Sara,
Do you have an electronic medical record?  If so, look into building a SIRS 
Screening process into nursing's q4h documentation (assessment & re-assessment 
process).

If no EMR, then use paper for the same purpose.

Either way, nursing must screen in real time and call Rapid response when SIRS 
positive with suspected infection.

Then Rapid should initiate labs, cultures, initial fluid resuscitation, 2 large 
bore IVs, call MD, etc.  Antibx are initiated upon call to MD along with the 
rest of a standardized orderset.

At this point hospitals differ in approach. Most put the pt in ICU and continue 
with the rest of the initial resuscitation bundle. Some allow a small subset of 
pts to go to PCU where fluid resuscitation continues until lactate WNL and pt 
is asymptomatic.

Retrospective review is a waste of your time.....perhaps intellectually 
stimulating but no help to the patient.

Sent from my iPhone
Please excuse typos
Peggy Rice, RN, MBA
Assistant CNO
Good Samaritan Hospital
San Jose, CA
(408) 438-0986 cell
(408) 559-2329 office

On Dec 18, 2012, at 5:14 AM, "Sara Valentine" 
<[email protected]<mailto:[email protected]>> wrote:

Hello,

I am interested to learn the process of how anyone’s institution is 
implementing concurrent monitoring of SS or SSH patients. Currently, my process 
is to get the patient’s name of suspected sepsis and I screen for the SIRS, 
infectious source, and the organ dysfunction. Unfortunately, most of my chart 
reviews are done retrospectively, usually days after initial presentation, thus 
not allowing appropriate time to help intervene to encourage use of the 
protocol.

There is ongoing education within the facility of the nursing staff, hopefully 
getting nurses to call a rapid response, which I will respond to and there is a 
specific Sepsis protocol to follow. But I was curious to see if anyone has a 
great program that wouldn’t mind sharing how they go about monitoring their 
patients and interventions.

Thanks for your time!


Sara Valentine, BSN, RN, CNRN
Nurse Educator/Clinical Sepsis Coordinator
Medical Center Hospital
500 West 4th Street
Odessa, Texas  79761
ph: 432.640.1085
fax:432.640.2885


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