Good morning all, I'm getting up to speed on sepsis. Can anyone provide the August 22, 2014 CMS announcement of the bundle delay and any follow on CMS traffic? I've seen secondary references to the delay and indirect references on conference call transcripts from the CMS contractor. For my records I'd like the primary source and haven't been able to find it on the CMS site. Please reply or direct if you can help.
Thanks! jy John Young, MBA, RN | Improvement Coach America’s Essential Hospitals 1301 Pennsylvania Avenue, NW, Suite 950 Washington, DC 20004 202.585.0136 telephone | 202.585.0101 fax [email protected] | www.essentialhospitals.org Advance your hospital and your career at VITAL2015. Register now to join us June 24-26, in San Diego. Follow us on Facebook and Twitter. ________________________________________ From: Sepsisgroups <[email protected]> on behalf of [email protected] <[email protected]> Sent: Thursday, June 4, 2015 3:11 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 159, Issue 12 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: Sepsisgroups - Core Measure - ED and IP? (Izard, Kimberly) 2. fluid bolus methodology (Dierks, Patricia) ---------------------------------------------------------------------- Message: 1 Date: Tue, 2 Jun 2015 21:03:57 +0000 From: "Izard, Kimberly" <[email protected]> To: Beth Leffard <[email protected]>, "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Sepsisgroups - Core Measure - ED and IP? Message-ID: <[email protected]> Content-Type: text/plain; charset="iso-8859-1" Beth, You are correct. It applies to ED patients/direct admits. And those that develop sepsis during the stay. Thank you, Kim Kim Izard, BS, RN Supervisor Clinical Outcomes/Core Measures SSM Health - St. Louis Network 1015 Corporate Square Drive Suite 240 Creve Coeur, MO 63132 Office - 314-989-2137 Cell - 618-670-3616 [email protected] "Change is a challenge and an opportunity; not a threat" -Prince Phillip of England This e-mail message is confidential, intended only for the named recipient(s) above and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s) please notify the sender at the e-mail address or telephone number above and delete this e-mail from your computer. Thank you! -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Beth Leffard Sent: Friday, May 29, 2015 9:43 AM To: [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups - Core Measure - ED and IP? For someone further along in Sepsis Core Measure prep than me: My first impression from reading the CMS guidelines was that this measure would only apply to ED patients or direct admits (not transfer from ACF), but upon further reading, it appears it will apply to inpatients who develop sepsis during the stay. Is that correct? Does the CMS Sepsis Core Measure apply to both ED pts and IPs with sepsis not present on admission? Thank you. Beth Beth Leffard, MSN, RN - Assistant Director of Quality Management University of South Alabama Medical Center 2451 Fillingim St. Mobile, AL 36617 Office 251-471-7210 / Fax 251-445-9118 email [email protected] THIS TRANSMISSION CONTAINS CONFIDENTIAL HEALTH INFORMATION THAT IS LEGALLY PROTECTED. AS THE RECIPIENT OF THIS TRANSMISSION, YOU ARE OBLIGATED TO MAINTAIN IT IN A SAFE AND CONFIDENTIAL MANNER. UNAUTHORIZED RE-DISCLOSURE OR A FAILURE TO MAINTAIN THE CONFIDENTIALITY OF THE INFORMATION CONTAINED HEREIN COULD SUBJECT YOU TO PENALTIES UNDER STATE AND FEDERAL LAW. -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Friday, May 29, 2015 7:33 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 158, Issue 11 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: CMS Guidelines ([email protected]) ---------------------------------------------------------------------- Message: 1 Date: Thu, 28 May 2015 16:02:43 +0000 From: <[email protected]> To: <[email protected]>, <[email protected]> Subject: Re: [Sepsis Groups] CMS Guidelines Message-ID: <1629a24ac5c93b429687ace36144bb2905ffa...@xrdcwpmsghcmd2a.hca.corpad.net> Content-Type: text/plain; charset="us-ascii" Notice that the guidelines state reassessment "by a licensed independent practitioner"....RNs do not qualify for that position because we are not independent. Docs, PAs, ARNPs is what I believe they are saying it has to be. I truly believe an RN could do those things so I am unclear as to why they chose that title to do that reassessment. Any input on that .....or did we interpret it incorrectly? From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Wednesday, May 27, 2015 3:25 PM To: [email protected] Subject: [EXTERNAL] [Sepsis Groups] CMS Guidelines So, I've read through the new CMS Guidelines and it states that a repeat assessment must be completed within 6 hrs with either a focused exam (including VS, cardiopulmonary exam, cap refill, peripheral pulse eval