We use Cerner EMR as well. We can right click the result in the lab review band and see the history of the order. We use the collected in lab time for meeting the measure for the drawing the Lactate but use the result verified time (also called completed time in our system) for the organ time if that is the validating organ for severe sepsis. Our lab reference range for our Lactic Acid is actually 0.5-2.2 but when abstracting a case for CMS and Surviving Sepsis guidelines we also use the >2.0 for organ failure for severe sepsis and >4 for shock, in the absence of any other underlying or chronic disease state that would be an explanation for the elevated lactic acid. Hope that helps.
Michelle Foss RN Critical Care Data Coordinator Shawnee Mission Health Kansas City Metro Area -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Saturday, August 12, 2017 2:10 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 257, Issue 11 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://secure-web.cisco.com/19j-SwyNhs6jaVM3XXhDKSlpD0p6zBqMYwT-wUkhhLUNMaZiGbP5I6uZzKP2TxM4sT2VuKIKGiVM4RNl-Xa_br0QBTwm_CzXZ0DCir3CMqc3XpO2tsodCzMESue3taMpgpqRa0Z-uzL1vo35F1LqYe0poB_VyFDtPQEgfW8GTTNXlDto-J10_rG2QgscWucDbqizk4_kmRtYW6lQrWBYXzKUxxZM_2W-ScaTO1bljrj-hRs1avku1vhoQogT5Zlf4LmCT7y2bCj0cOp4HbeoBSU1dOKu1WNygBGwBu1c7kuiXlE6Rgzc4_NeRWcOtMaoUBIpymiQM5MDJnmlKf2o_AIB5LZpoxjKnLWxLkSxjNLnzTBM0w3cNnBY-jL_t8poSB4QoTTO2SHVNzWbyBwUGIOQvsb9Dj47_53ii2-boUNo/http%3A%2F%2Flists.sepsisgroups.org%2Flistinfo.cgi%2Fsepsisgroups-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. Lactic Acid result/time (Bivins, Nancy N.) 2. Register for Maternal and Neonatal Sepsis Congress (Surviving Sepsis) ---------------------------------------------------------------------- Message: 1 Date: Thu, 10 Aug 2017 13:22:00 +0000 From: "Bivins, Nancy N." <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Lactic Acid result/time Message-ID: <bn3pr0601mb13326800e7b28038a63c8aec9d...@bn3pr0601mb1332.namprd06.prod.outlook.com> Content-Type: text/plain; charset="us-ascii" Good morning! Within our BayCare Health System, we use, per the Truven/CMS Specs guidelines, the date and time the LA was collected, which coincides with the result time in the Cerner EMR. The result must be greater than 2.0 for severe sepsis. Oddly, for septic shock, it must be greater than OR equal to 4.0. Hope this is helpful! Nancy Bivins, RN, BSN Clinical Data and Quality Coordinator Department of Evidence-based Medicine BayCare Health Systems Office 2985 Drew St. Clearwater, Fl . 33759 727-519-1233 [email protected] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Wednesday, August 09, 2017 4:13 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 257, Issue 6 **WARNING** This e-mail originated from outside of BayCare Health 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 