Lori, We have an automatic repeat lactic acid order for >2. It fires at 3 hrs from the first lactate result. We have had good success with this process.
Jeanie Bollinger MSN,RN,ACCNS-AG, CCRN Clinical Nurse Specialist Acute Medicine Mission Health Asheville, NC Phone:828-213-7171 -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Thursday, February 02, 2017 10:48 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 232, Issue 6 WARNING: This email originated outside of Mission Health email system DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe. Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Sepsis Screen in ED (Gena Henriques) 2. question ([email protected]) 3. Core measure: VS in the OR (Jeanie Bollinger) 4. Re: repeat lactate levels ([email protected]) ---------------------------------------------------------------------- Message: 1 Date: Fri, 27 Jan 2017 21:25:50 -0600 From: Gena Henriques <[email protected]> To: [email protected] Subject: [Sepsis Groups] Sepsis Screen in ED Message-ID: <caa3yf25tsvn5modurhcsfrgst_-ccf5s-wwwbxf4xo7dnbi...@mail.gmail.com> Content-Type: text/plain; charset="utf-8" Hi, Would anyone mind sharing what the sepsis screen looks like in your ED? Thanks, Gena Henriques, MSN. RN Sepsis Coordinator Touro Infirmary New Orleans, LA -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20170127/2a873e05/attachment-0001.htm> ------------------------------ Message: 2 Date: Wed, 1 Feb 2017 14:13:59 +0000 From: <[email protected]> To: <[email protected]> Subject: [Sepsis Groups] question Message-ID: <23319868f1cf9c4ca1a7ba82cfd6131526e8f...@fwdcwpmsghcmd4b.hca.corpad.net> Content-Type: text/plain; charset="us-ascii" Hello group, I am being told by our quality department that if a patient is documented with severe sepsis and has a lactic acid greater than 4 that it is automatically coded as septic shock even though it's not documented. Is this true? Thanks, Debbie Chambless Sepsis Coordinator Osceola Regional Medical Center Kissimmee, Fl 34371 407-518-3949 -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20170201/9ef5c884/attachment-0001.htm> ------------------------------ Message: 3 Date: Wed, 1 Feb 2017 20:57:20 +0000 From: Jeanie Bollinger <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Core measure: VS in the OR Message-ID: <bn6pr04mb0565ea586ed2afa3a957309b82...@bn6pr04mb0565.namprd04.prod.outlook.com> Content-Type: text/plain; charset="us-ascii" We have received some fall outs of the Sepsis Measure due to vital signs in the OR being used for time zero. I sent this to QNet and below is the response that I received: Unless there is physician documentation that the low BP or MAP is due to the medications or other condition within the OR, the BP's may be used to meet criteria. The anesthesiologist or CRNA does not document a narrative note as to "why" the BP dropped. Is this a reasonable expectation? The patient is in the OR for source control and is being monitored constantly. Is there consideration for excluding these patients from the measure or at least excluding vital signs recorded in the OR? Jeanie Bollinger MSN,RN,ACCNS-AG, CCRN Clinical Nurse Specialist Acute Medicine Mission Health Asheville, NC Phone:828-213-7171 ------------------------------------------------------------------------------ This message and its attachments may contain confidential and/or legally-sensitive information that is intended for the sole use of the addressee(s). Any unauthorized review, use, disclosure, or distribution of the information contained in this message and its attachments is prohibited. If you have received this message or any of its attachments in error, please destroy all originals and copies of the same and notify the sender immediately. -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20170201/208da2ce/attachment-0001.htm> ------------------------------ Message: 4 Date: Thu, 2 Feb 2017 15:45:58 +0000 From: <[email protected]> To: <[email protected]>, <[email protected]> Cc: [email protected] Subject: Re: [Sepsis Groups] repeat lactate levels Message-ID: <57e29d65be6c56458a495d277a4ce7721191f...@fwdcwpmsghcmd3d.hca.corpad.net> Content-Type: text/plain; charset="us-ascii" Lori, we have the reflex order here set for 2 hours post the initial lactate level. It has been working well for us. I know originally some wanted to push the reflex back to 4 hours, but I am worried that if we do that we might experience a delay that leads to a fallout. Maggie Macias, RN Sepsis Program Coordinator Valley Regional Medical Center Brownsville, TX (956) 350-7179 (O) [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Bly, Lori Sent: Friday, January 27, 2017 10:51 AM To: [email protected] Cc: Verdi, Rachel C. <[email protected]> Subject: [EXTERNAL] [Sepsis Groups] repeat lactate levels At our facility we are considering placing a reflex order on initial lactate levels >2.0. Has anyone else initiated this and how is it working? Thank you Lori Bly, RN Quality Management Department ACMH Hospital One Nolte Drive Kittanning, PA 16201 Extension: 8459 email: [email protected]<mailto:[email protected]> Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. 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