Sepsis or Sepsis 3

proddy@clarionhospital.orgproddy@clarionhospital.org
in Clinical & Coding
I am wondering if you all are using the Sepsis 3 guidelines or the old Sepsis guidelines in determining when to query for Sepsis.  Given the CMS stance on Sepsis 3, we have not really changed our process here, and I am wondering if others are moving forward with it?

Comments

  • katysuegood@gmail.comkatysuegood@gmail.com
    We adopted Sepsis-3 as a facility in May of 2016. We now only query FOR sepsis based on SOFA and query 'against' sepsis when the patient does not meet sepsis-3 criteria as well. Its a work in progress but it's going fairly well....
  • rpeigh@marshallmedical.orgrpeigh@marshallmedical.org

    We are still using 2 or more SIRS markers + infection = sepsis. The providers I work with wanted to stay consistent with core measure/SEP-1 definitions so they didn't want to change to Sepsis-3/SOFA criteria yet.

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    We use SIRS, but I make every attempt to review for a SOFA of at least '2' attributable to Sepsis as well as ensuring documentation can, when indicated,  support an acute organ failure 2/2 sepsis, which codes to severe sepsis.
  • proddy@clarionhospital.orgproddy@clarionhospital.org
    ok, thanks for your input!! It's reassuring to know we're not alone out here!
  • jackietouch@aol.comjackietouch@aol.com
    I work in a children's hospital and we use the previous sepsis criteria as there are no updated guidelines for pediatrics. For teens and young adults >/= 18 years old, we query using Sepsis 3 criteria but have not yet started clinically validating ("anti-query") if MD documents sepsis based on previous criteria.

    Jackie
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    I think the 'best' thing we can do, regardless of the criteria endorsed by our sites, is try to ensure that any acute organ dysfunction that is DUE to sepsis is clearly stated as such, when appropriate...it seems to me this would satisfy most 'reasonable' auditors.
  • jackietouch@aol.comjackietouch@aol.com
    Good point, Paul. I totally agree and that is exactly what we do...if we clarify for sepsis and MD agrees, we then ask if organ dysfunction (whatever they may be, each presented individually in the case of multiple abnormalities) is due to the sepsis or due to another cause and ask that it be documented as such. I am in a teaching hospital, so it is a great way to facilitate discussion among the med students, residents, fellows, and attendings.
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