Hello,

I would like to ask a question related to the infusion rate of 
Piperacillin/Tazobactam in patients with severe sepsis and septic shock.  I am 
aware of some studies that indicate reduced clinical failure rates and reduced 
ICU length of stay when extended infusions of Zosyn are employed.  I cannot 
find any data on the optimal infusion rate of the first dose of Zosyn in 
patients with severe sepsis or septic shock.  My question is should the first 
dose of Zosyn be infused over 30 minutes with subsequent doses infused at the 
extended infusion rate?  Thank-you.


Jeanie Bollinger MSN,RN,ACCNS-AG, CCRN
Sepsis Clinical Nurse Specialist
Nursing Department of Excellence
Mission Health
Asheville, NC

Phone: 828-213-5878
Beeper: 828-207-2363



-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
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Sent: Saturday, March 28, 2015 3:08 PM
To: [email protected]
Subject: Sepsisgroups Digest, Vol 149, Issue 7

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Today's Topics:

   1. Re: ProMISE study (Coopersmith, Craig)
   2. Re: CMS Quality Measure Submission October 2015 (Joyce Stout)


----------------------------------------------------------------------

Message: 1
Date: Fri, 27 Mar 2015 03:02:31 +0000
From: "Coopersmith, Craig" <[email protected]>
To: "'[email protected]'"
        <[email protected]>,
        "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] ProMISE study
Message-ID:
        
<444ac11a8afd6c43b47714d2aea272e9010ef0b...@e14mbx14n.enterprise.emory.net>
        
Content-Type: text/plain; charset="us-ascii"

Revised statement is available on the SSC website here:
http://www.survivingsepsis.org/Guidelines/Pages/default.aspx


Craig Coopersmith, MD, FACS, FCCM
Professor of Surgery
Director, 5E Surgical Intensive Care Unit Associate Director, Emory Critical 
Care Center Vice Chair for Research, Department of Surgery Emory University 
School of Medicine Atlanta, GA [email protected]
Phone: (404) 727-4273
Fax: (404) 727-3660

President, Society of Critical Care Medicine


-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of [email protected]
Sent: Thursday, March 26, 2015 9:27 AM
To: [email protected]
Subject: [Sepsis Groups] ProMISE study

So the last of the 3 studies designed to test EGDT has been published.  
(ProMISE). This study along with the ARISE, and ProCESS have concluded that 
EGDT has no mortality benefit over usual or standard care.   Does anyone know 
if Surviving Sepsis Campaign is going to put out a statement or are there going 
to be any changes to the guidelines?? I appreciate your input.

Chelsea Bibelhauser RN, BSN
Sepsis Coordinator
Clark Memorial Hospital
1220 Missouri Ave
Jeffersonville, IN 47130
812-283-2880


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Message: 2
Date: Fri, 27 Mar 2015 19:07:55 +0000
From: Joyce Stout <[email protected]>
To: Karen Young <[email protected]>,
        "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] CMS Quality Measure Submission October
        2015
Message-ID:
        
<cy1pr0501mb11954d4e6919c1bafcf84dcef7...@cy1pr0501mb1195.namprd05.prod.outlook.com>
        
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Hi,
We are just starting to use the SSC data base to collect retrospective data.  I 
have not been able to find in the resource guide for the SSC which diagnostic 
codes should be used.  Could anyone please share which codes they are using if 
they are doing retrospective data  collection from administrative data?
Thanks very much,
Joyce Stout

Joyce Stout,RN, MPA, NE-BC
Department of Performance Improvement
215 955-2589
[email protected]





-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Karen Young
Sent: Thursday, March 26, 2015 3:57 PM
To: [email protected]
Subject: [Sepsis Groups] CMS Quality Measure Submission October 2015

Yes, we've heard the same, at a Sepsis Symposium this month where one of the 
CMS measure writers who spoke on the topic indicated the CMS data collection is 
set to start this October.
I've asked FAQs at QNet earlier this month if we could get the specs any sooner 
than April 1-- the answer was yes, Specs are published on April 1 and no, you 
can't get them sooner.
I anticipate we'll need some build in our electronic record to support the data 
collection and our reporting needs.

The speaker said  measures are focused on 3-hour Sepsis bundle compliance and a 
medical re-evaluation of fluid responsiveness in the 3-6 hour period, which can 
be done in a number of different ways to meet the standard.

Data definitions will be crucial to understanding the measured population, as 
well as how "present on admission" fits into the picture;  those are my 
preliminary assumptions to be verified when the Spec Manual comes out April 1st.
I've alerted my IT department and ED department to expect work to be needed on 
the EHR; we'll be meeting as soon as the Spec Manual is published.
I'm also learning more about coding rules for Severe Sepsis/Septic Shock to 
prepare.

There will probably be value in continuing to collect some additional data 
points beyond the CMS measures, however that is achieved at one's organization.

Karen Young RN CPHQ
QI Specialist-Sepsis
Valley Medical Center
Renton WA 98055
425-228-3440 ext 5963
[email protected]






Today's Topics:

   1. CMS -Severe Sepsis & Septic Shock Management Bundle
      (Orth, Claudia)


----------------------------------------------------------------------

Message: 1
Date: Wed, 25 Mar 2015 19:15:09 +0000
From: "Orth, Claudia" <[email protected]>
To: "[email protected]"
        <[email protected]>
Subject: [Sepsis Groups] CMS -Severe Sepsis & Septic Shock Management
        Bundle
Message-ID:
        <b482f481b7b4d745be676ceff55ec9405168e...@mmc-exchmbs03.ad.mhc.net>
Content-Type: text/plain; charset="us-ascii"

Good Afternoon,

I was just informed by a colleague that they were told during a Quantros 
webinar today, which is the software solution we currently use to submit Core 
Measures, that the Severe Sepsis and Septic Shock Management Bundle will be 
required by CMS effective October 1, 2015 discharges and that they are planning 
to release the spec manual on April 1, 2015.

Has anyone else heard about this and what steps are other institutions taking 
to prepare for this? Also, are you planning, if you currently do so, to 
continue submitting data to the SSC database and then also using whatever 
software you currently use to submit the CMS measures?

Any thoughts and feedback would be greatly appreciated! Thank you in advance 
for your time and willingness to share!

Respectfully,
Claudia

Claudia Orth BSN, RN, CCRN-K
Regional Sepsis Coordinator
Munson Medical Center
(231) 935-5692 (Voice)
[email protected]<mailto:[email protected]>

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