Not per routine. Can be helpful if bacterial etiology unclear. Sent from Rich's iPhone
On Mar 28, 2013, at 10:16 AM, "Angela Long" <[email protected]> wrote: > I have a topic - Is Procalcitonin routinely drawn in the ED? I just was > reading an article that there is no data on routine Procalcitonin level > evaluation in the ED. Just wondering if other hospitals get this level while > in the ED. > > > >>> <[email protected]> 3/27/2013 6:24 PM >>> > Send Sepsisgroups mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: EPIC facilities and ED Sepsis (Miller, Kevin - SFMH) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Wed, 27 Mar 2013 13:47:30 -0700 > From: "Miller, Kevin - SFMH" <[email protected]> > To: "Hunter, Patricia" <[email protected]>, "Alexander O. Sy" > <[email protected]>, that <[email protected]>, > "[email protected]" > <[email protected]>, > "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis > Message-ID: > <14d6990dd3b8104c82254ccd1826f9f31471ce0...@phx-msg-006-n1.chw.edu> > Content-Type: text/plain; charset="us-ascii" > > We currently have a Sepsis screening tool in Cerner. It does have a smart > template which pulls in abnormal vital signs, and abnormal labs within the > last 16 hours on the screening form. Another smart template pulls in > antibiotics that are currently ordered on the patient. > The tool we developed in Cerner is built on conditional logic. The first > question is Signs of Infection, if the nurse documents "None", then they are > done with the Sepsis screening. The other options are "Suspected Infection, > Known infection, Failed outpatient therapy, On antibiotic therapy", if they > choose any of these on the first question the SIRS box opens with all of the > SIRS criteria (this is where the labs and vital signs are useful to have in > the smart template). If the patient meets 2 or more SIRS criteria, the Organ > Dysfunction Signs and Symptoms box lights up. If they document Signs of > Organ dysfunction, when signing the form they receive a Discern Alert which > instructs them to notify the physician immediately of the positive Sepsis > screen. > > This tool has inherent problems: > > 1. If the nurse does not suspect infection, they will not get to the > SIRS or Organ dysfunction screens > > 2. Some clinicians are more focused on "overall" presenting picture of > patient, than others which can lead to different assessments between > different clinicians. > > 3. This alert is based upon human entry and is not automated from the > system to identify from data points a patient that might meet SIRS or Sepsis. > > > > [cid:[email protected]] > > "Procrastination is the thief of time" > > Kevin P. Miller, RN, BSN > Manager, Risk Management > Saint Francis Memorial Hospital > Phone: (415) 353-6296 > Fax: (415) 353-6177 > Right Fax: (415) 591-6364 > [email protected] > [cid:[email protected]] > > > > Confidentiality Notice: This message and any attachments are for the sole use > of the intended recipient(s) and may contain information that is legally > privileged and/or confidential. This message may also contain confidential > health information. If you are not the intended recipient or a person > responsible for delivering this message to an intended recipient, you are > hereby notified that any review, dissemination, distribution, or copying of > this communication is strictly prohibited. If you are not the intended > recipient or a person responsible for delivering this message to an intended > recipient, please contact the sender immediately by reply email and destroy > all copies of the original message. Confidential health information is > protected by state and federal law, including but not limited to, the Health > Insurance Portability and Accountability Act (HIPAA) of 1996 and related > regulations. > > From: [email protected] > [mailto:[email protected]] On Behalf Of Hunter, > Patricia > Sent: Wednesday, March 27, 2013 12:44 PM > To: Alexander O. Sy; that; [email protected]; > [email protected] > Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis > > We will be launching CERNER in the near future. Any advice from current > CERNER users as to what to build into the product for Sepsis - pulling data, > sepsis alert, identification of patients, auditing, etc.? > > Thanks, > Pat > > Patricia Hunter, RN > Clinical Data Analyst > Performance Excellence > Mercy Medical Center - Des Moines, Iowa > 515-643-2206 > > "Life is not about waiting for the storms to pass... > it's about learning to dance in the rain!" > > > > From: [email protected] > [mailto:[email protected]] On Behalf Of Alexander > O. Sy > Sent: Monday, March 25, 2013 12:06 PM > To: that; [email protected]; > [email protected] > Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis > > If you have access to the Epic Users website, you can search the library for > a sepsis Best Practice Alert developed by UVA and another hospital in the > Washington area. You can start with this. > > We have Epic but our institution launched with the bare bones with nothing > built or tested beyond copying a small percentage of our legacy CPOE and > notes. We are trying to get this built into our Epic (with much resistance) > to no avail so far. So believe it or not, we are using paper documentation > for this! > > Alexander Sy MD, FCCP, FACP, FAASM > Diplomate, American Board of Sleep Medicine > Associate Professor > Associate Director, MICU > Associate Director, Pulmonary Critical Care Fellowship Program > Director, MICU -Advance Practice Providers Program > Pulmonary, Critical Care, Allergy and Immunology > Wake Forest University Health Sciences > Medical Center Blvd > Winston- Salem, NC 27157 > Tel. No. (336) 716- 4328 > Fax No. (336) 716-7277 > Pager No. (336) 806-6111 > Email: [email protected]<mailto:[email protected]> > [cid:[email protected]] > > Confidential and Privileged > The information contained in this e-mail may be privileged and confidential > information intended for the sole use of the addressee. If the reader of > this e-mail is not the intended recipient, you are hereby notified that any > dissemination, distribution or copying of this communication is strictly > prohibited. If you have received this e-mail in error, please immediately > notify me by responding to this message. > > > > > > From: > [email protected]<mailto:[email protected]> > [mailto:[email protected]] On Behalf Of that > Sent: Saturday, March 23, 2013 4:53 PM > To: > [email protected]<mailto:[email protected]>; > > [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] EPIC facilities and ED Sepsis > > We are just rolling over to Epic in the fall so this would be very helpful to > us as well. > Jeffrey R Hanlon RN > Stamp Out Sepsis > > [http://www.world-sepsis-day.org/cgi-bin/WebObjects/WsdCMS.woa/2/wr?wodata=Media%2FWSD%2FMedia%2FWorld+Sepsis+Day+Logo%2Fstop.png]<http://www.world-sepsis-day.org/WSD/en?sid=u5iqdrmsatL1SZb01Ehxkw&iid=2> > > -----Original Message----- > From: Luginbuhl, Ryan S. > <[email protected]<mailto:[email protected]>> > To: '[email protected]' > <[email protected]<mailto:[email protected]>> > Sent: Sat, Mar 23, 2013 12:31 pm > Subject: [Sepsis Groups] EPIC facilities and ED Sepsis > Hello, > > This question is for Epic hospitals. I was wondering if any you have a > validated and reliable Epic built solution for early recognition of sepsis in > the ED. We are open to any solution that is Epic-based. We want a solution > that pulls the data (vitals, complaint, labs) and alerts of a sepsis risk > and allows the staff to easily use the sepsis protocol (a direct link to an > orderset). We are open to any other ideas as well. Your feedback would be > greatly appreciated. > > Thanks, > > Ryan Luginbuhl RT(R), BS > Six Sigma Black Belt | Process Improvement > OSF Saint Francis Medical Center > www.osfsaintfrancis.org<https://owa.osfhealthcare.org/owa/redir.aspx?C=c43N-PDc7kaFMnRQlHCcYipj0FJ8hc8IkrC_p1D1vQYHG5RbKolwAcwIpYCqS51mTzc2RyOjBXc.&URL=http%3a%2f%2fwww.osfsaintfrancis.org%2f> > > "Serving With the Greatest Care and Love" > > ==================== > The information in this message is confidential and may be legally > privileged. Access to this message by anyone other than the addressee is not > authorized. If you are not the intended recipient, or an agent of the > intended recipient, any disclosure, copying, or distribution of the message > or any action or omission taken by you in reliance on it, is prohibited and > may be unlawful. If you have received this message in error, please contact > the sender immediately and permanently delete the original e-mail, > attachment(s), and any copies. > ==================== > > _______________________________________________ > > Sepsisgroups mailing list > > [email protected]<mailto:[email protected]> > > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > This electronic mail and any attached documents are intended solely for the > named addressee(s) and contain confidential information. If you are not an > addressee, or responsible for delivering this email to an addressee, you have > received this email in error and are notified that reading, copying, or > disclosing this email is prohibited. 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