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-ssi-event
This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Surgical Site Infection Event. This report is for reporting data on each patient having a SSI event related to one of the NHSN operative procedures selected for monitoring.
Outpatient Procedure Component Surgical Site Infection (SSI) Event
| url | http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-ssi-event |
| Version | R1 |
| title | Outpatient Procedure Component Surgical Site Infection (SSI) Event |
| 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 | date | true | false | |
| Infection Details | group | true | false | |
| Infection Details | Event Type | choice | true | false |
| Infection Details | Date of event | date | true | false |
| Infection Details | NHSN Procedure Code Category | choice | true | false |
| Infection Details | CPT Procedure Code | choice | true | false |
| Infection Details | Procedure Id | url | true | false |
| Infection Details | Surgical Site Infection (SSI) Level | choice | true | false |
| Infection Details | Criteria of Diagnosis | group | true | false |
| Criteria of Diagnosis | Abscess | boolean | true | false |
| Criteria of Diagnosis | Redness | boolean | true | false |
| Criteria of Diagnosis | Fever | boolean | true | false |
| Criteria of Diagnosis | Purulent drainage | boolean | true | false |
| Criteria of Diagnosis | Wound spontaneously dehisced | boolean | true | false |
| Criteria of Diagnosis | Incision deliberately opened | boolean | true | false |
| Criteria of Diagnosis | Other evidence of infection found on invasive procedure, gross anatomic exam, or histopathologic exam | boolean | true | false |
| Criteria of Diagnosis | Localized swelling | boolean | true | false |
| Criteria of Diagnosis | Pain or tenderness | boolean | true | false |
| Criteria of Diagnosis | Organism Identified | boolean | true | false |
| