In Version 5.4 they have added the new Data Element "Repeat Volume Status and Tissue Perfusion Assessment Performed". With this the volume status and tissue perfusion assessment must include any 1 of the following 3:
1. MD/APN/PA documentation that a Severe Sepsis/Septic Shock focused exam was completed (same as in the last Specification Manual) Or 2. MD/APN/PA documentation indicating that a review of at least 5 of the following 7 parameters was performed, ie SaO2, capillary refill, cardiopulmonary assessment, peripheral pulses, skin color or condition, urine output, or VS. Or 3. Documentation that 1 of the following was measured, ie CVP, ScvO2, Cardiac Echo, or Fluid Challenge or Passive Leg Raise. These changes seem to have "lightened" the requirements for the reassessment but it does not appear that a focused exam is gone altogether. -----Original Message----- From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Conaway, Pamela Sent: Wednesday, April 18, 2018 4:32 AM To: Fiona Winterbottom; sepsisgroups@lists.sepsisgroups.org Subject: Re: [Sepsis Groups] Focused exam Dignityhealth.org made the following annotations --------------------------------------------------------------------- STOP, THINK, READ. This is an external email. Exercise extra caution responding to it, opening attachments and following links. --------------------------------------------------------------------- The focused exam will not be necessary beginning with July 2018 discharges. This information can be found on Quality Net in the July 2018 inpatient quality reporting specifications. -----Original Message----- From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Fiona Winterbottom Sent: Thursday, April 12, 2018 2:12 PM To: sepsisgroups@lists.sepsisgroups.org Subject: [Sepsis Groups] Focused exam Good Afternoon, I was recently at a large conference where the audience was told that the focused exam was no longer necessary. Could someone clarify this with supporting data of where this can be found? Thanks Fiona -----Original Message----- From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org Sent: Monday, April 09, 2018 9:22 AM To: sepsisgroups@lists.sepsisgroups.org Subject: Sepsisgroups Digest, Vol 285, Issue 1 THIS EMAIL IS FROM AN EXTERNAL SENDER! DO NOT click links or provide your User ID or Password if the sender is unknown. Send Sepsisgroups mailing list submissions to sepsisgroups@lists.sepsisgroups.org To subscribe or unsubscribe via the World Wide Web, visit https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flists.sepsisgroups.org%2Flistinfo.cgi%2Fsepsisgroups-sepsisgroups.org&data=02%7C01%7Cpamela.conaway%40mclaren.org%7C060ee7fc763f4e10756708d5a4900eb0%7C82021bda879141b4807aff5b548750e6%7C0%7C1%7C636595860989859174&sdata=vHArypP4pE9F%2BKDeSkn7yagBfbX7X87I7GaGwLsmiik%3D&reserved=0 or, via email, send a message with subject or body 'help' to sepsisgroups-requ...@lists.sepsisgroups.org You can reach the person managing the list at sepsisgroups-ow...@lists.sepsisgroups.org When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Re: Question re: documentation of attestation that focused exam was completed (Pamela Green) 2. Re: Sepsisgroups Digest, Vol 284, Issue 3 (Pender.Linda) 3. OB patients (richard.rutherf...@ventura.org) ---------------------------------------------------------------------- Message: 1 Date: Thu, 5 Apr 2018 18:21:54 +0000 From: Pamela Green <pa...@howardmemorial.com> To: "Duane, Molly" <mdu...@dmc.org>, "Sepsisgroups@lists.sepsisgroups.org" <Sepsisgroups@lists.sepsisgroups.org> Cc: Alesha Collins <ales...@howardmemorial.com>, "Britni N. Fannin" <britn...@howardmemorial.com>, Steven May <stev...@howardmemorial.com> Subject: Re: [Sepsis Groups] Question re: documentation of attestation that focused exam was completed Message-ID: <cb8b1d4c6616c649be06e4604857ee8605567...@hmhexchange.howardmemorial.com> Content-Type: text/plain; charset="us-ascii" Good afternoon everyone, We are having a difficult time getting the appropriate documentation to meet the bundle compliance even though everything is done correctly! Use of our Sepsis Screening and Evaluation Documentation tool is hit and missed although I can see by the labs and treatment protocol that they are doing it. On the IP side it is the issue with getting them to document to the Sepsis Shift Screen and Focus reassessment. With the physicians if they are here when patient is admitted to the floor they usually do an admit note that includes a focused reassessment so we will catch those. If it is after hours we are hoping to hold the ER physicians accountable to documenting a focused reassessment prior to moving patient to PCU or ICU. I would be open to suggestions for better documentation compliance also. Pam Pam From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Duane, Molly Sent: Thursday, April 05, 2018 11:18 AM To: Sepsisgroups@lists.sepsisgroups.org Subject: [Sepsis Groups] Question re: documentation of attestation that focused exam was completed Hello All, I was wondering if your physicians were using the attestation statement instead of documenting the specific focused exam components. If so, how is that going? How did you implement this? We had a miss this month: even though the physician documented in his note the specific amount of fluid that was given, followed with "after these interventions the patient was reassessed", we missed because the attestation did not have a specific time included. The time the note was opened/started was used. This was an ED note, started at the beginning of the pt's visit, so that was prior to fluids being given. It is frustrating to see that the correct care is being given, yet we are missing on documentation technicalities. Does anyone have suggestions? Thanks, Molly Molly Duane RN, BSN, CCRN Sepsis Program Coordinator Detroit Receiving Hospital Harper-Hutzel Hospital Mobile: 248-709-6218 DRH: 313-966-8087 HUH: 313-745-4340 Email: mdu...