For our ED population we use known/suspected infection, altered mental status and abdominal pain as triggers. Hope this helps!!
Angela Craig APN,MS,CCNS ICU Clinical Nurse Specialist 1 Medical Center Boulevard, Cookeville, TN 38501 Phone: 931-783-5035 Fax: 931-783-5039 [email protected] | crmchealth.org |Facebook | Twitter Cookeville Regional Medical Center: Building Healthier Communities From: Sepsisgroups [mailto:[email protected]] On Behalf Of McKnight, Elise Sent: Tuesday, October 08, 2019 12:32 PM To: [email protected] Subject: [Sepsis Groups] Sepsis BPAs and screening in the ED *** WARNING: This is an EXTERNAL EMAIL that originated outside of CRMC's Email System. Do not click any links or open any attachments unless you trust the sender and know the content is safe. *** Hello, I know this topic has been talked about a few times but wondering what others use as triggers for sepsis identification in the Emergency Department. We have nurses answer a 'yes'/'no' question about suspected sepsis and then if they say 'yes' Epic looks for 2 or more SIRS on the patient and will fire a BPA (Best Practice Alert) to RN/provider that says the patient might have sepsis and to get a CBC/Lactate. If the patient then develops hypotension or a lactate > 2.0 it will fire another BPA to say to call a Sepsis Alert and initiate the rest of the sepsis bundle. We struggle with getting the 'yes'/'no' on the infection question accurate and that is the hinge to the BPA firing. Additionally, we currently hinge calling an alert on either the lactate or hypotension. We are only getting the infection question right about 50% of the time meaning a lot of septic patients miss getting a BPA fire. - What do other have built within their EHR to help trigger staff the patient might be septic? - Anyone else found a way to pull for concern of infection other than staff answering a yes/no question? - Any other logic other than SIRS for EHR triggers? - Does anyone have staff trigger a sepsis alert off of just suspected infection + SIRS - What are your triggers for calling a sepsis alert in the ED We also have a lot of pushback with concerns of over treating viral, strep throat, etc based on the BPAs. Anyone else found this? Solutions? I know sometimes because we did draw a lactate we found that "healthy" 20year old with pharyngitis is actually quite sick but looking at ways to show data on patients we would have missed if we did not draw a lactate on seemingly "healthy" patients. If anyone doesn't mind sharing it would be greatly appreciated. Thanks! Elise McKnight Sepsis Coordinator Northern Colorado Medical Center of the Rockies Poudre Valley Hospital Yampa Valley Medical Center Longs Peak Hospital Greeley Hospital 2500 Rocky Mountain Ave Loveland, CO 80538 O 970.624.2153 C 970.290.9436 F 970.624.2192 [email protected] uchealth.org<http://uchealth.org> [UCHealth]<https://www.uchealth.org/> This email message has been delivered safely and archived online by Mimecast. For more information please visit http://www.mimecast.com
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