Having an alert for SIRS without an infection in the problem list or a culture 
in progress will give you a huge volume of BPAs
Second, we also used 'currently being treated for sepsis' as a response for the 
RN, however it causes some misses for patients who have simple sepsis who 
convert to SEVERE SEPSIS.
If this occurs, the RN is correct to respond already being treated for sepsis, 
but perhaps the response should be more granular so as not to miss the 
progression of disease when an organ failure occurs, provided of course that 
you have that parameter in an alert.

Thanks,

MARY ANN BARNES-DALY RN BSN CCRN DC  | Clinical Performance Improvement 
Consultant
Sutter Health - Clinical Integration Department | 2200 River Plaza Drive, 
Sacramento, CA 95833
Mobile 916.200.5604| Office 916.286.6717  | [email protected]

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Alverson, Verna
Sent: Thursday, October 02, 2014 12:29 PM
To: [email protected]
Subject: Re: [Sepsis Groups] Sepsis EMR Notification

We are currently developing an electronic notification (best practice alert) as 
well for the EMR- EPIC that we have. We are utilizing  2 SIRS criteria [we are 
just in the testing phase (firing behind the scenes) to see if it is firing 
appropriately for the criteria we have set up and adjusting the parameters due 
to the frequency it is firing, etc]. Currently we elected it to fire to nurses 
and nurse aide/patient care techs.
If it fires for nurse aide/PCT we have the verbiage: (not sure if this will be 
the final)
! Patient is displaying signs of "Systemic Inflammatory Response" (SIRS). 
Reassess: Vitals (including SpO2 and increased oxygen requirements) LOC. Notify 
primary nurse to further evaluate patient.
It pulls in the patients vitals in the last 24 hours with date and time: 
9/15/2014, Temp: 39.4 C (103F), Pulse 100
Acknowledge reason: drop down box for them to select and a button to click 
"primary nurse notified"
If fires to the nurse we have similar verbiage with it stating also: to 
reassess the patient. If this patient has changed clinically, notify provider 
and/or rapid response team.
Again this not final.
We have not determined what satisfies the BPA for the nurse yet and for how low 
the  alert is satisfied for... any input would be appreciated.
    Couple satisfiers we have come up with- provider notified
                                                                                
      - immediate post op patient/trauma patient
                                                                                
      - currently treating for sepsis
Any lessons learned that we should avoid trying would also we appreciated.

Verna Alverson
Inpatient Clinical Quality Analyst
Essentia Health-SU/SSC Department
Quality Department
1702 South University Drive
Fargo ND 58103-4940
P:701-364-3210
 verna.alverson@essentiahealth<mailto:verna.alverson@essentiahealth>.org


From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Jessica Wonderly
Sent: Thursday, October 02, 2014 8:41 AM
To: 
[email protected]<mailto:[email protected]>
Subject: [Sepsis Groups] EMR Notification

We are currently in development of an electronic notification via the EMR when 
a patient exhibits 2 SIRS criteria. This has presented a huge challenge for us 
as we currently utilize openvista. I would like to reach out to any cerner or 
epic users about how the notifications are structured.

Jessica Wonderly, RN
Special Projects:
DSRIP Sepsis/CLABSI Facilitator
Hospital Staff Nurse II
Kern Medical Center
Phone: (661) 326-5637
Pager: (661) 307-1098
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