ACM SEP-1: EARLY MANAGEMENT BUNDLE, SEVERE SEPSIS/SEPTIC

SHOCKNumerator-Patients who received ALL of the following: Within 3 hours of presentation of severe sepsis:

Initial lactate level measurement Blood cultures drawn prior to antibiotic administration Broad spectrum or other antibiotics administered

AND Within 6 hours of presentation of severe sepsis:

Repeat lactate level measurement only if initial lactate level is elevated

AND ONLY if Septic Shock present: Received within 3 hours of presentation of septic

shock: Resuscitation with 30 ml/kg crystalloid fluids

ACM SEP-1: EARLY MANAGEMENT BUNDLE, SEVERE SEPSIS/SEPTIC

SHOCKAND ONLY if hypotension persists after fluid

administration, received within 6 hours of presentation of septic shock:

Repeat volume status and tissue perfusion assessment consisting of either: A focused exam including all of the following:

Vital signs Cardiopulmonary exam Capillary refill evaluation Peripheral pulse evaluation Skin examination

OR Any 2 of the following 4:

Central venous pressure measurement Central venous oxygen measurement Bedside cardiovascular ultrasound Passive leg raise or fluid challenge

ACM SEP-1: EARLY MANAGEMENT BUNDLE, SEVERE SEPSIS/SEPTIC

SHOCK

Denominator: Inpatients age 18 or over with an ICD-10-CM Principal or Other Diagnosis Code of Sepsis, Severe Sepsis, or Septic Shock