I did not listen to the presentation, though I would assume she is referring to the evolution of this measure component - In October 2015, it was a requirement to document all component of the tissue perfusion assessment - cardiopulmonary, vital signs, capillary refill, skin assessment; OR a provider could document a passive leg raise with cardiac ultrasound. This has evolved to a minimum requirement of attestation to completing this assessment. So, a provider can document variations of this attestation including the original 5 components, or 4 of the 5 components plus O2 sat, or the passive leg raise with cardiac ultrasound, or stating a variation of the following - "fluids given. Reassessment complete" "focused exam complete" "patient reassessed after bolus" etc etc.
The timeframe still stands that this must be completed after the initiation of the total 30ml/kg bolus. Hope this helps! Danette Danette Culver, MSN, APRN, ACNS-BC, CCRN-K, RN-BC Clinical Nurse Specialist Norton Healthcare 4967 U.S. Hwy 42, Suite 100 Louisville, KY 40222 O: 502.420.4371 C: 812.881.0080 A Clinical Nurse Specialist (CNS) is a Master's prepared Advance Practice Nurse whose function is to improve outcomes in patient care. The CNS is a clinical practice expert, an educator, a researcher, and a consultant who influences the three spheres of practice: patient care, nursing, and systems. - National Association of Clinical Nurse Specialists From: Sepsisgroups [mailto:[email protected]] On Behalf Of Cooke, Susan Sent: Tuesday, November 24, 2020 12:48 PM To: '[email protected]' <[email protected]> Subject: [EXTERNAL] [Sepsis Groups] Tissue perfusion assessment CAUTION: **EXTERNAL EMAIL** Do NOT click links or open attachments unless you recognize the sender and know the content is safe. If you are not sure, please forward the email to [email protected]<mailto:[email protected]> for review. ________________________________ Hi and good morning, I was wondering if this group could clear up something I heard in a presentation on the SCCM website. I am new to my role but not new to the sepsis bundle. I have a question related to a presentation from the July 22, 2020 SCCM 47th Critical Care Congress titled " Improving the Early Detection of Sepsis in the ED and Patient Wards". In one of the segments titled " Reconciliation of SEPSIS-3 with CMS SEP-1 Standards: A Minor Adjustment or Extensive Overhaul? Sean R. Townsend, MD. (Actually presented by Tiffany Osborn MD from Washington Univ in St Louis in Dr Townsends absence) she clearly states that the SEP-SHOCK 6 HR BUNDLE requirement of tissue perfusion assessment is no longer required. She repeats this 3 or more times. She states that the only requirement is that the practitioner must document that another bedside evaluation was done to assess the treatment response thus far. I have searched for verification of this statement in CMS guidelines and cannot find this in writing. Actually I still find it clearly written in the CMS SEP-1 requirements that a tissue perfusion assessment is required. I attached it here. Can anyone verify this and provide me with a resource? Thank you so much. Susan Cooke MSN RN, NEA-BC Sepsis Program Coordinator University Medical Center New Orleans Member of LCMC Health (O) 504-702-2924 (F) 504-702-2119 [email protected]<mailto:[email protected]>
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