World Sepsis Day 2018

Antibiotics

100

Which antibiotic would you give first in a Code Green? Zosyn or Vancomycin

Zosyn

200

Both Zosyn and Vancomycin are ordered by The Physician. Vancomycin is available right now, and Zosyn will take some time for Pharmacy to prepare. True or False? It is okay to give the Vancomycin while you wait for the Zosyn.

False

300

Why is Vancomycin infused last during a Code Green?

Because it is not a broad spectrum antibiotic and it takes longer to infuse.

400

Name three antibiotic options that are appropriate to hang first during a Code Green.

Ex. Zosyn, Levaquin, Cefepime Not Vancomycin

Charting

100

True or False? You must chart your blood culture collection before you chart that you have given your antibiotic.

True

200

Who charts the focused assessment on the patient when a Code Green is cancelled?

The Physician/Hospitalist

300

Where can you find the Code Green Bundle?

Under --> Orders -->Suggested Plans

400

What time frame must a Code Green be completed in?

1 hour

500

Where do you chart that your Blood Culture has been collected?

Under Interactive I &O-->Patient Care Interventions-->Blood Specimen Collected

Fluids

100

How many hours do you infuse a bolus over?

One hour

200

Which fluid is infused for the IV Bolus during Code Green?

Normal Saline

300

Is it okay to infuse a bolus on a patient with CHF or on HD?

Yes, it is okay to infuse a bolus on these patients. Sepsis is the priority and the fluid overload may be treated after.

400

What is the rate of the fluid bolus to be given during Code Green?

30ml/kg over 1 hour

Code Green Fall-Outs

100

Name 1 reason why RNs fail the Code Green Core Measures

Documentation of antibiotics prior to blood cultures RN cancelling Code Green Improper charting of IV fluid Bolus Blood pressures after fluid bolus, 15 minutes apart x 2 Cancelling repeat Lactic Acid Vancomycin given first during Code Green

200

Name 2 reasons why RNs fail Code Green Core Measures

Documentation of antibiotics prior to blood cultures RN cancelling Code Green Improper charting of IV fluid Bolus Blood pressures after fluid bolus, 15 minutes apart x 2 Cancelling repeat Lactic Acid Vancomycin given first during Code Green

300

Name 3 reasons why RNs fail Code Green Core Measures

Documentation of antibiotics prior to blood cultures RN cancelling Code Green Improper charting of IV fluid Bolus Blood pressures after fluid bolus, 15 minutes apart x 2 Cancelling repeat Lactic Acid Vancomycin given first during Code Green

400

Name 4 reasons why RNs fail Code Green Core Measures

Documentation of antibiotics prior to blood cultures RN cancelling Code Green Improper charting of IV fluid Bolus Blood pressures after fluid bolus, 15 minutes apart x 2 Cancelling repeat Lactic Acid Vancomycin given first during Code Green

Code Green Triggers

100

True or False? A Code Green is triggered by Cerner and then called overhead by the Operator

True

200

If a Code Green trigger such as elevated HR or Low BP was entered by mistake, can you then cancel the Code Green yourself?

No, the patient must be seen and assessed by a Physician and then cancelled by the Physician. The physician will then write a focused assessment as to why they cancelled the Code Green.

300

List 5 triggers of a Code Green.

2 SIRS Criteria : - Temp <96.8, or >101.12 - HR >95 - RR> 23 - WBC >12K, <4K or Band >10% 1 Organ Dysfunction Indicator - Lactate > 2mmol/L - SBP <90 or MAP <65 - Creatinine increase of 0.5mg/dl over 72 hours - Bilirubin >2.1

400

Where can you find the reason why a Code Green was called?

Under activities and interventions if you hover over Code Sepsis Alert. You may also see it on the Code Green Pop-Up/Discern Alert. Otherwise you can utilize your Code Sepsis Alert Criteria sheet which is attached on all WOWs and compare to recent labs of your patient.