Re: [Sepsis Groups] Sepsis & COVID

[Shimandle, Ruth [UCH]]

Specifications Manual 5.7 states:
Choose Value “2” if within 6 hours after documentation meeting clinical 
criteria or physician/APN/PA documentation of Severe Sepsis there is additional 
physician/APN/PA documentation indicating: ….
o Severe Sepsis or Septic Shock is due to a viral, fungal, or parasitic 
infection.

My understanding of the abstraction notes is:
If there is documentation within 6 hours of meeting severe sepsis criteria, 
stating severe sepsis or septic shock is related to COVID (even if it could 
also have a bacterial component) we should answer “no” to Severe Sepsis Present.
If however there is only documentation stating infection or sepsis is related 
to COVID, then you would ignore documentation of viral infection, but accept 
documentation of that may also be associated with bacterial infection. For 
example, “Infection: Covid vs bacterial”, you would accept that as 
documentation of infection, based on the documentation that it could be a 
bacterial infection. “Septic Shock: Covid with superimposed bacterial pna”, you 
would answer “no” to Severe Sepsis present, based on the documentation that 
septic shock is due to a viral infection.


RUTH SHIMANDLE, RN, MPH, CPHQ
Clinical Documentation Nurse
Data and Analytics
UChicago Medicine
5700 S. Maryland Ave. | CCD 1192, MC2009 | Chicago, IL 60637
Office: 773-702-3192
AT THE FOREFRONT®
uchospitals.edu
uchicagokidshospital.org
facebook.com/UChicagoMed
Twitter: @UChicagoMed

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Roney, Jamie K
Sent: Thursday, June 11, 2020 10:29 AM
To: Deffenbaugh, Amy M ; Merwin, Courtney C. 
; 'sepsisgroups@lists.sepsisgroups.org' 

Subject: Re: [Sepsis Groups] [EXTERNAL] Re: Sepsis & COVID

Good morning,

Any organism, whether viral, fungal, parasitic, bacterial, etc., has always had 
the possibility of triggering the systemic sepsis response and has never 
changed the treatment recommendations of EGDT by experts. Viral infection is 
not an exclusionary criteria for abstraction and both co-owners of the CMS 
Sepsis Core Measure are a part of this forum (one being Dr. Rivers who 
introduced us to EGDT), thus I should not speak for them. Known bacterial 
infection or not does not impact our treatment or abstraction of these patients.

Respectfully,

Dr. Roney


Jamie Roney, DNP, RN, BSHCM, NPD-BC, CCRN-K
Regional sepsis coordinator/Nursing Professional Development Specialist IV
"Be a yardstick of quality. Some people aren't used to an environment where 
excellence is expected." ~Steve Jobs

3615 19th Street, Lubbock, TX 79410
T: (806) 725-4689C: (806) 773-1914
www.covenanthealth.org
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[Sepsis Groups] Fluid Resuscitation Protocol

[Shimandle, Ruth [UCH]]

In an attempt to address physician reluctance to implement the 30cc/kg 
recommendations for our severe sepsis patients with significant comorbidities, 
namely patients with significant heart failure (EF<15%), significant cirrhosis 
and/or ESRD, we plan to develop  a fluid resuscitation protocol. Has anyone 
already developed such a protocol that you would be willing to share?
Thanks,
Ruth

RUTH SHIMANDLE, RN, MPH, CPHQ
Clinical Documentation Nurse
Center for Quality
The University of Chicago Medicine
5841 S. Maryland Ave. | Rm. S-152, MC2009 | Chicago, IL   60637
Office: 773-702-3192
Fax: 773-834-5923
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