Hello, 

If infection/suspect infection is already established however the patient does 
not meet criteria until 8 hours after documentation of infection (SIRS + Organ 
Dysfunction) do we have to tie in the infection documentation again within 6 
hours or is it already assumed since infection has been documented/confirmed 
before the vital signs/abnormal lab values. 

For Example: Patient presents to ED with Fever 09:00 and Chest X-Ray shows 
Pneumonia subsequently documented by ED at 9:30 no other abnormal labs or 
vitals. 16:00 Fever Persists, HR elevated, Lab work shows 16:20 lactate = 2.1 
and progress note 21:00 with documented interventions for PN. Do we have to tie 
the infection documentation timing back into the evaluation or because Patient 
already noted to have PN by ED at 9:30 that counts as 1 of the three criterion 
and 16:20 = Time Zero. Or do we account for all three criterion and 21:00 is 
new time zero as all three criterion within 6 hours of each other. 

Cindy

Cynthia Wells
Steward Health Care
Director of Clinical Performance Analytics
(508) 404-8647 

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