QA Septic Shock
Kendiss Olafson and the QA team are monitoring performance and appropriate interventions for Septic Shock in the ICUs in the Winnipeg Region.
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.
First SBP<90
- Project: QASeptic
- Item: First SBP<90
- Date and Time: that the blood pressure (BP) criteria is met for the first time as per 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
Special Cases
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.
First NEW Antibiotic
The time of antibiotics is the date and time antibiotics are given for sepsis.
- Project: QASeptic
- Item: First Antibiotic
- Date and Time: Date/Time of first antibiotic given to treat sepsis
- Comment:
- note reason if an antibiotic was not given
- state if non-standard source of information was used
Special Cases
Use your judgment to determine the first antibiotic likely administered to treat septic shock.
If a patient was on antibiotics prior to meeting the conditions for shock, then:
- if the antibiotic is not changed after going into shock, use the date/time of the last antibiotic administered prior to onset of shock;
- if the antibiotic is changed and administered shortly before or 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 administered 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 administered antibiotic change AFTER or the most recent change BEFORE (again, use your judgment)
If you are using non-standard data sources such as the in/out sheet, note so in the comment field.
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
Start Date 2 - April 1, 2012
Three month data collection for the Septic Shock Study. Before the 3 month period ends, the statistician will make an assessment. If the data is not conclusive, and there is not enough in the population, collection will be extended for a short period to obtain what is needed.
- Targeted completion date June 31, 2012, but may be extend after review before this end date.--Trish Ostryzniuk 14:38, 2012 February 23 (CST)
Template:Discussion Tina do you have any suggestion how to organize the multiple start & stop dates in one articles?Trish Ostryzniuk 20:21, 2012 February 17 (CST)
Start date 1: October 8, 2009
Every qualifying patient sent after this date will need to have a temp entry, not only patients admitted after this date.
Review Date
Feb 2,2010
- 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.--TOstryzniuk 16:30, 2 February 2010 (CST)--TOstryzniuk 16:30, 2 February 2010 (CST)
End Date 1
- STOP on Friday, July 1, 2011 - we will resume in fall time "after" Education blitz completed by ICU QA team.
- Stop for all patient, that include those already in unit prior to July 1 who develop septic shock after July 1.--TOstryzniuk 14:42, 27 June 2011 (CDT)
Consistency Checks
Tmp Checker will check for the following:
Date or Comment
Every entry for project QA Septic must have either a date or a time.
Dx but no tmp
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
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.