CCMDB Wiki

QA Septic Shock: Difference between revisions

← Older edit
m Text replacement - "[[Category: " to "[[Category:"
 
(77 intermediate revisions by 6 users not shown)
Line 1: Line 1:
Kendiss Olafson & the QA team are monitoring performance and appropriate interventions for [[Septic Shock]] in the ICUs in the Winnipeg Region.
{{Project
|ProjectActive=legacy
|ProjectProgram=CC
|ProjectRequestor=Dr. Kendiss Olafson
|ProjectCollectionStartDate=2017-03-06
|ProjectCollectionStopDate=2017-06-30
|Project={{PAGENAME}}
}}
 
{{LegacyContent
|explanation=Tmp project ended
|content=
see [[#Study Run Times]] for details.
 
Kendiss Olafson and the QA team are monitoring performance and appropriate interventions for [[Septic Shock]]/[[Shock, septic]] in the ICUs in the Winnipeg Region.


==Data Collection Method==
==Data Collection Method==
For the '''first episode''' of '''[[Septic Shock]]''' (admit or complication) of any ICU patient, the following two entries must be made in the TMP, [[L_TmpV2]] file.
For the '''first episode''' of '''[[Septic Shock]]/[[Shock, septic]]''' (admit or complication) of any ICU patient, the following two entries must be made in the TMP, [[L_TmpV2]] file.
   
   
=== First SBP<90 ===
=== BP Criteria ===  
* Project: QASeptic
* Project: QASeptic
* Item: First SBP<90
* Item: BP Criteria   
* Date and Time: that the '''blood pressure''' (BP) criteria is met for the '''first time''' as per [[Septic_Shock#.281.29_Blood_pressure_.28BP.29_criteria | Septic Shock Blood Pressure Guideline]] guideline
* Date and Time: that the '''blood pressure''' (BP) criteria is met for the '''first time''' as per [[Septic_Shock#.281.29_Blood_pressure_.28BP.29_criteria | Septic Shock Blood Pressure Guideline]] guideline
* Comment: only in case of transfer from other ICU, enter '''transfered from previous ICU with DX of shock already coded'''; in that case don't code date/time
* '''Comment''': only in case of ''transfer from other ICU'', enter '''transferred from previous ICU with DX of shock already coded'''; in that case don't code date/time


==== Special Cases ====
==== BP prior to admission ====
First low BP '''may be prior''' to ICU admission.
First low BP '''may be prior''' to ICU admission.


If a patient with existing septic shock is '''transferred''' from one ICU to another, for next ICU transferred ''into'' code Item: First BP <90 with '''no date/time''' and enter ''transfered from previous ICU with DX of shock already coded'' as the comment.
If a patient with existing septic shock is '''transferred''' from one ICU to another, for next ICU transferred ''into,'' code Item: First BP <90 with '''no date/time''' and enter ''transferred from previous ICU with DX of shock already coded'' as the '''COMMENT'''.


=== First '''NEW''' Antibiotic ===
=== First '''NEW''' Antibiotic ===
Line 19: Line 33:


* Project: QASeptic
* Project: QASeptic
* Item: First Antibiotic
* Item: First Antibiotic  
** includes all antimicrobials, not just antibiotics
** if causative agent turns out insensitive to that antimicrobial, still enter it; this study is concerned with the delays in treatment, not the use of the correct drug
* Date and Time: Date/Time of first antibiotic given to treat sepsis
* Date and Time: Date/Time of first antibiotic given to treat sepsis
* Comment:  
* Comment:  
Line 25: Line 41:
** state if non-standard source of information was used
** state if non-standard source of information was used


==== Special Cases ====
==== Special Cases ====
Antibiotic may be given prior to the development of shock or after. 
Use your '''judgment''' to determine the '''first''' antibiotic likely <u>administered</u> to '''treat septic shock'''.  
 
If the person then goes into septic shock and the antibiotics '''are not changed''' the time is that of '''original''' antibiotic coverage.


If the antibiotics '''are changed''' in response to the new shock state then the time of Antibiotics is the date/time that the '''new''' antibiotics were given.
If a patient was on antibiotics '''prior to''' meeting the conditions for shock, then:


If the patient '''does not receive Antibiotics''' (e.g. DC treatment) provide a reason in the comment section of the "First Antibiotic" entry.
*if the antibiotic is '''not''' changed after going into shock, use the date/time of the last antibiotic <u>administered</u> '''prior to''' onset of shock;
*if the antibiotic '''is''' changed and <u>administered</u>'''&nbsp; shortly before '''or'''&nbsp; after''' going into shock then use your judgment to determine the following:
**if the antibiotic change was likely '''related''' to the imminent septic shock, record the date/time that '''new''' antibiotic was <u>administered</u> as the start dt/tm; you can state your reason in the comments field.
**if the antibiotic change was likely '''unrelated''' to septic shock, code the date and time of the first <u>administered</u> antibiotic change AFTER or the most recent change BEFORE&nbsp; (again, use your judgment)


Use your best judgment in entering this. If you are using non-standard sources such as the in/out sheet, note so in the comment field.
<br> If you are using '''non-standard data sources''' such as the in/out sheet, note so in the comment field.  


If the patient was already on a likely unrelated antibiotic and they develop new sepsis/infection, the antibiotic date should be left blank and in the comment section state patient already on antibiotic and there were no antibiotic changes made.
If the patient '''does not receive Antibiotics''' (e.g. DC treatment) don't enter a date but provide a reason in the comment section of the "First Antibiotic" entry.


