New sepsis criteria?? Say what?
Rhonda sent me this information and I asked her if I could put this out for discussion. Anyone else looking into this? Thoughts?
I am not sure everyone is aware but this will drastically impact CDI, Coding and reimbursement. Do you plan to change your criteria / clinical indicators?
• http://www.esicm.org/news-article/Sepsis-3-International-Consensus-definitions-Sepsis-Septic-Shock-Feb-2016
• http://jama.jamanetwork.com
Key points:
• Sepsis is now defined as a ‘life-threatening organ dysfunction due to a dysregulated host response to infection’
• The key element of sepsis-induced organ dysfunction is defined by ‘an acute change in total SOFA score ≥ 2 points consequent to infection, reflecting an overall mortality rate of approximately 10%’.
• A simple bedside score (‘qSOFA’, for quick SOFA) has been proposed, which incorporates hypotension (systolic blood pressure ≤100mmHg), altered mental status and tachypnea (respiratory rate > 22/min): the presence of at least two of these criteria strongly predicts the likelihood of poor outcome in out-of-ICU patients with clinical suspicion of sepsis.
• Septic shock is now defined as a ‘subset of sepsis where underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality’. Clinical criteria identifying such condition include the need for vasopressors to obtain a MAP≥ 65mmHg and an increase in lactate concentration > 2 mmol/L, despite adequate fluid resuscitation.
• Given the urgent need to widely spread education campaigns and better inform the public about the clinical and economic implications of such condition, a lay definition of sepsis as ‘a life-threatening condition that arises when the body’s response to infection injures its own tissue’ has been also endorsed.
In essence, SIRS in the concept of infection is now dead. One has to meet criteria for severe sepsis now to have sepsis. I am not sure how this will impact the new Core Measure for Severe Sepsis.
I am doing some research on this but wanted to reach out to you to hear your thoughts and opinions.
Thanks in advance for your feedback. Enjoy your day.
Sincerely,
Rhonda West-Haynes, MHA, BSN, RHIA, CCDS, CCS Manager Clinical Documentation Specialists Chester County Hospital
Tel: 610-738-2428 | Cell: 484-401-4669 | Fax: 610-732-6811 Please update your contact list with my NEW email address:
Email: rhonda.west-haynes@uphs.upenn.edu
[1]
I am not sure everyone is aware but this will drastically impact CDI, Coding and reimbursement. Do you plan to change your criteria / clinical indicators?
• http://www.esicm.org/news-article/Sepsis-3-International-Consensus-definitions-Sepsis-Septic-Shock-Feb-2016
• http://jama.jamanetwork.com
Key points:
• Sepsis is now defined as a ‘life-threatening organ dysfunction due to a dysregulated host response to infection’
• The key element of sepsis-induced organ dysfunction is defined by ‘an acute change in total SOFA score ≥ 2 points consequent to infection, reflecting an overall mortality rate of approximately 10%’.
• A simple bedside score (‘qSOFA’, for quick SOFA) has been proposed, which incorporates hypotension (systolic blood pressure ≤100mmHg), altered mental status and tachypnea (respiratory rate > 22/min): the presence of at least two of these criteria strongly predicts the likelihood of poor outcome in out-of-ICU patients with clinical suspicion of sepsis.
• Septic shock is now defined as a ‘subset of sepsis where underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality’. Clinical criteria identifying such condition include the need for vasopressors to obtain a MAP≥ 65mmHg and an increase in lactate concentration > 2 mmol/L, despite adequate fluid resuscitation.
• Given the urgent need to widely spread education campaigns and better inform the public about the clinical and economic implications of such condition, a lay definition of sepsis as ‘a life-threatening condition that arises when the body’s response to infection injures its own tissue’ has been also endorsed.
In essence, SIRS in the concept of infection is now dead. One has to meet criteria for severe sepsis now to have sepsis. I am not sure how this will impact the new Core Measure for Severe Sepsis.
I am doing some research on this but wanted to reach out to you to hear your thoughts and opinions.
Thanks in advance for your feedback. Enjoy your day.
Sincerely,
Rhonda West-Haynes, MHA, BSN, RHIA, CCDS, CCS Manager Clinical Documentation Specialists Chester County Hospital
Tel: 610-738-2428 | Cell: 484-401-4669 | Fax: 610-732-6811 Please update your contact list with my NEW email address:
Email: rhonda.west-haynes@uphs.upenn.edu
[1]
Comments
http://qsofa.org/
LeeAnn Conaway, RN, CCRN, CCDS
Supervisor CDI/Coding, UPMC
1) SEP-1, the new sepsis core measure in the United States does not rely on these new definitions and will not be updated to incorporate the changes proposed. A change to SEP-1 that was not field tested would adversely affect 5000 acute care hospitals in the United States gather information under SEP-1 to improve patient care.
2) The new definitions and screening strategies derived from them have not been field tested.
I hope this is useful.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
• http://www.esicm.org/news-article/Sepsis-3-International-Consensus-definitions-Sepsis-Septic-Shock-Feb-2016
Julie Draper
Interim Coding & CDI Supervisor
641.428.7032
draperj@mercyhealth.com
Can you check to see if it is correct?
Thank