Here is the criteria from the core measure specification manual pertaining to severe sepsis presentation time:
Specifications Manual for National Hospital Inpatient Quality Measures Discharges 01-01-17 (1Q17) through 12-31-17 (4Q17) 1-216 * If severe sepsis is present on arrival to the Emergency Department or severe sepsis is identified in triage (all three clinical criteria must be met or documented during 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 who arrive to the ED with severe sepsis clinical criteria met or physician/APN/PA documentation of severe sepsis, that bypass triage or a triage time is not documented, use the ED arrival time. In this case, it would be interesting to see the BP on arrival, the WBCs, and the suspected source of infection, especially with the lactic acid of 1.6. Thank you, Julie Julie Maykel, RN, BSN Quality Coordinator [email protected] Seton Medical Center | Part of Verity Health System 1900 Sullivan Avenue, Daly City CA 94015 Office 650-991-6366 Fax 650-991-6390 seton.verity.org | Verity.org Confidentiality Notice: This transmission and any attached documents may be confidential and contain information protected by State and Federal Medical Privacy statutes and is legally privileged. They are intended for use only by the addressee. If you are not the intended recipient of this transmission, or an agent of the intended recipient, you are prohibited from reading, disclosing, printing, saving, copying, using or otherwise disseminating any information contained in this transmission. If you received this transmission in error, please accept our apologies and notify the sender via reply e-mail. Please delete entire message and its attachments. Thank you From: Sepsisgroups [mailto:[email protected]] On Behalf Of Belfi, Karen Sent: Tuesday, February 21, 2017 9:00 AM To: [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Subject: [External Email] Re: [Sepsis Groups] Present on arrival question Warning: This message is from an external sender. Remember to avoid sending sensitive information via e-mail. ________________________________ There's no infection documented. From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Tuesday, February 21, 2017 10:53 AM To: [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Subject: [EXTERNAL] Re: [Sepsis Groups] Present on arrival question If the BIPAP is documented for acute resp. failure at 02:10, would it not mean that severe sepsis criteria are met at 02:10?? Then septic shock is documented at 02:45 so septic shock onset would be 02:45 unless it met by CMS criteria prior to that time??? We are to use whatever time is the earliest.. Correct? Jocelyne [cid:[email protected]][cid:[email protected]] "Teamwork is the ability to work together toward a common vision--the ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results"- Andrew Carnegie Jocelyne F. Davis, MSN, RN, CNRN Stroke and Sepsis Programs Coordinator Ph: (941) 342-1139 Fax: (941)379-5466 Doctors Hospital of Sarasota 5731 Bee Ridge Road Sarasota, FL 34233 doctorsofsarasota.com [cid:[email protected]] [cid:[email protected]] This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. From: Sepsisgroups [mailto:[email protected]] On Behalf Of Merwin, Courtney C. Sent: Thursday, February 16, 2017 9:40 AM To: Kalaw, Carmencita ARMC-Performance Improvement <[email protected]>; Siscoe-Hapshie Anita <[email protected]>; '[email protected]' <[email protected]>; '[email protected]' <[email protected]> Subject: [EXTERNAL] Re: [Sepsis Groups] Present on arrival question I agree, Severe sepsis and Septic shock times are 0245. Courtney Merwin BS, RRT Quality Management East Jefferson General Hospital 4200 Houma Blvd. Metairie, LA 70006 504-503-5968 [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Kalaw, Carmencita ARMC-Performance Improvement Sent: Monday, February 13, 2017 10:24 AM To: '[email protected]'; '[email protected]'; '[email protected]' Subject: Re: [Sepsis Groups] Present on arrival question Severe sepsis time presentation would be the same time in which the physician documented septic shock at 0245. [cid:[email protected]] Carmencita S. Kalaw, BSN, RN Performance Improvement Quality Management Nurse ----------------------------------------------- Phone: 909.580.1036 www.arrowheadmedcenter.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.arrowheadmedcenter.org&d=DwMFAg&c=qqcbk_QeabW4Z7GBhIMNtn_B7aQjktEuWNmUvrzri9o&r=9XT3K_nIvIIF-7Bh2TiB0g&m=GeNkUfPzmybpfKqZahEJ4TCvfmdmzA19_TqLtF2KJQo&s=KDIK1vbGo88-wvcAbgBhHWNYHIG4BHDYBsVMqmQ_mfY&e=> From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected]<mailto:[email protected]> Sent: Friday, February 10, 2017 3:11 PM To: [email protected]<mailto:[email protected]>; [email protected]<mailto:[email protected]> Subject: Re: [Sepsis Groups] Present on arrival question Yes Anita Siscoe-Hapshie Anita Siscoe-Hapshie, RN, MSN, CCRN Sepsis Coordinator [email protected]<mailto:[email protected]> Citrus Memorial Hospital 502 W. Highlands Blvd. Inverness, FL 34452 Office 352.560.6214 Fax 352.726.9119 Nurses are true [cid:[email protected]] [cid:[email protected]] P please consider the environment before printing this email This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of the email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. CONFIDENTIAL-This email may contain proprietary information. Not intended for external distribution. From: Sepsisgroups [mailto:[email protected]] On Behalf Of Bly, Lori Sent: Thursday, February 09, 2017 8:40 AM To: [email protected]<mailto:[email protected]> Subject: [EXTERNAL] [Sepsis Groups] Present on arrival question Scenario: female pt to ED - Arrival time: 015 Triage: 0151 SIRS temp 102.8, hr 141 , resp 34 all at 0154 , wbc CPap 0154 BiPap at 0210 (new for this pt) Initial Lactate 1.6 at 0205 Documentation of Septic shock 0245 on ED physician note Is this case a present on arrival ? What time do I use for Severe Sepsis Presentation. 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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