multisystem organ failure

Question: What does one do with the diagnosis of "multisystem organ failure"

Could I / should I ask a broad question asking for delineation of the failing organs or based on clinical indicators address each system separately? The diagnosis of acute renal failure has been documented. The patient is in an acute CML blast crisis. I also have a diagnosis of 'presumed DIC'. There are indicators for sepsis and pneumonia is a 'possible' diagnosis. ABG's were done: C02 31, PO2 56 with a sat of 88.8%. The patient was made comfort care only.

Any thoughts?



Charlene Thiry RN, BSN, CPC, CCDS
Clinical Documentation Specialist
Quality Resources
Menorah Medical Center

Comments

  • edited May 2016
    I would query for the cause of the organ failure. As you indicated this
    is a complex patient with a lot going on, but if they don't document it
    and make the links between conditions then the severity/mortality scores
    may not accurately represent the patient's condition. CML patients (if
    I recall correctly from my first 2 years in nursing working a
    hematology/oncology floor) in blast crisis are also usually hit with a
    lot of chemotherapy which, if that did happen may also be a contributing
    factor.

    Robert

    Robert S. Hodges, BSN, MSN, RN, CCDS
    Clinical Documentation Improvement Specialist
    Aleda E. Lutz VAMC
    Mail Code 136
    1500 Weiss Street
    Saginaw MI 48602
    P: 989-497-2500 x13101
    F: 989-321-4912
    E: Robert.Hodges2@va.gov

    "We are continually faced by great opportunities brilliantly disguised
    as insolvable problems." Benjamin Franklin
  • using clinical indicators I would ask what systems are in failure- respiratory? renal? heart? liver? etc.
    Laurie L. Prescott RN, MSN CCDS
    lprescott@morehead.org
  • I query for the individual organ failures. I edit the attached query in these instances.

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • edited May 2016
    Katy,

    I sure like the choices 'acute. . . .'

    Do you fit the clinical indicators in on the form somewhere to make sure the support for a diagnosis is there?

    Charlene Thiry RN, BSN, CPC, CCDS
    Clinical Documentation Specialist
    Quality Resources
    Menorah Medical Center
  • Yup. Include clinical indicators.

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
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