QA Septic Shock

Purpose

Kendiss Olafson & the QA team are monitoring performance and appropriate interventions for Septic Shock in the ICUs.

Data Collection Method

If an ICU patient has an admit or complication diagnosis of Septic Shock, the following two entries must be made in the L_TmpV2 file:

• Project: QASeptic
• Item: First SBP<90
• Date and Time

• Project: QASeptic
• Item: First Antibiotic
• Date and Time

Discussion

• The time of first hypotension should be clarified. Is this during their specific icu stay or the first hypotension at presentation to the health care system ie. emergency, community hospitals, nursing homes, wards, etc.

?Hypotension can sometimes go on for days prior to actual diagnosis of septic shock and transfer to ICU. Also it needs to be clear that the antibiotic start time must be related to the specific presentation of septic shock. Sometimes the patient is on antibiotics prior to onset of shock. I think I know what Dr.Kumar wants here as I have done some chart reviews for him in the past, but this must be made clear to all the data collectors so that it is consistent. Also, be aware that finding the initial hypotension and antibiotic start times can sometimes require quite an extensive chart search in some cases if the patient has been moved around between hospitals or wards.

• • waiting for clarification from Kendiss Olafson Ttenbergen 15:30, 29 September 2009 (CDT)

Consistency Checks

Tmp Checker will check for the following:

Dx but no tmp

L_Tmp entry is required if:

• a DX of Septic shock exists
• program is "CC"

Tmp but no dx

A diagnosis must exist if:

• a "QASeptic" entry is present in L_Tmp
• program must be "CC"

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.