Excellent question.
 
  First: The SEP -1 bundle requires that to enter it you must  have " 2 + 
1" due to infection with the word sepsis in the documentation being  enough 
to satisfy the "infection" part of the bundle.
 
  Second: Although Lactate levels > 2 mmol/L are  not part of the SOFA 
score ( Sepsis 3), it is evidence of organ  dysfunction in  SEP-1 bundle
 
  Third:  P/F ratios were left out of SEP -1 bundle defining  organ 
dysfunction, (but will  be added with the next update), they are  part of 
Sepsis 3 
definition SOFA score.
 
  Finally:  In regards to septic shock,  with SEP 1 bundle  has evidence of 
hypoperfusion that persist despite fluid administration as  evidenced by 
blood pressure parameters OR lactate level  > 4 mmol/L in a patient with 
documented severe sepsis, where Sepsis 3  definition requires both with 
different 
lactate levels (>2  mmo/L) and requiring vasopressors.
 
To make matters worse as stated earlier, the RACs will apply sepsis 3  
definition to non traditional Medicare
 
Get ready to "Rock and Roll"
 
William E.  Haik, M.D., F.C.C.P., C.D.I.P.
AHIMA Approved ICD-10-CM/PCS  Trainer
Office: _(850) 863-2110_ (tel:(850)%20863-2110) 
Cell: _(850) 803-5854_ (tel:(850)%20803-5854) 
Fax: (850) 864-4438  

 
In a message dated 6/14/2016 11:12:03 A.M. Central Daylight Time,  
[email protected] writes:

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Today's Topics:

1. Re: qSOFA  (Kramer, George C.)
2. Re: qSOFA (Muhr, Lori)
3. Re: Sepsisgroups Digest, Vol 208, Issue 13 (phoebe  atieno)


----------------------------------------------------------------------

Message:  1
Date: Sat, 11 Jun 2016 10:56:16 +0000
From: "Kramer, George C."  <[email protected]>
To: "Thompson, Tyra"  <[email protected]>
Cc: "Mileski, William"  <[email protected]>,
"[email protected]"
<[email protected]>, "Enkhbaatar,     Perenlei"
<[email protected]>, "Fukuda, Satoshi"  <[email protected]>
Subject: Re: [Sepsis Groups] qSOFA
Message-ID:  <[email protected]>
Content-Type:  text/plain; charset="windows-1252"

Great question.

And do the  new SSC guidelines conflict with the CMS SEP-1 bundles in 
anyway??

My  sense is that all of this is getting more complicated with limited 
added value  for the some of the recent changes.

Please set me  straight.

George


George Kramer, PhD
Professor
Director  Resuscitation Research Lab
Dept. of Anesthesiology
UTMB,  Galveston
409-939-3040

On Jun 10, 2016, at 12:58 PM, Thompson, Tyra  
<[email protected]<mailto:[email protected]>>  wrote:

Greetings,

Have any facilities incorporated the new  Sepsis definition and guidelines 
into their practice and would you be willing  to share?

What were some of your ?first steps? in preparing for your  transition?

Tyra Thompson, RN
Quality Management  Specialist
Putnam Hospital Center
670 Stoneleigh Avenue l Carmel, NY  10512 l (845)279-5711 Extension  4027
[email protected]<mailto:[email protected]>
<image001.png>


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rg>
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Message:  2
Date: Mon, 13 Jun 2016 14:18:43 +0000
From: "Muhr, Lori"  <[email protected]>
To:  "[email protected]"
<[email protected]>
Subject: Re: [Sepsis Groups]  qSOFA
Message-ID:
<ac1acc651979404686489f99b6d022004f975...@da1exdb102.jpshealthnetwork.org>

Content-Type: text/plain; charset="us-ascii"

All

The  qSOFA is an un-validated screening tool in the hospital environment.  

It has not been tested in the inpatient environment in a RCT, a  
quasi-experimental trial, or even a side-by-side trial for screening Sepsis  
patients. 
 

It has been validated in one EMS community in the  Seattle area, as an 
assessment tool for prioritizing patients and run  levels.

CMS has chosen to stay with methods that have significant  research 
validity to maintain best practice in the care and treatment of the  Sepsis 
patient.