@dmc.org<mailto:mdu...@dmc.org> This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation. -------------- next part -------------- An HTML attachment was scrubbed... URL: <https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flists.sepsisgroups.org%2Fpipermail%2Fsepsisgroups-sepsisgroups.org%2Fattachments%2F20180405%2Ffa40c9f9%2Fattachment-0001.html&data=02%7C01%7Cpamela.conaway%40mclaren.org%7C060ee7fc763f4e10756708d5a4900eb0%7C82021bda879141b4807aff5b548750e6%7C0%7C1%7C636595860989859174&sdata=Q7QRs2v9RA%2Bo9AldOcEXDy%2FxH1jwLG12C09KSyAaT7Y%3D&reserved=0> ------------------------------ Message: 2 Date: Thu, 5 Apr 2018 20:35:43 +0000 From: Pender.Linda <pender.li...@navicenthealth.org> To: "sepsisgroups@lists.sepsisgroups.org" <sepsisgroups@lists.sepsisgroups.org> Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 284, Issue 3 Message-ID: <sn6pr11mb2765422ef07f4d6a862b7feff6...@sn6pr11mb2765.namprd11.prod.outlook.com> Content-Type: text/plain; charset="iso-8859-1" Molly, We had the same issue with physicians documenting everything that occurred for hours within the note they started at the time of admission. We requested for the physicians to add a date and time of their re-assessments. This has surprisingly worked for us since we were able to show failures due to the technicalities. Linda G. Pender RRT-NPS Sepsis Coordinator Patient Care Services Administration Navicent Health phone: 478-633-6806 pager: 4444 KNOW Sepsis: Inside & Out Confidential Quality Improvement: Not for Disclosure Email: pender.li...@navicenthealth.org -----Original Message----- From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of sepsisgroups-requ...@lists.sepsisgroups.org Sent: Thursday, April 05, 2018 4:07 PM To: sepsisgroups@lists.sepsisgroups.org Subject: Sepsisgroups Digest, Vol 284, Issue 3 [ W A R N I N G ] This email originated outside of Navicent Health. Do not click on links or attachments unless you recognize the sender and know the content is safe. Sender: sepsisgroups-boun...@lists.sepsisgroups.org ========================================================================================================= * ** Send Sepsisgroups mailing list submissions to sepsisgroups@lists.sepsisgroups.org To subscribe or unsubscribe via the World Wide Web, visit https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flists.sepsisgroups.org%2Flistinfo.cgi%2Fsepsisgroups-sepsisgroups.org&data=02%7C01%7Cpamela.conaway%40mclaren.org%7C060ee7fc763f4e10756708d5a4900eb0%7C82021bda879141b4807aff5b548750e6%7C0%7C1%7C636595860989859174&sdata=vHArypP4pE9F%2BKDeSkn7yagBfbX7X87I7GaGwLsmiik%3D&reserved=0 or, via email, send a message with subject or body 'help' to sepsisgroups-requ...@lists.sepsisgroups.org You can reach the person managing the list at sepsisgroups-ow...@lists.sepsisgroups.org When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Question re: documentation of attestation that focused exam was completed (Duane, Molly) ---------------------------------------------------------------------- Message: 1 Date: Thu, 5 Apr 2018 12:17:56 -0400 From: "Duane, Molly" <mdu...@dmc.org> To: "Sepsisgroups@lists.sepsisgroups.org" <Sepsisgroups@lists.sepsisgroups.org> Subject: [Sepsis Groups] Question re: documentation of attestation that focused exam was completed Message-ID: <DC544FE7FA833F49A1F4F0CA3CDC145003BDC7001F59@MAIL03.dmcnt1.local> Content-Type: text/plain; charset="us-ascii" Hello All, I was wondering if your physicians were using the attestation statement instead of documenting the specific focused exam components. If so, how is that going? How did you implement this? We had a miss this month: even though the physician documented in his note the specific amount of fluid that was given, followed with "after these interventions the patient was reassessed", we missed because the attestation did not have a specific time included. The time the note was opened/started was used. This was an ED note, started at the beginning of the pt's visit, so that was prior to fluids being given. It is frustrating to see that the correct care is being given, yet we are missing on documentation technicalities. Does anyone have suggestions? Thanks, Molly Molly Duane RN, BSN, CCRN Sepsis Program Coordinator Detroit Receiving Hospital Harper-Hutzel Hospital Mobile: 248-709-6218 DRH: 313-966-8087 HUH: 313-745-4340 Email: mdu...@dmc.org<mailto:mdu...@dmc.org> This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. 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Navicent Health. https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2 Fwww.navicenthealth.org%2F&data=02%7C01%7Cpamela.conaway%40mclaren.org%7C060ee7fc763f4e10756708d5a4900eb0%7C82021bda879141b4807aff5b548750e6%7C0%7C1%7C636595860989859174&sdata=IZEeGAFYmwnRGtsN8zeM4P7zd5K6WmgMd%2Ft6M3p%2BPMI%3D&reserved=0 ------------------------------ Message: 3 Date: Sat, 07 Apr 2018 01:25:43 +0300 From: richard.rutherf...@ventura.org To: Sepsis List Serve <sepsisgroups@lists.sepsisgroups.org> Subject: [Sepsis Groups] OB patients Message-ID: <1523053543.589153...@f14.my.com> Content-Type: text/plain; charset="utf-8" Hello All, We are initiating protocols to screen and treat obstetrical patients for Sepsis. Are your hospitals using the same protocols as for medical and surgical patients? ?If not, would you be willing to send me examples of protocols specific to obstetrics? 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