It sounds like it will be an outlier. We’ve had this issue as well.
Karen Belfi, RN, MSN Quality Outcomes Coordinator Lankenau Medical Center 484-476-8092 Pager: 5240 [cid:[email protected]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Charity Love Sent: Tuesday, June 28, 2016 12:49 PM To: Greg Stanford; Veronica Tarala Cc: [email protected] Subject: [EXTERNAL] Re: [Sepsis Groups] Sepsisgroups Digest, Vol 209, Issue 1 Would like an opinion on a specific case. I have a patient that came in through the ED and only fit criteria for sepsis, not severe in the ED and blood cultures were not taken prior to IV ABX administration. This patient later became hypotensive on the floor, thus fitting the criteria for severe sepsis since two SIRS were present at this time. Since blood cultures were not originally taken prior to ABX administration would this still be a fallout even if at the time the ABX were given the patient did not yet meet severe sepsis criteria? If blood cultures are taken once we have the presentation of severe sepsis would this fit the measure even if it would be after the first dose of ABX was already given? Would appreciate anyone’s input on this matter. Thanks, Charity Love, RN, CCRN Sepsis Coordinator Mount Sinai Medical Center-Infection Control Office: (305) 674-2121 X54926 Pager: (305) 212-4041 Cell: (305) 785-4214 From: Sepsisgroups [mailto:[email protected]] On Behalf Of Greg Stanford Sent: Saturday, June 25, 2016 2:20 PM To: Veronica Tarala Cc: [email protected]<mailto:[email protected]> Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 209, Issue 1 Here you go. On Jun 25, 2016, at 12:06 PM, Veronica Tarala <[email protected]<mailto:[email protected]>> wrote: Does anyone have access to an article that has the latest definition of sepsis? On Jun 23, 2016, at 6:47 PM, Greg Stanford <[email protected]<mailto:[email protected]>> wrote: No. Coding should not be using a differential diagnosis. It depends on how it is worded. “Probable”, for example, will get coded. “Possible” will not. I have ED docs who will put everything but the kitchen sink into the differential because they think that will justify a higher level of billing. They frequently have a template with a huge list of differentials. And it does not meet criteria for source of infection. Greg Stanford, MD Medical Director Clinical Documentation Improvement and Outcomes 1840 Amherst Street | Winchester, Va 22601 Phone: (540) 596 4999 Cell: 540 664 5736 | |[email protected]<mailto:[email protected]> <image001.png> CONFIDENTIALITY NOTICE: This e-mail is confidential, may be legally privileged, and for the intended recipient only. Access, disclosure, copying, forwarding and distribution by any means is strictly prohibited. If received in error, do not read but delete and e-mail confirmation to the sender. I would like to understand how my peers are abstracting a particular issue. I have a question for the group… If you have a patient in the EC and the physician lists as part of the differential diagnoses a UTI or PNA. Then the physician documents as his final EC diagnosis respiratory failure, COPD with exacerbation. Then let’s say the patient does have the clinical signs to support severe sepsis. (temp 102, Pulse 124, Respiratory failure documented and placed on vent). Do you count the differential diagnoses of UTI and PNA as a source of infection in this scenario? Thanks, Debra Debra M. Cox, BSN, RN STTI Member Corporate Quality Specialist | Quality Services <image001.png> 101 East Wood Street | Spartanburg, SC 29303 O: 864-560-2694 | c: 864-327-5731 | f: 864-560-7365 e: [email protected]<mailto:[email protected]>| w: SpartanburgRegional.com<http://www.spartanburgregional.com/> "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." ~R. Buckminster Fuller _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ________________________________ Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain CONFIDENTIAL or PRIVILEGED information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and immediately destroy all copies of the original message and all attachments.
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