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 (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.1.0. 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."
}
]
}
]
}
