If they document present on arrival does that change it to the triage time?
Jennifer Rowe, RN, BSN Director of Critical Care Services Odessa Regional Medical Center Odessa, Texas 79760 Office: 432-582-8856 Mobile: 432-238-5654 Email: [email protected] NOTICE: This email may contain PRIVILEGED AND CONFIDENTIAL information and is intended only for the use of the specific individual(s) to which it is addressed. It may contain Protected Health Information that is privileged and confidential. Protected Health Information may be used or disclosed in accordance with law and you may be subject to penalties under law for improper use or further disclosure of the Protected Health Information in this email. If you are not an intended recipient of this email, you are hereby notified that any unauthorized use, dissemination or copying of this email or the information contained in it or attached to it is strictly prohibited. If you have received this email in error, please delete it and immediately notify the person named above by reply email. Thank you. From: Claire Sirois-Melvin <[email protected]> To: "[email protected]" <[email protected]> Date: 08/04/2016 07:42 AM Subject: [Sepsis Groups] Repeat Lactate Sent by: "Sepsisgroups" <[email protected]> Hello, We are having challenges at some of our facilities with meeting bundle compliance due to timing of repeat lactates. The issue is often that even though we are drawing more than 1 Lactate, the second lactate is actually becoming our ?Initial Lactate? due to timing of Severe Sepsis. According to Technical Specifications, the ?initial Lactate? is the one drawn closest to time 0. For example, Patient comes in with a cough, fever, and an elevated HR at 1420, MD orders lactate and Blood Culture which are drawn at 1430. Lactate results come back at 3.0 at 1515. MD orders fluids and antibiotics at 1530, but does not document infection until 1700 (? pneumonia in admission order.) Repeat Lactate ordered and drawn at 1830 with result of 2.2 ... In this scenario, the Severe Sepsis time zero is 1700. Based on abstraction guidelines, this makes the second Lactate at 1830 the ?initial Lactate? since it is the one drawn closest to time 0. Providers do not order another lactate to be drawn until the next morning since the value is trending downward. This case fails due to no repeat Lactate within 6 hrs of SST zero. This is frustrating for providers since the care is appropriate, and just the timing of documentation throws off the timing of initial lactate. Is anyone having similar challenges or does anyone have a process/recommendation in place for such scenerios. Any information you can share would be greatly appreciated. Thank you in advance! Claire Claire Sirois-Melvin RN, BSN Quality Measure Resource Specialist - Steward Healthcare 824 Oak Street, Brockton, MA 02301 Email: [email protected] This is an External E-Mail and not from IASIS Healthcare. Please validate this e-mail before responding to or Opening/Clicking on any request from this external source. If you suspect this is a malicious e-mail - i.e. Phishing/Spoofing - forward it to [email protected] and delete it from your e-mail list. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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