OK - I know personally how important a re-assessment is but I am trying to
clarify what CMS is requiring.
According to the NQF SEP -1-2 it makes it sound like repeat volume assessment
and tissue perfusion is only necessary for the "persistent hypotensive" pt
"and only if hypotension persists after fluid administration, received within 6
hours of presentation of septic shock;
*Vasopressors (I know we would only give these for persistent
hypotension)
*Repeat volume status and tissue perfusion assessment.......
I know that a lactic acid level > or = to 4 constitutes shock as well. - are
they NOT including these patients in this requirement? In the individual
element guidelines it states for septic shock without persistent hypotension
statement. I believe we should be doing this for ALL septic shock pts but this
is not spelled out like that in the NQF as listed above.
Am I missing something here or is this written incorrectly?
Angela Craig APN,MS,CCNS
Clinical Nurse Specialist
Intensive Care Unit
Cookeville Regional Medical Center
931-783-5035
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