When to query for sepsis

stayrookgt@gmail.com

So I have had several patients come in that met SIRS criteria and were sick (weakness and body aches) they end up having positive blood cultures but do not meet SOFA criteria. The patient has ESRD and is chronically on dialysis. Awaiting final culture results to determine the source of infection.   No other organ failure.  Do you query for sepsis if there is no other organ failure?  What to do?

rmendoza

You still can query for sepsis even without organ failure. If you have enough clinical indicators like fever, tachycardia, leukocytosis, and if you have positive blood cultures, and patient is being treated with IV antibiotics. Sepsis with organ failure will code to Severe Sepsis.

evanspx@sutterhealth.org

If one adheres to Sepsis -3, the organ failure or dysfunction should be:

1. Acute

2. Due to Sepsis and not some other condition

Paul Evans RHIA, CCDS

katysuegood@gmail.com

We are utilizing sepsis-3 criteria which demands organ failure to diagnose sepsis. I think you would find this chart very vulnerable to audit if you queried for sepsis and the provider agreed. Katy Good

jackietouch@aol.com

I agree with Paul and Kathryn: If you are utilizing Sepsis-3 criteria, it doesn't appear that there are enough indicators to query for sepsis. If this were a pediatric patient, however, sepsis 3 does not yet apply so might be appropriate to query. 

Jackie Touch, MSN, RN, CCM
CHOC Children's
Orange, CA

katysuegood@gmail.com

based off of the question, I was assuming the facility has adopted sep-3. If not, They would be able to query based on the SIRS criteria.

Katy

proddy@clarionhospital.org

Maybe this has already been asked and addressed, but is anyone using a "double standard" and using SIRS to query and or validate Sepsis for medicare payors and SOFA to query or validate Sepsis for commercial/managed care payors that are denying sepsis based on SIRS? 

evanspx@sutterhealth.org

It is my opinion a site should use and establish clinical definitions that are universally accepted and vetted by our medical staff and apply that to all cases regardless of payer. 

Good question!

P. Evans, RHIA