The CMS specs manual specifically says “Documentation that is not acceptable for infection: Viral infections” Also, it says, “If physician/APN/PA documentation within 6 hours following the initial documentation of an infection indicates that the infection is due to a viral, fungal or parasitic source disregard the documentation of the initial infection” From: Roney, Jamie K <jro...@covhs.org> Sent: Thursday, June 11, 2020 11:29 AM To: Deffenbaugh, Amy M <amdeffenba...@mercy.com>; Merwin, Courtney C. <ccmer...@ejgh.org>; 'sepsisgroups@lists.sepsisgroups.org' <sepsisgroups@lists.sepsisgroups.org> Subject: RE: [EXTERNAL] Re: [Sepsis Groups] Sepsis & COVID
Good morning, Any organism, whether viral, fungal, parasitic, bacterial, etc., has always had the possibility of triggering the systemic sepsis response and has never changed the treatment recommendations of EGDT by experts. Viral infection is not an exclusionary criteria for abstraction and both co-owners of the CMS Sepsis Core Measure are a part of this forum (one being Dr. Rivers who introduced us to EGDT), thus I should not speak for them. Known bacterial infection or not does not impact our treatment or abstraction of these patients. Respectfully, Dr. Roney Jamie Roney, DNP, RN, BSHCM, NPD-BC, CCRN-K Regional sepsis coordinator/Nursing Professional Development Specialist IV "Be a yardstick of quality. Some people aren't used to an environment where excellence is expected." ~Steve Jobs 3615 19th Street, Lubbock, TX 79410 T: (806) 725-4689 C: (806) 773-1914 www.covenanthealth.org<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Fwww.covenanthealth.org-252F-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227045827-26sdata-3D5zjfS8-252FEVUuhOhFVOm2-252BBClDRJEassSzhdsHyuyxPn8-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3DPeFB1vLqSAu7_726-NHoqF-pNxiwF4WqChZ_w-QGsSA%26e%3D&data=02%7C01%7CAMDeffenbaugh%40mercy.com%7C9c6af019275c49251c1408d80e1c3104%7Cbb84ecdc9a5141eb880c178c5153d561%7C0%7C0%7C637274861680911636&sdata=P2pT%2BM2TxkCb%2FyUVcVd0rkYLImGeOlsLE9pX5s7YhHA%3D&reserved=0> ………………………………………………………………………….. [cid:image003.png@01D63FEC.410F93E0][socialicons.jpg]<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Fwww.facebook.com-252FCovenantHealth-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227050811-26sdata-3DAKnGxKCjGEo47IjljUBJD5ZLVl4JjpKWI0xADqay-252B1A-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3Ddl_8-DKmRtlgkvuU5cpOl8i-GfKu2nhUuOIO3WXqBQs%26e%3D&data=02%7C01%7CAMDeffenbaugh%40mercy.com%7C9c6af019275c49251c1408d80e1c3104%7Cbb84ecdc9a5141eb880c178c5153d561%7C0%7C0%7C637274861680921628&sdata=8RmuBVoLlOrsI8Xp9MsYTkQaQ3Po2QpciBn9VOFN41s%3D&reserved=0> [socialicons.jpg] <https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Ftwitter.com-252F-2523-21-252F-2540covhs-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227055800-26sdata-3DSnyH3ZbJ31JSYCUVZXQqNoQwPQatVBcVJoOcTsl7KPQ-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3D0CBzMEaboXAleKkOg7X5GAcVr9YmOajETdzD2WSB37w%26e%3D&data=02%7C01%7CAMDeffenbaugh%40mercy.com%7C9c6af019275c49251c1408d80e1c3104%7Cbb84ecdc9a5141eb880c178c5153d561%7C0%7C0%7C637274861680921628&sdata=peXQ10%2BKRUU%2Bw4lonCLKHkcuK4G%2BG3AmegaKyXsF9Yk%3D&reserved=0> [socialicons.jpg] <https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Fwww.everymomentmatters.org-252F-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227060791-26sdata-3DCHaguE7O8L6SRHTCi23I84zr077bXGcdDxOfS5pxU3M-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3DI6QpHLdY66G8axgxIdSXebJLaH5H3sKLYZi8kXRdzyM%26e%3D&data=02%7C01%7CAMDeffenbaugh%40mercy.com%7C9c6af019275c49251c1408d80e1c3104%7Cbb84ecdc9a5141eb880c178c5153d561%7C0%7C0%7C637274861680931620&sdata=FXBnVb9glavAW3f0SQ2cOOBem3VtGSIvEnerSGnx%2BH4%3D&reserved=0> [cid:image012.png@01D63FEC.410F93E0] From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Deffenbaugh, Amy M Sent: Tuesday, June 9, 2020 5:07 AM To: Merwin, Courtney C. <ccmer...@ejgh.org<mailto:ccmer...@ejgh.org>>; 'sepsisgroups@lists.sepsisgroups.org' <sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>> Subject: [EXTERNAL] Re: [Sepsis Groups] Sepsis & COVID In my opinion, even if there is septic shock, if your source is viral, you still do not have to abstract. If there is a “possible superimposed bacterial infection” being treated with antibiotics, you would have to abstract. And check your documentation within 6 hours to rule out infection and 24 hours for rule out of SIRS and organ dysfunction Amy M Deffenbaugh RN, BSN Quality Improvement Coordinator St Rita’s Medical Center 730 W Market St Lima, OH 45801 Phone (419) 996-5513 Fax ( 419) 226-9180 amdeffenba...@mercy.com<mailto:amdeffenba...@mercy.com> From: Sepsisgroups <sepsisgroups-boun...@lists.sepsisgroups.org<mailto:sepsisgroups-boun...@lists.sepsisgroups.org>> On Behalf Of Merwin, Courtney C. Sent: Thursday, May 14, 2020 11:49 AM To: 'sepsisgroups@lists.sepsisgroups.org' <sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>> Subject: [Sepsis Groups] Sepsis & COVID How are you handling abstractions for Sepsis with COVID? Clearly infection is suspected to be viral including documentation of such. But when a physician documents septic shock, does that have to be abstracted as Severe sepsis presentation? What about when there is documentation of antibiotics ordered for “possible superimposed bacterial infection”? Courtney Merwin BS, RRT, CPHQ Clinical Quality Analyst East Jefferson General Hospital 4200 Houma Blvd. Metairie, LA 70006 504-503-5968 ccmer...@ejgh.org<mailto:ccmer...@ejgh.org> ________________________________ IMPORTANT NOTICE: This message and any included attachments are from East Jefferson General Hospital or its Affiliates, is for the intended addressee(s)only, and may include Protected Health (PHI) or other confidential information. If you are the intended recipient, you are obligated to maintain it in a secure and confidential manner and re-disclosure without additional consent or as permitted by law is prohibited. If you are not the intended recipient, use of this information is strictly prohibited and may be unlawful. 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