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<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>We are in process on implementation of a
formal sepsis management program at Iowa Health – <st1:City w:st="on"><st1:place
w:st="on">Des Moines</st1:place></st1:City> as part of our corporate Iowa
Health System sepsis initiative. Our <st1:City w:st="on"><st1:place w:st="on">Des
Moines</st1:place></st1:City> screening plan: the sepsis screening tool will
be a permanent part of the medical record & signed by the ED physician
(draft attached). This approach is a result of discussion with our internal
RAC team. It starts appropriate physician & staff documentation at the
point of service. It will be on a pastel pink paper & stored in the ED
records of our paper medical record (yes, we’re still part paper &
EMR). We will begin implementation in September along with a sepsis treatment
order set currently being developed under the leadership of one our trauma
surgeon intensivists who is highly engaged.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>If the patient is screened in the ED, but
responds appropriately to therapy & is admitted to a general med/surg area,
we will have a visual cue, pink paper, to all staff the patient had been
screened at point of service. Part of the required communication handoff
documented on the sepsis screening tool specifically addresses the handoff
communication has occurred by whom & with whom on the receiving end. In
the event of a RRT call, the RRT team will have been taught to scan the chart
for the “pink paper”. We are currently in process of building
approved RRT protocols internally, of which sepsis is a separate protocol. Though
our RRT previously provided some of the appropriate care, they were practicing “bare”
for most types of RRT responses. Thus, formalization of their protocols under
a medically sanctioned Orders Approval Committee became necessary. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Evelyn Schnoor, MSN, RN, ARNP,
ACNS-BC</span></font><font color=black><span style='color:black'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Quality Improvement Coordinator, IH-DM</span></font><font
color=black><span style='color:black'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Desk 515.263.5507</span></font><font
color=black><span style='color:black'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Fax 515.263.5415</span></font><font
color=black><span style='color:black'><o:p></o:p></span></font></p>
<p class=MsoNormal><em><i><font size=2 color=black face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:black'>"Where minds are
open, there will always be a frontier."</span></font></i></em><font
color=black><span style='color:black'><o:p></o:p></span></font></p>
<p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><strong><b><font
size=5 color=green face=Webdings><span style='font-size:18.0pt;font-family:
Webdings;color:green'>P</span></font></b></strong><strong><b><font size=2
color=blue face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:blue'> </span></font></b></strong><strong><b><font size=2 color=green
face="Trebuchet MS"><span style='font-size:10.0pt;font-family:"Trebuchet MS";
color:green'>Save Paper - Do you really need to print this e-mail?</span></font></b></strong><strong><b><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'><o:p></o:p></span></font></b></strong></p>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
sepsisgroups-bounces@lists.sepsisgroups.org
[mailto:sepsisgroups-bounces@lists.sepsisgroups.org] <b><span style='font-weight:
bold'>On Behalf Of </span></b>Melnik, Lana (<st1:City w:st="on"><st1:place
w:st="on">Tacoma</st1:place></st1:City>)<br>
<b><span style='font-weight:bold'>Sent:</span></b> Thursday, July 23, 2009 1:02
PM<br>
<b><span style='font-weight:bold'>To:</span></b> Glenn H Howell;
Sepsisgroups@lists.sepsisgroups.org<br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: [Sepsis Groups] Rapid
Response</span></font><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-family:"Times New Roman"'><o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Yes, we have added sepsis screening as
part of the rapid response team algorithm.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Lana Melnik, RN BSN<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Performance Improvement Coordinator<o:p></o:p></span></font></p>
<p class=MsoNormal><st1:place w:st="on"><st1:City w:st="on"><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'>Tacoma</span></font></st1:City><font size=2 color=navy
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:navy'>, <st1:State
w:st="on">WA</st1:State></span></font></st1:place><font size=2 color=navy
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<div>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
sepsisgroups-bounces@lists.sepsisgroups.org
[mailto:sepsisgroups-bounces@lists.sepsisgroups.org] <b><span style='font-weight:
bold'>On Behalf Of </span></b>Glenn H Howell<br>
<b><span style='font-weight:bold'>Sent:</span></b> Thursday, July 23, 2009 6:39
AM<br>
<b><span style='font-weight:bold'>To:</span></b>
Sepsisgroups@lists.sepsisgroups.org<br>
<b><span style='font-weight:bold'>Subject:</span></b> [Sepsis Groups] Rapid
Response</span></font><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-family:"Times New Roman"'><o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'>Does
the Rapid Response team in your hospital capture a lot of septic patients and
improve interventions early that would enhance positive patient outcomes.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'>Glenn
Howell MSN<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'>Quality
Improvement Coordinator<o:p></o:p></span></font></p>
<p class=MsoNormal><st1:place w:st="on"><st1:PlaceName w:st="on"><font size=2
face=Calibri><span style='font-size:11.0pt'>Wake</span></font></st1:PlaceName>
<st1:PlaceType w:st="on">Forest</st1:PlaceType> <st1:PlaceType w:st="on">University</st1:PlaceType>
<st1:PlaceName w:st="on">Baptist</st1:PlaceName> <st1:PlaceName w:st="on">Medical</st1:PlaceName>
<st1:PlaceType w:st="on">Center</st1:PlaceType></st1:place><o:p></o:p></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'>Phone:
(336) 716-5047<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'>E-Mail:
ghowell@wfubmc.edu<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Calibri><span style='font-size:11.0pt'><o:p> </o:p></span></font></p>
</div>
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