Thank you all for your expertise, thoughts, and feedback. Also just wanted share the QNet Response for anyone interested. Happy Wednesday!
Subject Weight and 30ml/kg Crystalloid Fluid Resuscitation Discussion Thread Response Via Email (Jennifer Witt) 06/29/2016 01:00 PM Correct. Customer By Web Form (Claudia Orth) 06/29/2016 12:57 PM So am I understanding correctly, that despite the 80kg being a "stated" weight and being 30kg heavier than the patients ACUTAL weight the first scenario below would be a fall out based on the fact that the patient only received 2000cc instead of 2400cc? Is that correct? Thank you again for your time! Response Via Email (Jennifer Witt) 06/29/2016 11:55 AM 1. Since there was a weight before the crystalloid fluid order using that weight would be appropriate (80kg). 2. If there was no weight recorded prior to the order the weight recorded closest to and after the crystalloid fluid order would be acceptable to use. I hope this helps. Customer By Web Form (Claudia Orth) 06/29/2016 11:27 AM This Question is in reference to the below statements in the Additional notes for Abstraction: Use the weight documented closest and prior to the order for crystalloid fluids. If a weight is not documented prior to the crystalloid fluid order, use the weight recorded closest to and after the crystalloid fluid order. However, it also states: Use the patient's actual weight. Use estimated weight only if actual weight is not available. Do not use ideal weight. We have a case where the patient's stated weight at the time of diagnosis for Severe Sepsis is 80kg. The patient was given 2000cc of fluid which would not have met the 30ml/kg measure criteria. However several hours later outside of the 6 hour window the patient is actually weighed and his weight is ONLY 50kg!!! Are we okay as we are abstracting retrospectively to answer "Yes" to the 30ml/kg crystalloid fluid bolus question? Another scenario would be a patient (and this is rare, but can happen) that develops Severe Sepsis but is never actually weighed until the next day. If his weight at that time is such that the amount of fluid received is 30ml/kg can we answer "YES" there as well, even though the provider ordering the fluids at the time is not doing so based off of an actual weight? Thank you in advance for any clarification you may be able to offer! Claudia Orth - Regional Sepsis Coordinator [email protected]<mailto:[email protected]> Question Reference #160629-000052 Product Level 1: Measures & Data Element Abstraction Category Level 1: Hospital Inpatient - Sepsis Category Level 2: Crystalloid Fluid Administration Date Created: 06/29/2016 11:27 AM Last Updated: 06/29/2016 01:00 PM Status: Resolved (IP only) Discharge Period: 10/01/2015 - 06/30/2016 ~Claudia Claudia Orth BSN, RN, CCRN-K Regional Sepsis Coordinator Clinical Quality Munson Medical Center 1105 Sixth Street Traverse City, MI 49684-2386 (231) 935-5692 (Voice) (231) 318-0394 (Pager) [email protected]<mailto:[email protected]> From: Orth, Claudia Sent: Tuesday, June 28, 2016 9:58 AM To: hiqrimprove-poc-discuss ([email protected]); [email protected] Cc: Horton, Kirsten Subject: Fluid Resuscitation Question Hi All, We have a case where the patient's stated weight at the time of diagnosis for Severe Sepsis is 80kg. The patient was given 2000cc of fluid which would not have met the 30ml/kg measure criteria. However several hours later outside of the 6 hour window the patient is actually weighed and his weight is ONLY 50kg!!! Are we okay as we are abstracting retrospectively to answer "Yes" to the 30ml/kg crystalloid fluid bolus question? Another scenario would be a patient (and this is rare, but can happen) that develops Severe Sepsis but is never actually weighed until the next day. If his weight at that time is such that the amount of fluid received is 30ml/kg can we answer "YES" there as well, even though the provider ordering the fluids at the time is not doing so based off of an actual weight? Thanks so much in advance for any guidance! Best, ~Claudia Claudia Orth BSN, RN, CCRN-K Regional Sepsis Coordinator Clinical Quality Munson Medical Center 1105 Sixth Street Traverse City, MI 49684-2386 (231) 935-5692 (Voice) (231) 318-0394 (Pager) [email protected]<mailto:[email protected]>
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
