NHSN Healthcare Associated Infection (HAI) Reports Long Term Care Facilities (HAI-LTCF-FHIR), Release 1 - US Realm (Release 0.1.0 STU1 Ballot)

This page is part of the Healthcare Associated Infection Reports (HAI) Long Term Care Facilities (LTCF) (v0.1.0: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

JSON Format: QuestionnaireResponse-hai-ltcf-questionnaireresponse-mdro-cdi-event

Raw json

{
  "resourceType" : "QuestionnaireResponse",
  "id" : "hai-ltcf-questionnaireresponse-mdro-cdi-event",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2019-06-25T19:23:28.000-04:00"
  },
  "language" : "en-US",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en-US\">\n         <table xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\" class=\"bare\">\n            <tr>\n               <td>\n                  <b>Id:</b>\n               </td>\n               <td>hai-ltcf-questionnaireresponse-mdro-cdi-event</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Meta:</b>\n               </td>\n               <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                     <li>1</li>\n                     <li>2019-06-25T19:23:28.000-04:00</li>\n                  </ul>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Language:</b>\n               </td>\n               <td>en-US</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Identifier:</b>\n               </td>\n               <td>\n                  <span>hai-ltcf-questionnaireresponse-mdro-cdi-event-example-1</span>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Questionnaire:</b>\n               </td>\n               <td>http://hl7.org/fhir/us/hai-ltcf/Questionnaire/hai-ltcf-questionnaire-mdro-cdi-event|1.0.0</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Status:</b>\n               </td>\n               <td>completed</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Subject:</b>\n               </td>\n               <td>\n                  <a href=\"Patient-hai-ltcf-resident-1.html\">hai-ltcf-resident-1</a>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Author:</b>\n               </td>\n               <td>\n                  <a href=\"Device-hai-ltcf-authoring-device.html\">hai-ltcf-authoring-device</a>\n               </td>\n            </tr>\n         </table>\n         <br xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\"/>\n         <table xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\" class=\"bare\">\n            <tr>\n               <td>\n                  <b>Facility ID</b>\n               </td>\n               <td>facility-id</td>\n               <td>urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Date of First Admission to Facility</b>\n               </td>\n               <td>date-of-first-admission-to-facility</td>\n               <td>2018-12-05</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Date of Current Admission to Facility</b>\n               </td>\n               <td>date-of-current-admission-to-facility</td>\n               <td>2019-01-15</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Event Details Group</b>\n               </td>\n               <td>event-details-group</td>\n               <tr>\n                  <td>\n                     <b>Date Specimen Collected</b>\n                  </td>\n                  <td>date-specimen-collected</td>\n                  <td>2019-01-19</td>\n               </tr>\n               <tr>\n                  <td>\n                     <b>Specimen Type</b>\n                  </td>\n                  <td>specimen-type</td>\n                  <td>\n                     <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>stool specimen</li>\n                        <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                        </li>\n                        <li>Code: 119339001</li>\n                     </ul>\n                  </td>\n               </tr>\n               <tr>\n                  <td>\n                     <b>Resident Care Location</b>\n                  </td>\n                  <td>resident-care-location</td>\n                  <td>urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:1A</td>\n               </tr>\n               <tr>\n                  <td>\n                     <b>Primary Resident Service Type</b>\n                  </td>\n                  <td>primary-resident-service-type</td>\n                  <td>\n                     <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>LTCF General Nursing Unit</li>\n                        <li>Code system: <a href=\"CodeSystem-2.16.840.1.113883.6.259.html\">http://hl7.org/fhir/us/hai-ltcf/CodeSystem/2.16.840.1.113883.6.259</a>\n                        </li>\n                        <li>Code: 1258-3</li>\n                     </ul>\n                  </td>\n               </tr>\n            </tr>\n            <tr>\n               <td>\n                  <b>Encounters Group</b>\n               </td>\n               <td>encounters-group</td>\n               <tr>\n                  <td>\n                     <b>Transfer From Acute Care Facility to LTCF in Past Four Weeks</b>\n                  </td>\n                  <td>transfer-from-acute-care-facility</td>\n                  <td>true</td>\n               </tr>\n               <tr>\n                  <td>\n                     <b>Date of Last Transfer From Acute Care to LTCF</b>\n                  </td>\n                  <td>date-of-last-transfer</td>\n                  <td>2019-01-25</td>\n               </tr>\n               <tr>\n                  <td>\n                     <b>Resident on Antibiotic Therapy for Specific Organism at Time of Transfer to Facility</b>\n                  </td>\n                  <td>antibiotic-at-time-of-transfer</td>\n                  <td>true</td>\n               </tr>\n            </tr>\n            <tr>\n               <td>\n                  <b>Findings Group</b>\n               </td>\n               <td>findings-group</td>\n               <tr>\n                  <td>\n                     <b>Specific Organism Type</b>\n                  </td>\n                  <td>specific-organism-type</td>\n                  <td>\n                     <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                        <li>Clostridium difficile</li>\n                        <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                        </li>\n                        <li>Code: 5933001</li>\n                     </ul>\n                  </td>\n               </tr>\n            </tr>\n            <tr>\n               <td>\n                  <b>Comments</b>\n               </td>\n               <td>nhsn-comment</td>\n               <td>NHSN text comment that is less than 2000 characters.</td>\n            </tr>\n         </table>\n      </div>"
  },
  "identifier" : {
    "value" : "hai-ltcf-questionnaireresponse-mdro-cdi-event-example-1"
  },
  "questionnaire" : "http://hl7.org/fhir/us/hai-ltcf/Questionnaire/hai-ltcf-questionnaire-mdro-cdi-event|1.0.0",
  "status" : "completed",
  "subject" : {
    "reference" : "Patient/hai-ltcf-resident-1",
    "display" : "hai-ltcf-resident-1"
  },
  "author" : {
    "reference" : "Device/hai-ltcf-authoring-device",
    "display" : "hai-ltcf-authoring-device"
  },
  "item" : [
    {
      "linkId" : "facility-id",
      "text" : "Facility ID",
      "answer" : [
        {
          "valueUri" : "urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1"
        }
      ]
    },
    {
      "linkId" : "date-of-first-admission-to-facility",
      "text" : "Date of First Admission to Facility",
      "answer" : [
        {
          "valueDate" : "2018-12-05"
        }
      ]
    },
    {
      "linkId" : "date-of-current-admission-to-facility",
      "text" : "Date of Current Admission to Facility",
      "answer" : [
        {
          "valueDate" : "2019-01-15"
        }
      ]
    },
    {
      "linkId" : "event-details-group",
      "text" : "Event Details Group",
      "item" : [
        {
          "linkId" : "date-specimen-collected",
          "text" : "Date Specimen Collected",
          "answer" : [
            {
              "valueDate" : "2019-01-19"
            }
          ]
        },
        {
          "linkId" : "specimen-type",
          "text" : "Specimen Type",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "119339001",
                "display" : "stool specimen"
              }
            }
          ]
        },
        {
          "linkId" : "resident-care-location",
          "text" : "Resident Care Location",
          "answer" : [
            {
              "valueUri" : "urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:1A"
            }
          ]
        },
        {
          "linkId" : "primary-resident-service-type",
          "text" : "Primary Resident Service Type",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://hl7.org/fhir/us/hai-ltcf/CodeSystem/2.16.840.1.113883.6.259",
                "code" : "1258-3",
                "display" : "LTCF General Nursing Unit"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "encounters-group",
      "text" : "Encounters Group",
      "item" : [
        {
          "linkId" : "transfer-from-acute-care-facility",
          "text" : "Transfer From Acute Care Facility to LTCF in Past Four Weeks",
          "answer" : [
            {
              "valueBoolean" : true
            }
          ]
        },
        {
          "linkId" : "date-of-last-transfer",
          "text" : "Date of Last Transfer From Acute Care to LTCF",
          "answer" : [
            {
              "valueDate" : "2019-01-25"
            }
          ]
        },
        {
          "linkId" : "antibiotic-at-time-of-transfer",
          "text" : "Resident on Antibiotic Therapy for Specific Organism at Time of Transfer to Facility",
          "answer" : [
            {
              "valueBoolean" : true
            }
          ]
        }
      ]
    },
    {
      "linkId" : "findings-group",
      "text" : "Findings Group",
      "item" : [
        {
          "linkId" : "specific-organism-type",
          "text" : "Specific Organism Type",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "5933001",
                "display" : "Clostridium difficile"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "nhsn-comment",
      "text" : "Comments",
      "answer" : [
        {
          "valueString" : "NHSN text comment that is less than 2000 characters."
        }
      ]
    }
  ]
}