Here's a better example of the crystalloid fluid issue. Karen Belfi RN, MSN Quality Outcomes Coordinator Lankenau Medical Center 484-476-8092
From: IQR Q&A System [mailto:[email protected]] Sent: Thursday, March 28, 2019 1:43 PM To: Belfi, Karen Subject: [EXTERNAL] Crystalloids with antibiotics [Incident: 190326-000096] 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]<mailto:[email protected]> ________________________________ Recently you requested personal assistance from our on-line support center. Below is a summary of your request and our response. If this issue is not resolved to your satisfaction, you may reopen it within the next 1095 days. Thank you for allowing us to be of service to you. To access your question from our support site, click here.<https://urldefense.proofpoint.com/v2/url?u=https-3A__cms-2Dip.custhelp.com_app_account_questions_detail_i-5Fid_413327&d=DwMFAw&c=qqcbk_QeabW4Z7GBhIMNtn_B7aQjktEuWNmUvrzri9o&r=9XT3K_nIvIIF-7Bh2TiB0g&m=IJpBj7uP9tM681ZXd5ro-G-95fZuXV9tSkVzYmN7VME&s=zrFzNCs6fSdzCaLKu3ddmGA2iKKlii2xpwOT6jMtIg4&e=> Subject Crystalloids with antibiotics Discussion Thread Response Via Email (Noel Albritton) 03/28/2019 01:43 PM Hi, Since the infusion that completed the target volume was started at 1310, this time would be used for the crystalloid fluid administration time. Customer By Web Form (Karen Belfi) 03/26/2019 12:07 PM So I've been told to use the time the final bag was hung for crystalloid fluid time. If the fluids were ordered in one order, and antibiotics were given at >125/hr in the time frame, and the final bag from the initial order is outside the window? If septic shock time is 10:00 (and that's the trigger for fluids), the pt needs 2700 mL, The physician ordered 3000 mL@ 1000 mL/hr, and they're hung like this: 1000 mL 10:30, 1000 mL 11:30, 1000 @ 13:10. But the pt got vanco 250 mL @ 250/hr at 12:00? That would make us have to use the latest time since it's multiple orders. But if we use the latest time, that's 1310 and outside the window. So in this scenario, which time would I use? Thanks! Question Reference #190326-000096 Product Level 1: Measures & Data Element Abstraction Category Level 1: Hospital Inpatient - Sepsis Category Level 2: Crystalloid Fluid Date and Time Date Created: 03/26/2019 12:07 PM Last Updated: 03/28/2019 01:43 PM Status: Solved Discharge Period: 01/01/2019 - 06/30/2019
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