and skin exam) or any two of the four: CVP, SV02, bedside cardiovascular ultrasound, passive leg raise or fluid challenge. At our hospital, we have the "shift evaluation" and "shift re-evaluation." If the nurse documents the "shift re-evaluation" they are basically saying nothing has changed since the last evaluation. I'm wondering if that will suffice, or if they actually have to do another complete head-to-toe assessment. Any thoughts?? Thanks, Debbie Debbie Chambless, MSN, RN, ARNP-C Sepsis Coordinator Osceola Regional Medical Center Kissimmee, Fl 34741 Office: 407-518-3949 Cell: 772-807-0525 ~~Recognizing sepsis as a global enemy. Hoping for global unity in finding a solution~~ [cid:[email protected]] -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150528/957e9c96/attachment.htm> -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 18061 bytes Desc: image001.jpg URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150528/957e9c96/attachment.jpg> ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 158, Issue 11 ********************************************* ________________________________ This transmission may contain confidential health information that is legally protected. As the recipient of this transmission, you are obligated to maintain it in a safe and confidential manner. Unauthorized re-disclosure or a failure to maintain the confidentiality of the information contained herein could subject you to penalties under State and Federal Law. If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, the reader is hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please notify sender immediately. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ________________________________ Confidentiality Notice: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. ------------------------------ Message: 2 Date: Tue, 2 Jun 2015 18:06:29 +0000 From: "Dierks, Patricia" <[email protected]> To: "'[email protected]'" <[email protected]> Subject: [Sepsis Groups] fluid bolus methodology Message-ID: <[email protected]> Content-Type: text/plain; charset="utf-8" Maureen, We give our fluid boluses with a 1 liter pressure bag to infuse them quickly. 1 liter can be infused in 15-20 minutes with this method. Patricia Dierks, MS, RN, CCRN Advanced Practice Partner, ICU/IMCU Department of Professional Practice Delnor Hospital 300 Randall Road Geneva, IL 60134 630-938-8169 office [email protected] nm.org cadencehealth.org ? -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Tuesday, June 02, 2015 11:46 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 159, Issue 5 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. CMS Data Element - Organ dysfunction (Adams, Martina) 2. Re: Sepsisgroups - Core Measure - ED and IP? (Beth Leffard) 3. IV bolus methodology (Seckel, Maureen) ---------------------------------------------------------------------- Message: 1 Date: Sat, 30 May 2015 19:26:53 +0000 From: "Adams, Martina" <[email protected]> To: "'[email protected]'" <[email protected]> Subject: [Sepsis Groups] CMS Data Element - Organ dysfunction Message-ID: <20a26800a971b242b0e37c68b00515b8e77eb...@fchexmbp06.fm.frd.fmlh.edu> Content-Type: text/plain; charset="us-ascii" On reviewing version 5.0 CMS data element organ dysfunction criteria, there are no respiratory or AMS criteria listed. In our experience septic inpatients are frequently identified as having severe sepsis based on meeting 2 SIRS criteria and having increasing oxygen needs, decreasing SpO2, or acutely altered mental status, and are transferred to the ICU before they decompensate further. Can anyone speak to why these criteria were eliminated, and will they be kept in your hospital's screening protocol? Thanks, Martina Martina Adams, BS, RN, CCRN, FCCS Rapid Response Team Pager: 414-590-5907 [email protected]<mailto:[email protected]> Froedtert & the Medical College of Wisconsin 9200 W. Wisconsin Avenue Milwaukee, WI 53226 froedtert.com Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150530/bb7171c6/attachment-0001.htm> ------------------------------ Message: 2 Date: Fri, 29 May 2015 14:42:33 +0000 From: Beth Leffard <[email protected]> To: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Sepsisgroups - Core Measure - ED and IP? Message-ID: <9053864F768506498E5E01DE0F8AC253023C0C94@JANDC200-MBN01.usahealth.local> Content-Type: text/plain; charset="us-ascii" For someone further along in Sepsis Core Measure prep than me: My first impression from reading the CMS guidelines was that this measure would only apply to ED patients or direct admits (not transfer from ACF), but upon further reading, it appears it will apply to inpatients who develop sepsis during the stay. Is that correct? Does the CMS Sepsis Core Measure apply to both ED pts and IPs with sepsis not present on