We have EPIC as our EHR and have developed a smart phrase for the scribe/MD to put in the chart called .sepsisalert that includes a time stamp, VS, SIRS criteria, signs of end organ failure, plan of care, When the sepsisalert is called overhead, they can insert it in the note (but fill out rest later).
Karin Molander MD Mills-Peninsula Hospital Sutter On Sun, Oct 18, 2015 at 7:32 AM, Townsend, Sean, M.D. < [email protected]> wrote: > Yes, you need to look at all notes from nursing as well. Simply relying > on md documentation will be too late. > > On Oct 18, 2015, at 7:08 AM, Karen Young <[email protected] > <mailto:[email protected]>> wrote: > > Please share what data source your organization is using for a date/time > stamp for suspicion of clinical source of infection. Are you using an RN > progress note time? How specific about suspicion are you requiring in > documentation? Have you standardized the question to a yes or no? > > Our ED physicians say their Note Time does not reflect suspicion time as a > Severe Sepsis criteria fulfilled, because progress notes are opened before > labs are resulted or exams performed. File Time of the note is several > hours after the care is delivered and using that time admittedly would not > drive early treatment. > From where are you taking a date/time stamp for physician diagnosis or > suspicion? > > Karen Young RN CPHQ > QI Specialist > Valley Medical Center > Renton WA 98055 > 425-228-3440 ext 5963 > [email protected]<mailto:[email protected]> > > > DISCLAIMER: This message is confidential, intended only for the named > recipient(s) 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 > information is strictly prohibited. If you received this message in error, > please notify the sender then delete this message. > > > _______________________________________________ > Sepsisgroups mailing list > [email protected]<mailto: > [email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > -- Karin H. Molander
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