== Study Run Times ==
== Study Run Times ==
=== Start date: October 8, 2009 ===
===Third wave - Start Date: March 6, 2017 00:01 / End Date: June 30, 2017 23:59 ===
'''Every''' qualifying patient sent after this date will need to have a temp entry, not only patients admitted after this date.
Any patient who is discharged between the above dates and has a DX of septic shock needs to have a QASeptic Tmp entry.
 
*Tmp entry is not required for those patients admited during the study time but discharged after June 30 23:59 (confirmed with Julie)[[User:GHall|GHall]] 10:34, 2017 July 6 (CDT)
=== Review Date ===
*The ICU QI team has requested an updated review.


==== Feb 2,2010'''====
===Second wave - Start Date: April 1, 2012 / End Date: June 30, 2012 ===
*Data is showing some good trends for ICU's in the Region.  Dr. Kendiss Olafson from the ICU QI team will present at the data collection team meeting in April 2010.--[[User:TOstryzniuk|TOstryzniuk]] 16:30, 2 February 2010 (CST)--[[User:TOstryzniuk|TOstryzniuk]] 16:30, 2 February 2010 (CST)
Three month data collection for the Septic Shock Study.  A review of the current data has been completed by the [[p:Julie Mojica |statistician]] and the ICU QI on June 12.12. 
**see: [http://ltc.umanitoba.ca/wikis/ccmdb/index.php/QA_Septic_Shock#Update:_Feb_2.2010_Review_Meeting Feb 2.2010 Review Meeting]
*RE: '''stop date''': Patients '''ADMITTED up to midnight June 30th''' will '''continue to be entered and followed''' for QASeptic Study '''until they are discharged''' from the ICU.
*Any new patients ADMITTED on July 1st 0001 hrs will not be entered into the QASeptic Study.--[[User:TOstryzniuk|Trish Ostryzniuk]] 16:05, 2012 June 13 (CDT).


==== May 4 ,2010 from 1100-1200 hrs ====
=== First wave - Start Date: October 8, 2009 / End Date: July 1, 2011 ===
*meeting request sent out Feb 2.10 by [[User:TOstryzniuk|TOstryzniuk]] 22:21, 2 February 2010 (CST)
Every qualifying patient sent after this date will need to have a temp entry, not only patients admitted after this date.
 
*Review Date - done Feb 2,2010
=== End Date ===
**Data is showing some good trends for ICU's in the Region.  Dr. Kendiss Olafson from the ICU QI team will present at the data collection team meeting in April 2010.--[[User:TOstryzniuk|TOstryzniuk]] 16:30, 2 February 2010 (CST)--[[User:TOstryzniuk|TOstryzniuk]] 16:30, 2 February 2010 (CST)
*Preliminary End Date: '''December 31.2010'''---[[User:TOstryzniuk|TOstryzniuk]] 17:04, 8 February 2010 (CST)(extended from April 8.10)
**see: [[QA_Septic_Shock#Update:_Feb_2.2010_Review_Meeting Feb 2.2010 |Review Meeting]]
**'''(set in ccmdb.mdb consistency checks)'''See: [http://ltc.umanitoba.ca/wikis/ccmdb/index.php/CCMDB.mdb_Change_Log_2010#V1.993_Changes | See:change request log]
*Stop for '''all''' patient, that include those already in unit prior to July 1 who develop septic shock after July 1
 
*we will attempt to resume in fall time "after" Education blitz completed by ICU QA team.--[[User:TOstryzniuk|TOstryzniuk]] 14:42, 27 June 2011 (CDT)
== Consistency Checks ==
[[Tmp Checker]] will check for the following:  


=== Date or Comment ===
=== Date or Comment ===
Every entry for project QA Septic must have either a date or a time.
Every entry for project QA Septic must have either a date or a time.


=== Dx but no tmp ===
{{Data Integrity Check List|}}
[[L_TmpV2]] entry is required if:
* a DX of Septic shock exists
* program is "CC"
(implemented by [[s_tmp_QASeptic_Dx_no_tmp]])
 
=== Tmp but no dx ===
A diagnosis must exist if:
* a "QASeptic" entry is present in [[L_TmpV2]]
* program must be "CC"
**implemented by: [[S tmp QASeptic Dx no tmp]]


== Send mode ==
== Send mode ==
Data for '''all''' patients meeting requirements for this study, including patients you are not sending this batch, will be sent every time complete patients are sent.
Data for '''all''' patients meeting requirements for this study, including patients you are not sending this batch, will be sent every time complete patients are sent.


== Related articles ==
* [[Septic Shock]]


== Legacy ==
In [[CCMDB.mdb_Change_Log_2012#ver_2012-09-06]] "First SBP<90" was changed to "BP Criteria". [[User:Ttenbergen|Ttenbergen]] 11:08, 2012 September 12 (CDT)


== Related articles ==
}}
* [[Septic Shock]]


[[Category: Special_Short_Term_Projects]]
[[Category:Sepsis]]
[[Category: L_TmpV2 Data]]
[[Category:Shock]]
[[Category: All Projects]]
[[Category:L_TmpV2 Data]]
[[Category: QA]]
[[Category:QA]]
Retrieved from "https://ccmdb.kuality.ca/index.php?title=QA_Septic_Shock"