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