This page is part of the Healthcare Associated Infection Implementation Guide (v1.1.0: STU 2 Ballot 1) based on FHIR R3. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions 
Questionnaire: hai-questionnaire-opc-sdom-event
This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Same Day Outcome Measures Event Report. It records a late onset sepsis/meningitis infection event.
For Late Onset Sepsis/Meningitis Event Reports, a Medicaid beneficiary number may be present.
Late Onset Sepsis/Meningitis Event (LOS) Instance Details
| url | http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-sdom-event |
| Version | R1 |
| title | Outpatient Procedure Component Same Day Outcome Measures Event Report |
| Publish date | 2019-04-01 |
| Realm | US |
| Code | LOINC 51897-7: Healthcare Associated Infection report Document |
| Subject type | Patient |
Questionnaire Items
| Group | Item | Type | Required | Repeats |
|---|---|---|---|---|
| Facility ID | url | true | false | |
| Date of Encounter (Admission) | date | true | false | |
| Same Day Outcome Measures Event Details | group | true | false | |
| Same Day Outcome Measures Event Details | Patient burn | boolen | true | false |
| Same Day Outcome Measures Event Details | Patient fall | boolen | true | false |
| Same Day Outcome Measures Event Details | Hospital transfer/admission | boolen | true | false |
| Same Day Outcome Measures Event Details | Wrong site | boolen | true | false |
| Same Day Outcome Measures Event Details | Wrong side | boolen | true | false |
| Same Day Outcome Measures Event Details | Wrong patient | boolen | true | false |
| Same Day Outcome Measures Event Details | Wrong procedure | boolen | true | false |
| Same Day Outcome Measures Event Details | Wrong implant | boolen | true | false |
| Comments | text | false | false |