Further research needs to be done in both the ED and  inpatient areas to 
validate the use of SIRS, qSOFA, or a combination of these  two to develop a 
strong evidence based tool that can be used by healthcare  professionals in 
multiple environments.


Lori J. Muhr DNP, MHSM/MHA,  ACNS-BC, APRN-Rx, CCRN, CEN
Sepsis Program Manager
JPS Health  Network
Fort Worth, TX 


-----Original Message-----
From:  Sepsisgroups [mailto:[email protected]] On 
Behalf Of  [email protected]
Sent: Friday, June 10, 2016  4:39 PM
To: [email protected]
Subject: Sepsisgroups  Digest, Vol 208, Issue 13

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. qSOFA (Thompson,  Tyra)


----------------------------------------------------------------------

Message:  1
Date: Fri, 10 Jun 2016 17:58:20 +0000
From: "Thompson, Tyra"  <[email protected]>
To:  "[email protected]"
<[email protected]>
Subject: [Sepsis Groups]  qSOFA
Message-ID:  <2B4696B884D50A45852EC0101D3C088BDAAA7D3A@hqex2>
Content-Type:  text/plain; charset="iso-8859-1"

Greetings,

Have any facilities  incorporated the new Sepsis definition and guidelines 
into their practice and  would you be willing to share?

What were some of your "first steps" in  preparing for your transition?

Tyra Thompson, RN
Quality Management  Specialist
Putnam Hospital Center
670 Stoneleigh Avenue l Carmel, NY  10512 l (845)279-5711 Extension 4027 
[email protected]  [cid:[email protected]]



Health Quest has a secure  e-mail policy.

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and sensitive information, click the link  below.

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48e2492&type=1&p=0

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The information  contained in this e-mail is intended for the use of the 
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notify me immediately by  using your reply option to advise me of such error. 
Thank  you
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End  of Sepsisgroups Digest, Vol 208, Issue  13
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------------------------------

Message:  3
Date: Mon, 13 Jun 2016 11:05:31 +0000 (UTC)
From: phoebe atieno  <[email protected]>
To:  "[email protected]"
<[email protected]>
Subject: Re: [Sepsis Groups]  Sepsisgroups Digest, Vol 208, Issue 13
Message-ID:
<[email protected]>
Content-Type:  text/plain; charset="utf-8"

If CMS only accepts IV antibiotics, why is  Augumentin on the list for 
Monotherapy?

Sent from Yahoo Mail on Android  

On Fri, Jun 10, 2016 at 5:39 PM,  
[email protected]<[email protected]>
  wrote:   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. qSOFA (Thompson,  Tyra)


----------------------------------------------------------------------

Message:  1
Date: Fri, 10 Jun 2016 17:58:20 +0000
From: "Thompson, Tyra"  <[email protected]>
To:  "[email protected]"
???  <[email protected]>
Subject: [Sepsis Groups]  qSOFA
Message-ID:  <2B4696B884D50A45852EC0101D3C088BDAAA7D3A@hqex2>
Content-Type:  text/plain; charset="iso-8859-1"

Greetings,

Have any facilities  incorporated the new Sepsis definition and guidelines 
into their practice and  would you be willing to share?

What were some of your "first steps" in  preparing for your transition?

Tyra Thompson, RN
Quality Management  Specialist
Putnam Hospital Center
670 Stoneleigh Avenue l Carmel, NY  10512 l (845)279-5711 Extension  4027
[email protected]
[cid:[email protected]]



Health  Quest has a secure e-mail policy.

To learn more about this policy and  how to send and receive? confidential 
and sensitive information, click the  link  below.

http://userawareness.zixcorp.com/sites/index.php?b=34097e0b8324f132014f612bd
48e2492&type=1&p=0

If  you need assistance, please contact the Help Desk at  
[email protected] or call 845-483-6789.
The information  contained in this e-mail is intended for the use of the 
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this 
message is not the  intended recipient, you are hereby notified that any 
use, dissemination,  distribution or copying of this communication is strictly 
prohibited. If you  have received this communication in error, please 
notify me immediately by  using your reply option to advise me of such error. 
Thank  you
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