Mary Ann,
Thank you for this. Did they speak about the parameters changing or just taking
3 of what the SSC guidelines have now?
Thank you,
Amy
Amy L. Sprague MSN, RN, ACNS-BC, CCRN
Clinical Nurse Specialist~Critical Care
Franciscan St. Francis Health
8111 S. Emerson Avenue
Indianapolis, IN 46237
Office (317)528-6800
[email protected]
“Work for a cause, not for applause.
Live life to express, not to impress.
Don’t strive to make your presence noticed,
just make your absence felt.”
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of William Haik
Sent: Wednesday, January 21, 2015 8:32 AM
To: Barnes-Daly, Mary Ann
Cc: [email protected]
Subject: Re: [Sepsis Groups] SIRS/Sepsis Criteria and Coding
Thank you, Mary Ann.
Sounds like we are finally getting somewhere.
William E. Haik, M.D., F.C.C.P., C.D.I.P.
AHIMA Approved ICD-10-CM/PCS Trainer
Office: (850) 863-2110<tel:(850)%20863-2110>
Cell: (850) 803-5854<tel:(850)%20803-5854>
Fax: (850) 864-4438<tel:(850)%20864-4438>
On Jan 21, 2015, at 5:53 AM, Barnes-Daly, Mary Ann
<[email protected]<mailto:[email protected]>> wrote:
At the SCCM congress on Monday it was revealed that new criteria for the
screening and dx of sepsis were to be released in October. The somewhat
arbitrary use of SIRS criteria will be replaced with indicators that have been
identified by a retrospective analysis of large databases - "the new 3". Stay
tuned.
Sent from my Android phone using TouchDown
(www.nitrodesk.com<http://www.nitrodesk.com>)
-----Original Message-----
From: William Haik [[email protected]<mailto:[email protected]>]
Received: Wednesday, 21 Jan 2015, 1:10AM
To: Malik,Imrana [[email protected]<mailto:[email protected]>]
CC:
[email protected]<mailto:[email protected]>
[[email protected]<mailto:[email protected]>]
Subject: Re: [Sepsis Groups] SIRS/Sepsis Criteria and Coding
There is no literature that I am aware of that parses the sirs criteria however
what you say does make sense and is what I actually do in defining sepsis
William E. Haik, M.D., F.C.C.P., C.D.I.P.
AHIMA Approved ICD-10-CM/PCS Trainer
Office: (850) 863-2110<tel:(850)%20863-2110>
Cell: (850) 803-5854<tel:(850)%20803-5854>
Fax: (850) 864-4438<tel:(850)%20864-4438>
On Jan 17, 2015, at 12:50 PM, Malik,Imrana
<[email protected]<mailto:[email protected]><mailto:[email protected]>>
wrote:
SIRS criteria is only met if 2 out of the 4 are positive, of which one MUST be
a derangement in Temp or WBC. So tachycardia with tachypnea alone should not be
considered positive. Hope that helps.
________________________________
From: Sepsisgroups
[[email protected]<mailto:[email protected]><mailto:[email protected]>]
on behalf of Orth, Claudia
[[email protected]<mailto:[email protected]><mailto:[email protected]>]
Sent: Tuesday, January 13, 2015 2:00 PM
To:
[email protected]<mailto:[email protected]><mailto:[email protected]>
Subject: [Sepsis Groups] SIRS/Sepsis Criteria and Coding
I am writing to inquire how other institutions are handling or if you are even
encountering concerns, that we are “over-calling” early sepsis, especially
when the only SIRS criteria are tachycardia and tachypnea (sometimes only a
single set of VS). We are reviewing all short stay (Observation, 1-2 day stays)
and see “septic” patients who are “in no acute distress”, are only here in
Observation status and never Inpatient, or stay as IP only 1-2 days, are not
sent home on any antibiotics or only a short course of oral antibiotics.
Often their only SIRS criteria are tachycardia and tachypnea—which are quite
non-specific markers that can be seen with anxiety, pain, etc. but when paired
with a suspected or documented infection role up to Sepsis?!
Since Sepsis is a high-paying condition it’s also a high audit DRG (mainly
because, in the past, many patients were in ICU, very ill, and expending lots
of resources). Now that “early sepsis” is being diagnosed quite frequently,
external auditors are reviewing sepsis DRG charts, and disagree that sepsis
was present at all, recode the chart, reassign the DRG and reduce payment to
UTI, pneumonia, etc. This is so frustrating as we are trying to educated our
providers and nurses on the importance of having a high suspicion for sepsis
and early recognition and now are turning around and saying don’t say ‘Sepsis’
unless they are “sick” because we need to be able to defend it!? ☹
Any feedback, thoughts, or tools on how other institutions are handling this,
would be greatly appreciated especially when it comes to the SIRS criteria
which most of our clinicians call “soft criteria”?
Thank you in advance for your time and expertise!
Claudia
Claudia Orth BSN, RN, CCRN-K
Regional Sepsis Coordinator
Munson Medical Center
(231) 935-5692 (Voice)
[email protected]<mailto:[email protected]><mailto:[email protected]>
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