NHSN Healthcare Associated Infection (HAI) Reports, published by HL7 International - Structured Documents Work Group. This is not an authorized publication; it is the continuous build for version 2.1.0). This version is based on the current content of https://github.com/HL7/HAI/ and changes regularly. See the Directory of published versions
Active as of 2019-04-01 |
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="hai-questionnaire-los-event"/>
<meta>
<versionId value="13"/>
<lastUpdated value="2023-02-24T01:35:54.069+00:00"/>
<source value="#TutCpWfFornPy4FG"/>
<profile
value="http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire"/>
</meta>
<language value="en-US"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Placeholder</div>
</text>
<url
value="http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-event"/>
<identifier>
<value value="hai-questionnaire-los-event-v2"/>
</identifier>
<name value="HAI_questionnaire_los_event"/>
<title value="Late Onset Sepsis/Meningitis Event (LOS)"/>
<status value="active"/>
<experimental value="false"/>
<subjectType value="Patient"/>
<date value="2019-04-01"/>
<publisher value="HL7 International - Structured Documents Work Group"/>
<contact>
<name value="HL7 International - Structured Documents"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/structure"/>
</telecom>
</contact>
<description
value="This Questionnaire instance defines the questions and possible answers in the Late Onset Sepsis/Meningitis Event (LOS) Report. It records a late onset sepsis/meningitis infection event. For Late Onset Sepsis/Meningitis Event Reports, a Medicaid beneficiary number may be present.
For further details on reporting healthcare-associated infections see the specific protocols and data collection forms on the NHSN website [https://www.cdc.gov/nhsn/](https://www.cdc.gov/nhsn/).
"/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
<display value="United States of America"/>
</coding>
<text value="United States of America"/>
</jurisdiction>
<code>
<system value="http://loinc.org"/>
<code value="51897-7"/>
<display value="Healthcare Associated Infection report Document"/>
</code>
<item>
<linkId value="facility"/>
<text value="Facility ID"/>
<type value="url"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="event-number"/>
<text value="Event Number"/>
<type value="url"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="event-type"/>
<text value="Event Type"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.20"/>
</item>
<item>
<linkId value="date-of-event"/>
<text value="Date of Event"/>
<type value="date"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="facility-location"/>
<text value="Facility Location"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.19"/>
</item>
<item>
<linkId value="date-admitted-to-facility"/>
<text value="Date Admitted to Facility:"/>
<type value="date"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="inborn-outborn-observation"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="445087001"/>
<display value="Born before arrival to hospital (situation)"/>
</code>
<text
value="Inborn/Outborn: If the infant was outborn (born at a location other than the reporting hospital), select true. If the infant was inborn (born at the reporting hospital) select false."/>
<type value="boolean"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="risk-factors"/>
<code>
<system value="http://loinc.org"/>
<code value="51898-5"/>
<display value="Risk factors Document"/>
</code>
<text value="Risk Factors"/>
<type value="group"/>
<required value="true"/>
<repeats value="false"/>
<item>
<linkId value="risk-factors-group"/>
<text
value="This group contains risk factors such as central line present, birth weight, and gestational age."/>
<type value="display"/>
</item>
<item>
<linkId value="risk-factor-central-line"/>
<code>
<system
value="https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html"/>
<code value="1006-6"/>
<display value="central line including umbilical catheter"/>
</code>
<text
value="Risk Factor: Central line present prior to event, including umbilical catheter"/>
<type value="boolean"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="risk-factor-birth-weight"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="364589006"/>
<display value="Birth Weight"/>
</code>
<text value="Risk Factor: Birth weight (grams)"/>
<type value="quantity"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="gestational-age-known"/>
<text
value="Gestational age known: set true if known and false if unknown"/>
<type value="boolean"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
<display value="d"/>
</valueCoding>
</extension>
<linkId value="risk-factor-gestational-age"/>
<code>
<system value="http://loinc.org"/>
<code value="76516-4"/>
<display value="Gestational age--at birth"/>
</code>
<text value="Risk Factor: Gestational age (days)"/>
<type value="quantity"/>
<enableWhen>
<question value="gestational-age-known"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<required value="false"/>
<repeats value="false"/>
</item>
</item>
<item>
<linkId value="event-details"/>
<code>
<system value="http://loinc.org"/>
<code value="51899-3"/>
<display value="Details Document"/>
</code>
<text value="Event Details"/>
<type value="group"/>
<required value="true"/>
<repeats value="false"/>
<item>
<linkId value="event-details-group"/>
<text
value="This group contains details aboout the late onset septis infection event."/>
<type value="display"/>
</item>
<item>
<linkId value="infection-condition"/>
<text value="Specific Event"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3196"/>
</item>
<item>
<linkId value="criteria-used"/>
<text value="Laboratory Criteria Used"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3195"/>
</item>
<item>
<linkId value="died"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="419099009"/>
<display value="dead"/>
</code>
<text value="Died"/>
<type value="boolean"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="los-contributed-to-death"/>
<text value="Infection contributed to death"/>
<type value="boolean"/>
<enableWhen>
<question value="died"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="discharge-date"/>
<text value="Discharge Date"/>
<type value="date"/>
<required value="false"/>
<repeats value="false"/>
</item>
</item>
<item>
<linkId value="findings-group"/>
<code>
<system value="http://loinc.org"/>
<code value="18769-0"/>
<display value="Microbial susceptibility tests Set"/>
</code>
<text value="Findings Group"/>
<type value="group"/>
<required value="true"/>
<repeats value="true"/>
<item>
<linkId value="findings-group-description"/>
<text
value="This group records whether infection organisms were identified and, if so, records details about them."/>
<type value="display"/>
</item>
<item>
<linkId value="pathogen-identified"/>
<text value="Pathogen Identified"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.16"/>
</item>
<item>
<linkId value="pathogen-ranking"/>
<text value="Pathogen Ranking"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet
value="http://hl7.org/fhir/us/hai/ValueSet/nhsn-pathogen-ranking"/>
</item>
<item>
<linkId value="drug-susceptibility-test-group"/>
<text value="Drug Susceptibility Test Group"/>
<type value="group"/>
<repeats value="true"/>
<item>
<linkId value="drug-susceptibility-test-group-description"/>
<text
value="This group contains drug-susceptibility information such as the drug and the pathogen's susceptibility to it."/>
<type value="display"/>
</item>
<item>
<linkId value="drug-susceptibility-test"/>
<text value="Drug Susceptibility Test"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.15"/>
</item>
<item>
<linkId value="drug-susceptibility-test-interpretation"/>
<text value="Drug Susceptibility Test Interpretation"/>
<type value="choice"/>
<required value="false"/>
<repeats value="false"/>
<answerValueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.13"/>
</item>
</item>
</item>
<item>
<linkId value="nhsn-comment"/>
<code>
<system value="http://loinc.org"/>
<code value="86468-6"/>
<display value="Report Comment Section"/>
</code>
<text value="Comments"/>
<type value="text"/>
<required value="false"/>
<repeats value="false"/>
<maxLength value="2000"/>
</item>
</Questionnaire>
IG © 2020+ HL7 International - Structured Documents Work Group. Package hl7.fhir.us.hai#2.1.0 based on FHIR 4.0.1. Generated 2023-09-06
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