admission? Thank you. Beth Beth Leffard, MSN, RN - Assistant Director of Quality Management University of South Alabama Medical Center 2451 Fillingim St. Mobile, AL 36617 Office 251-471-7210 / Fax 251-445-9118 email [email protected] THIS TRANSMISSION CONTAINS CONFIDENTIAL HEALTH INFORMATION THAT IS LEGALLY PROTECTED. AS THE RECIPIENT OF THIS TRANSMISSION, YOU ARE OBLIGATED TO MAINTAIN IT IN A SAFE AND CONFIDENTIAL MANNER. UNAUTHORIZED RE-DISCLOSURE OR A FAILURE TO MAINTAIN THE CONFIDENTIALITY OF THE INFORMATION CONTAINED HEREIN COULD SUBJECT YOU TO PENALTIES UNDER STATE AND FEDERAL LAW. -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Friday, May 29, 2015 7:33 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 158, Issue 11 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: CMS Guidelines ([email protected]) ---------------------------------------------------------------------- Message: 1 Date: Thu, 28 May 2015 16:02:43 +0000 From: <[email protected]> To: <[email protected]>, <[email protected]> Subject: Re: [Sepsis Groups] CMS Guidelines Message-ID: <1629a24ac5c93b429687ace36144bb2905ffa...@xrdcwpmsghcmd2a.hca.corpad.net> Content-Type: text/plain; charset="us-ascii" Notice that the guidelines state reassessment "by a licensed independent practitioner"....RNs do not qualify for that position because we are not independent. Docs, PAs, ARNPs is what I believe they are saying it has to be. I truly believe an RN could do those things so I am unclear as to why they chose that title to do that reassessment. Any input on that .....or did we interpret it incorrectly? From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Wednesday, May 27, 2015 3:25 PM To: [email protected] Subject: [EXTERNAL] [Sepsis Groups] CMS Guidelines So, I've read through the new CMS Guidelines and it states that a repeat assessment must be completed within 6 hrs with either a focused exam (including VS, cardiopulmonary exam, cap refill, peripheral pulse eval and skin exam) or any two of the four: CVP, SV02, bedside cardiovascular ultrasound, passive leg raise or fluid challenge. At our hospital, we have the "shift evaluation" and "shift re-evaluation." If the nurse documents the "shift re-evaluation" they are basically saying nothing has changed since the last evaluation. I'm wondering if that will suffice, or if they actually have to do another complete head-to-toe assessment. Any thoughts?? Thanks, Debbie Debbie Chambless, MSN, RN, ARNP-C Sepsis Coordinator Osceola Regional Medical Center Kissimmee, Fl 34741 Office: 407-518-3949 Cell: 772-807-0525 ~~Recognizing sepsis as a global enemy. Hoping for global unity in finding a solution~~ [cid:[email protected]] -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150528/957e9c96/attachment.htm> -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 18061 bytes Desc: image001.jpg URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150528/957e9c96/attachment.jpg> ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 158, Issue 11 ********************************************* ________________________________ This transmission may contain confidential health information that is legally protected. As the recipient of this transmission, you are obligated to maintain it in a safe and confidential manner. Unauthorized re-disclosure or a failure to maintain the confidentiality of the information contained herein could subject you to penalties under State and Federal Law. If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, the reader is hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please notify sender immediately. ------------------------------ Message: 3 Date: Tue, 2 Jun 2015 10:46:49 +0000 From: "Seckel, Maureen" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] IV bolus methodology Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" Hi to all, I can't find any literature to support the best or any methodology for administering fluid boluses. There is a lot of variation; most IV pumps only give 999/hr, some RNs give via gravity, and some use a pressure bag. As we give large volumes for sepsis volume resuscitation in short amounts of time, what do you do in your facility and is there any literature regarding the safest method? Thanks, Maureen A. Seckel, APN, ACNS-BC, CCNS, CCRN, FCCM Lead CNS Medical Pulmonary Critical Care Sepsis Coordinator Christiana Care Health System 4755 Ogletown-Stanton Road 3E29 Newark, DE 19718 Office 302 733-6023 -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150602/a3201883/attachment.htm> ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 159, Issue 5 ******************************************** ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 159, Issue 12 ********************************************* _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
