Category: Federal Forum Posters
Purpose: For a hospital to receive reimbursement for patient care, Centers for Medicare & Medicaid Services (CMS) require that certain measures be met. Currently, CMS requires patients with sepsis receive the appropriate empiric antibiotics within a 3 hour timeframe. Recently, a randomized controlled trial indicated that outcomes significantly improved with a goal of 0.95 hours for time to antibiotics, and the 2016 Surviving Sepsis guidelines recommend administration of intravenous antimicrobials within 1 hour. The Indian Health Service faces unique challenges from the perspectives of both patient population and institution size that have not yet been studied.
Methods: This retrospective study will be submitted to the Institutional Review Board for approval. A search of the electronic medical record will identify charts with an International Classification of Disease 10th edition (ICD-10) code of A41.89, A41.9, R65.20, or R65.21 as the primary purpose of visit between September 1, 2017 and September 1, 2018. These ICD-10 codes represent other specified sepsis, unspecified sepsis, severe sepsis without septic shock, and severe sepsis with septic shock, respectively. An additional search for blood cultures drawn in the same time frame will serve as a cross-check to validate the diagnosis. The following data will be collected: ICD-10 code, date of admission, choice of empiric antibiotic therapy, time antibiotics were ordered, time antibiotics were verified by a pharmacist, time antibiotics were administered, and pertinent lab values such as white blood count, lactate levels, and blood cultures. Each chart will be de-identified and evaluated by a single reviewer for their compliance to sepsis guidelines using a standardized form. Each course of patient care will be rated as compliant or non-compliant with CMS guidelines as the primary endpoint, and rated as compliant or non-compliant with the 0.95 hour model.
Results: not applicable
Conclusion: not applicable
Abigail Petrulis– PGY1 Pharmacy Resident, Phoenix Indian Medical Center Indian Health Service, Phoenix, AZ