At West Suburban we admit severe sepsis to the step down unit where
nurses are trained to monitor for severe sepsis progression. We do not
admit to ICU unless patient does not respond to 3 hour bundle, requiring
vasopressors. As long as the unit admitting severe sepsis is trained and
has a defined process for screening and triggering intervention,
mortality will be reduced without taking an ICU bed. Now that our MS
tele units are screening for severe sepsis consistently, we are not
seeing acute care progression to septic shock. Only shock in the ICU is
coming from ED.
Nutshell- teach severe sepsis progression and define screening process
and response to positive screen, and patients without signs of shock can
be managed outside of ICU. We're 7 years into our program. It takes time
to hardwire the process.
Patty
From: Sepsisgroups [mailto:[email protected]]
On Behalf Of Barnes-Daly, Mary Ann
Sent: Monday, December 22, 2014 2:50 PM
To: 'Brown, Sheree'; '[email protected]'
Subject: Re: [Sepsis Groups] ICU Admission for All Severe Sepsis?
Yes, at Sutter Health we have done this at some of our affiliates with a
resultant reduction in mortality
We are now piloting some Standard Work that includes this as well as
admitting SEVERE SEPSIS patients with co-morbidities to a 'higher level
of care'. This looks like tele with frequent VS, lactate monitoring and
RRT/Sepsis alert for progression of sepsis or worsening of condition
The goal is for this Standard Work to be implemented system wide (25
acute care hospitals).
The challenge comes when ICU beds are tied up with 'real' critical care
patients.
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 Brown, Sheree
Sent: Monday, December 22, 2014 7:19 AM
To: '[email protected]'
Subject: [Sepsis Groups] ICU Admission for All Severe Sepsis?
We are going to initiate a new protocol whereby all patients with
suspected severe sepsis (with or without shock) will be expedited to the
ICU for admission.
We hope to reduce ED length of stay and prevent the progression of
sepsis that occurs due to inadequate treatment and/ or inadequate
monitoring. We believe this will help prevent the urgent transfers to
ICU when these patients have rapid deterioration on the floor. We
anticipate a short ICU stay for most of these patients.
Have any of you tried an aggressive approach such as this? Was it
successful? Obviously we have a lot of push-back from the intensivists.
Most of these patients aren't the typical ICU patient - i.e.,
non-ventilated, normotensive, etc.
Thanks,
Sheree
Sheree Brown MSN, RN, CNL
Manager, Performance Excellence
Phone: 517 788-4800 ext. 4209
Pager: 517 534-0127
Fax: 517 788-4715
[email protected]
________________________________
This e-mail message and any attachment(s) is intended only for the
individual(s) to whom it is addressed and may contain information that
is privileged, confidential or proprietary in nature. Any unauthorized
disclosure, copying or distribution of this e-mail or the content of
this message is prohibited. If you have received this e-mail message in
error, please immediately notify the sender at the e-mail address above,
permanently delete this e-mail and destroy any copies of this e-mail and
attachments in your possession. This electronic message ("e-mail"),
including the typed name of the sender, does not constitute an
electronic signature unless there is a specific statement to the
contrary included in this e-mail.
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._______________________________________________
Sepsisgroups mailing list
[email protected]
http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