https://secure-web.cisco.com/1lKqqouGhbFVFYAgV77Ds7T-BlIRBKkvDbTuVvba1TGLTF8bSfGOlVy8aCHM4yScYiTWNQ6ioNb8rv7fmmbTBPqbJATzqDSlavXTSaqdklLNmvqVVsuOeH1_PEGsoJmkj5ixgtj0kgDXGp0_uN9smydRl78m_V5xvbFEmUgs9RiNpxxV4Wjgme3bKv6ZvTXDsfr3sxrpn9CJdpgCqRWJbvuoutE42oq7ITG-1HT7k-X9NPCYIcq8-q9MHRJykZUB_DwlNfexm6yIdDkM9O8_K_dpqOElpmd6Aud81wCCy7nc8bSMtR2A2fxJmc8jSKEMbi4vhgPMyKxgARWNOFh8VQnq-6rb72mKYA9j9kAc7dBY4IVzocaPthRX2cBd7jjCfLfRp58L85LWCSU7Sj01Bqtq_eCNSACZPUowqEfqYEkI/https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttp-3A__lists.sepsisgroups.org_listinfo.cgi_sepsisgroups-2Dsepsisgroups.org%26d%3DDwICAg%26c%3DMS-5dKql6qjhmD6zBX8NdQ%26r%3D_zyNtgvJesjAQJLnTOMzw9cyU1aPPTY5fK9_kDan51Y%26m%3D9kzA8qSsNZyi1H5m1X0SIRk2t_ktqUoLziiucvai3oc%26s%3DiHbrXUbIyc2Pkreq0FcFTmk3m8QlL88c7_FiFW7nXHU%26e%3D 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. Re: Lab times (Pamela Green) 2. Evaluation for Severe Sepsis Screening Tool HMH revised (Pamela Green) ---------------------------------------------------------------------- Message: 1 Date: Tue, 8 Aug 2017 17:30:00 +0000 From: Pamela Green <[email protected]> To: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Lab times Message-ID: <cb8b1d4c6616c649be06e4604857ee86419...@hmhexchange.howardmemorial.com> Content-Type: text/plain; charset="koi8-r" We have been utilizing our Sepsis Protocol for the last Month and have been screening and intervening on several patients. There is one Level that we need clarification for. Our Protocol says any Lactate Level ?2 is considered to indicate sepsis, but our lab range is Normal for 0.4- 2.0. Would like to know how everyone is using this? Thanks Pam From: Sepsisgroups [mailto:[email protected]] On Behalf Of Belfi, Karen Sent: Thursday, August 03, 2017 12:27 PM To: [email protected] Subject: [Sepsis Groups] Lab times Hi, we are confused about something here. On our lab report in our EMR, it lists a time. It's the draw time, not report time, though it doesn't say draw time. We just know it is. Can we use that for severe sepsis criteria since it doesn't specify draw time? Thank you. Karen Belfi, RN, MSN Quality Outcomes Coordinator Lankenau Medical Center (484)476-8092 -------------- next part -------------- An HTML attachment was scrubbed... URL: <https://secure-web.cisco.com/1CphieTG57uMgr1A1pIa2eGnZaqP12orgNszvGyXUFYJekST2TOl_DV7Xm_KCR8492zp6bzWVePZZWgmuC175qZ7nvvFU9XRKRoyBmbjR5xES0BFyTwTvHEiIRXQlqnaNqrwqnJoS3KIXr6HaqW-rIRzimmWwDAKFnUBqgYoBegfoh9fbwGJ8nNap-i0MGEr6ddXePt1UMR1-36hkHddUKyvZTL5dWrgT7IWgjT6Il5QngszUeUOH3HEn0-YjnT7jyY8oguP0fii69zgb4Hqh_CN0KMYM61QfwriEQwQHYf7B-F_vvVkfueHp21Fln_xJA7Fq2DhkcdyJdu_jw8r9oNS1zcl9A3sp_usDimrClFf9cGrg9HPXCZCqnYYHJRwBxmxNIrSLsTd00uRcdMBaJTOEUIUT9N9OpoJUr_YalqA/https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttp-3A__lists.sepsisgroups.org_pipermail_sepsisgroups-2Dsepsisgroups.org_attachments_20170808_261afb5d_attachment-2D0001.htm%26d%3DDwICAg%26c%3DMS-5dKql6qjhmD6zBX8NdQ%26r%3D_zyNtgvJesjAQJLnTOMzw9cyU1aPPTY5fK9_kDan51Y%26m%3D9kzA8qSsNZyi1H5m1X0SIRk2t_ktqUoLziiucvai3oc%26s%3DbtYHtaNhwXT_IhYn4Yhho8BS4vpMpR9NszR7-eFK4q8%26e%3D > ------------------------------ Message: 2 Date: Wed, 9 Aug 2017 13:37:41 +0000 From: Pamela Green <[email protected]> To: "[email protected]" <[email protected]> Cc: HMH Directors <[email protected]> Subject: [Sepsis Groups] Evaluation for Severe Sepsis Screening Tool HMH revised Message-ID: <cb8b1d4c6616c649be06e4604857ee86419...