Our Indiana Hospital Association gave this for examples, I found it helpful. The 3rd bullet point gives good clarification.
Example: Patient was noted to have purulent drainage from the surgical wound on 01-10-20xx at 22:00, when the physician documented “suspect surgical wound infection. A culture of the surgical site was obtained. At 01:30 on 01-11-20xx, blood pressure was noted to be 74/40. At 02:00, 30 minutes later, temperature was 38.4 and pulse was 118. Severe Sepsis Presentation Time is 02:00. •Physician/APN/PA documentation of severe sepsis or suspected severe sepsis is acceptable. •If a suspected infection, severe sepsis or septic shock is in an ED physician note without a specific time documented within the note use the time the note was started or opened. •If severe sepsis is present on arrival to the Emergency Department or severe sepsis is identified in triage, the Severe Sepsis Presentation Time is the time the patient was triaged in the Emergency Department. If more than one triage time is documented (e.g., “Triage started” and “Triage completed”) use the later time reflecting triage is completed. •For patients with multiple episodes of severe sepsis, abstract only the first episode. •If there are multiple times documented when the last criterion to meet the definition of severe sepsis or physician/APN/PA documentation of severe sepsis occurred, and they are at variance with each other, use the earliest time. •If criteria for severe sepsis are met after physician/APN/PA documentation of septic shock, enter the time the physician/APN/PA documented septic shock. •If criteria for severe sepsis are not documented and there is not physician/APN/PA documentation of severe sepsis, but there is physician/APN/PA documentation of septic shock, enter the earliest time septic shock was documented Hope this helps! Katie Gibbs, RN, BSN Quality Improvement Specialist Witham Health Services PH 765-485-8459 CONFIDENTIALITY NOTICE: The information in this e-mail, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and legally privileged information. If you are not the intended recipient, any disclosure, copying, distribution or use of the contents of this information in any manner is strictly prohibited and may be unlawful. -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Saturday, July 23, 2016 5:51 PM To: Zhukov, Marina (Tacoma) Cc: Murray, Sandra; '[email protected]' Subject: Re: [Sepsis Groups] Time Zero Hello everyone, Just an fyi- At the UWMC we have a similar situation to what Marina has describe: We rarely hit all three criteria for severe sepsis when the patient walks in the ED door. The patient usually meets criteria later during the ED visit. Thanks, Mary L. Ransom, RN, BSN, MA, CPHQ Core Measures Project Manager Center for Clinical Excellence Box 359425 University of Washington Medical Center Seattle WA 98195 Office Days: Mon, Tues and Thurs *************************************** This message and any attachments to it is protected by coordinated quality improvement/risk management/peer review confidentiality under RCW 70.41.200/4.24.250/43.70.510. Privileged confidential patient identifiable information also may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply email and then destroy all copies of the message and any attachments. On Thu, 21 Jul 2016, Zhukov, Marina (Tacoma) wrote: > > This does not happen for the majority of our sepsis cases. Keep in > mind that patient needs to meet ALL criteria (infx, two SIRS and organ > dysfunction) during/before triage in order to use triage time. There is > always little something that shifts the clock so that triage time could not > be used. > > > > Also, with just added SEP-1 Additional Notes for Abstraction, Version > 5.1 there is new clarification: “if the note (physician’s note) states severe > sepsis was present on admission, use the earliest documented admission > date/time” > > > > Marina Zhukov, RN, BSN > > Clinical Data Abstractor > > CHI Franciscan Health > > > > > > > > From: Sepsisgroups > [mailto:[email protected]] On Behalf Of > Madrid, Pamela A > Sent: Thursday, July 07, 2016 9:45 AM > To: Belfi, Karen; Dena Videtic; Murray, Sandra; > '[email protected]' > Subject: [Sepsis Groups] Time Zero > > > > CAUTION: This email is not from a CHI source. Only click links or open > attachments you know are safe. > > > ______________________________________________________________________ > ______________________________________________________________________ > ________________________________________________ > > > Hi Everyone! Just a follow-up question/comment on the time zero discussion. > > > > For determination of time zero for patients who present to the > Emergency Department, how are you applying this portion of the Notes for > Abstraction on page 1-232. By this it seems that we should we be using triage > time for the majority of the severe sepsis and septic shock patients?? > > > > Severe Sepsis Time > > If severe sepsis is present on arrival to the Emergency Department or > severe sepsis is identified in triage, the Severe Sepsis Presentation Time is > the time the patient was triaged in the Emergency Department. If more than > one triage time is documented (e.g., “Triage started” and “Triage completed”) > use the later time reflecting triage is completed. > > > > > > Pam Madrid, RN, MS, CCRN, CCNS > > Clinical Nurse Specialist • Critical Care • Mercy Hospital, part of > Allina Health > > Phone: 763-236-8331 • Pager: 612-654-0624 • Fax: 612-236-8304 • > [email protected] > > Mail Route 51415 • 4050 Coon Rapids Blvd • Coon Rapids, MN 55434 > > > > “Information is random and miscellaneous, but knowledge is orderly and > cumulative.” Daniel Boorstin > > > > > > Image removed by sender. > This message contains information that is confidential and may be > privileged. Unless you are the addressee (or authorized to receive for the > addressee), you may not use, copy or disclose to anyone the message or any > information contained in the message. If you have received the message in > error, please advise the sender by reply e-mail and delete the message. > > > _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
