HAI Laboratory Identified MDRO or CDI Event Report for LTCF

This Questionnaire instance records the laboratory identification of a MDRO or CDI microorganism. These reports are submitted if the LTCF is monitoring the organism specified. Each report records a single organism event. Information regarding the resident's care location, type of primary service and date of current admission are recorded.

Key Encounter data in the report includes:

• The date of the current admission to the facility location where the specimen was collected.
• The date of specimen collection.

Key Finding data in this report includes:

• Information on the type of organism and the date which it was collected.

For further details see the NHSN website https://www.cdc.gov/nhsn/ for reporting healthcare-associated infections in long-term care facilities. The concepts reported in this Questionnaire are defined for the NHSN "LabID Event Protocol for LTCF" and the corresponding data collection form "Laboratory-identified MDRO or CDI Event for LTCF (CDC 57.138)".

Questionnaire Details

Id:	hai-ltcf-questionnaire-mdro-cdi-event
Meta:	10 2019-07-04T19:12:37.000-04:00 http://hl7.org/fhir/us/hai-ltcf/StructureDefinition/hai-single-person-report-questionnaire
Language:	en-US
Url:	http://hl7.org/fhir/us/hai-ltcf/Questionnaire/hai-ltcf-questionnaire-mdro-cdi-event
Identifier:	hai-questionnaire-los-event-v1
Version:	Version: 1.0.0
Name:	HAI_LTCF_questionnaire_mdro_cdi_event
Status:	draft
Subject Type:	Patient
Date:	2019-08-01
Publisher:	HL7
Jurisdiction:	Code: US
Code:	Healthcare Associated Infection report Document Code system: http://loinc.org Code: 51897-7

Questionnaire Items

Group	text	linkId	type	required	repeats	enableWhen	answerValueSet
	Facility ID	facility-id	url	true	false
	Date of First Admission to Facility	date-of-first-admission-to-facility	date	true	false
	Date of Current Admission to Facility	date-of-current-admission-to-facility	date	true	false
The Event Details Group records details about the event.
	Event Details	event-details-group	group	true	false
Event Details	Date Specimen Collected	date-specimen-collected	date	true	false
Event Details	Specimen Type	specimen-type	choice	true	false		http://hl7.org/fhir/us/hai-ltcf/ValueSet/2.16.840.1.114222.4.11.3249
Event Details	Resident Care Location	resident-care-location	url	true	false
Event Details	Primary Resident Service Type	primary-resident-service-type	choice	true	false		http://hl7.org/fhir/us/hai-ltcf/ValueSet/2.16.840.1.113883.10.20.5.1.5.9.3
The Encounters Group records the first admission date to the facility along with whether or not the resident was transferred from an acute care facility in the past four weeks.
	Encounters Group	encounters-group	group	true	true
Encounters Group	Transfer From Acute Care Facility to LTCF in Past Four Weeks	transfer-from-acute-care-facility	boolean	true	false
Encounters Group	Date of Last Transfer From Acute Care to LTCF	date-of-last-transfer	date	false	false	transfer-from-acute-care-facility="true"
Encounters Group	Resident on Antibiotic Therapy for Specific Organism at Time of Transfer to Facility	antibiotic-at-time-of-transfer	boolean	false	false	transfer-from-acute-care-facility="true"
The Findings Group records a laboratory-identified microorganism. It records one microorganism (if more were identified, each is recorded in a separate QuestionnaireResponse), and details about the specimen collection.
	Findings Group	findings-group	group	true	true
Findings Group	Specific Organism Type	specific-organism-type	choice	true	false		http://hl7.org/fhir/us/hai-ltcf/ValueSet/2.16.840.1.114222.4.11.3194
	Comments	nhsn-comment	text	false	false