@hmhexchange.howardmemorial.com> Content-Type: text/plain; charset="us-ascii" After meeting with HIM and coding yesterday it was brought to my attention that the Lab normal range high is 2. Our screening form had only the > 4 mmol/L under #3. Criteria for Severe Sepsis. So I went back to the original form the actual value is supposed to be >2 . The edited form had the wrong value of >4. So I have made that change on the screening form as indicated. I also, have a question out to the Sepsis Groups to understand how other facilities are using this measurement. Please make copies for your dept. and make changes to your existing forms thanks. Pam -------------- next part -------------- An HTML attachment was scrubbed... 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The information is intended to be for the addressee only. If you are not the addressee, any disclosure, copy, distribution or use of the contents of this message is prohibited. If you have received this electronic message in error, please notify the sender and destroy the original message and all copies. ------------------------------ Message: 2 Date: Fri, 11 Aug 2017 21:57:04 +0000 From: Surviving Sepsis <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Register for Maternal and Neonatal Sepsis Congress Message-ID: <bn6pr1101mb2148e530c67ac80bcb258447d3...@bn6pr1101mb2148.namprd11.prod.outlook.com> Content-Type: text/plain; charset="us-ascii" Maternal & Neonatal Sepsis Congress The Global Sepsis Alliance and the World Health Organization have joined forces to host the World Sepsis Congress (WSC) Spotlight: Maternal and Neonatal Sepsis on September 12, 2017. The WSC Spotlight is a free online congress in which 25 renowned experts from all around the world will give presentations on all aspects of maternal and neonatal sepsis, as well as give updates on sepsis in general. The congress will be held in English and is open to everyone with an internet connection. For more information on program, speakers, time zones, and to register for free, please visit http://secure-web.cisco.com/1c8aSltphSuKMeqHpfm7wOlseVhCjyC9XFjssLppgve59HSLv-MPAeJoTvqWKrIr3CJYas0lC6fca_2yEebwoQlNXZFwNQl6GDNgiVnnCuoEUBCXAbfQLG0ylqeBBBIJcDK--pUrhKUVu8ImS_nUbAVpgfNpBZ8OCi4U4WSElOLaS09TTIJoGtnDuM-MRFevPu-hIge8cMoQSxZVTkK3XiU3As-gi-jy6oJYlC68QgJNh3lpyf5BSMDkR2hEKq9MXi-cPRB83irtL-FpyAsS-GIJXwN3IOm-m-uEV3dV6rZXYfz2weX-FzvNO7gR8R9smVBJfC1Z0Zn3LnXRhbZQ1xD4AYu3Tg6cxutYKMVsTZq_5qHl6qeApZxL8oKumHwUxf3YDsRckGenKGyC7wnKFxXD7TEDIS2HW-fB1LBy4-ts/http%3A%2F%2Fwww.wscspotlight.org<http://secure-web.cisco.com/1-ekMMAGJTHSFS071PZcWhmDDpo0sytdMoRScvXBKagzLLqrNBDBS9pMG7kvLYWqOaHONfVxi7X9s6pEQRp0b979RbSYLSOAHjNxXZPFAq7UBOy7XpnU8iXRCwNLd_5QVfmUycc0X43dfn98m7pit2W2Aqljf96ti3iQqrTpHGHyfBGMTtMWc49-PIzdxABZ7F7P7-2TocvTZ6mQFNqlkYqkwCn1LbhHT0lbK4sczdM7dj-T4St9yhVXaGxd3u6XoWz3KoFI9Gp-At0zAEsrPLApHNqMraihVaUSUHLT4dR3ckktMpPbLh0hu0j4D1N5TIBNuAnNR7KkDqYdzgmFKCWoyIPOiaLNOloqVsPxSng7ZFJXIGBwb54Rb 9_YluQxy5kNSkxxZjbv58QTw0uZcw1eR7paF3KpTFt9GHiUgvjQ/http%3A%2F%2Fwww.wscspotlight.org%2F> -------------- next part -------------- An HTML attachment was scrubbed... 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