would choose the time at which the fluid was initiated, which was 12:07. If you worded your question the same when asking Q-Net, I wonder why they said 13:05. Thank you, Julie Julie Maykel, RN, BSN Quality Coordinator [email protected] Seton Medical Center | Part of Verity Health System 1900 Sullivan Avenue, Daly City CA 94015 Office 650-991-6366 Fax 650-991-6390 seton.verity.org | Verity.org Confidentiality Notice: This transmission and any attached documents may be confidential and contain information protected by State and Federal Medical Privacy statutes and is legally privileged. They are intended for use only by the addressee. If you are not the intended recipient of this transmission, or an agent of the intended recipient, you are prohibited from reading, disclosing, printing, saving, copying, using or otherwise disseminating any information contained in this transmission. If you received this transmission in error, please accept our apologies and notify the sender via reply e-mail. Please delete entire message and its attachments. Thank you From: Sepsisgroups [mailto:[email protected]] On Behalf Of Belfi, Karen Sent: Tuesday, March 19, 2019 7:12 AM To: [email protected] Subject: [External Email] [Sepsis Groups] Crystalloid fluids Please use caution when opening attachments or following links. Do not enter your credentials when prompted by external links. Please notify the Help Desk immediately if you believe you received a spam or phishing email and the attachment was opened, a link was clicked or credentials were provided. ________________________________ I wrote to Qnet regarding crystalloid fluids. This was my question: I have a strange case. Pt needs 2760 mL. The pt had an order for 3 liters of fluid, hung 12:07, 1231, 1306. The first liter ran over almost 2 hours. The others ran faster. At 1305 100 mL of antibiotics was hung at 150/hr. It ran concurrently with the first liter of fluid so was calculated into the crystalloid fluids. Would I take 12:07 for the crystalloid fluid time, or 13:05 since that was the latest one that got us to the 30 mL/kg? Thanks! I was told to take 13:05, because even though the fluids were ordered in one order, multiple bags were used to calculate the crystalloid fluids. The severe sepsis time was 10:00. If I used the time the fluids were hung, it would be 12:07, and we would be compliant. But because antibiotics were appropriately hung in the time frame, we had to use them, and it is now an outlier. Has anyone else experienced this? It's very difficult to explain to physicians that even though they did things appropriately, it is an outlier. Thanks, Karen Belfi MSN, RN Main Line Health (484)476-8092
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