Hi Dr. Townsend,

I have a concern over a group of pts that do not receive a broad spectrum or 
appropriate combo therapy for severe sepsis but will NOT fail the measure 
because they received an antibiotic w/in the 24 hr preceding the severe sepsis 
presentation time. For example, pt diagnosed with 'sepsis' 2 cellulitis; Clinda 
1645, Vanco 1904. Then, lactate reported later at 17:24 (level 2.2), thus, 
clinically met criteria for Severe Sepsis at 1724. Because the Clinda was given 
at 1645, I believe, this makes this case's antibiotic selection(s) an EXCLUSION 
from the broad spectrum SELECTION (antibiotics were given in the 24 hours 
BEFORE presentation). I was ready to count it as fail and give feedback to 
provider, but it's NOT failing. Are all pts who receive antibiotics for 
"sepsis" (received prior to severe sepsis presentation) going to be excluded 
from the SEP-1 antibiotic SELECTION?

Jennifer Halligan, RN
Quality Review Nurse
San Joaquin General Hospital
Tel: 209-468-7471
Fax: 209-468-7011

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