You are correct in your reading.  The LIP can now attest to the reperfusion 
assessment without giving greater detail.  What is more, nursing documentation 
and a nursing exam can be the basis of that attestation.  The only requirement 
is that the one exam item LIP has to do as part of that attestation is a 
cardiopulmonary exam.

This is huge. I hope you appreciate the change.  Our goal wasn't to make people 
document but rather to conduct an exam and satisfy themselves that the patient 
was perfusing adequately.

As regards antibiotic acceptable delay the provider has to state a delay of 45 
minutes or longer would have transpired.

Sean

On Aug 24, 2016, at 1:49 PM, Clement, Joseph (DPH) 
<[email protected]<mailto:[email protected]>> wrote:


Hello,


I'm reviewing the updated specification manual 5.2 for SEP-1, that will go into 
effect 1/1/17, and I have a few questions - I wonder if others are further 
along than me.

https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1228775749207<https://na01.safelinks.protection.outlook.com/?url=https%3a%2f%2fwww.qualitynet.org%2fdcs%2fContentServer%3fc%3dPage%26pagename%3dQnetPublic%252FPage%252FQnetTier3%26cid%3d1228775749207&data=01%7c01%7ctownsesr%40sutterhealth.org%7c9dad663bd1fe4129e4c108d3cc602cd1%7caef453eadaa243e0be62818066e9ff63%7c0&sdata=Lfj7WQvlpCs3T%2b0LsrjWZtrnfLyK42X5rtVyK7r924w%3d>


[] The manual says that MD attestation of reassessment, VS review, skin 
assessment, cardiopulmonary exam, and peripheral pulse exams are acceptable. It 
also says that "performing, or attesting to performing a physical examination, 
perfusion (re-perfusion) assessment, or sepsis (severe sepsis or septic shock) 
focused exam is acceptable."

At the risk of asking an obvious question, I just want to make sure I am 
getting this right.  If the MD signs something that says "I attest to having 
performed a severe sepsis re-perfusion exam at XX:XX", then this would meet the 
measure requirement?


[] I see that a new element was added "Blood Culture Collection Acceptable 
Delay" - but I'm not clear from the manual what constitutes an acceptable 
delay.  Am I missing something?  Can anybody clarify?


Thanks in advance!


Joe


Joseph Clement, MS, RN, CCNS
Clinical Nurse Specialist
San Francisco General Hospital
ph: 628 206-6174
pg: 415 327-0220
office: H5841
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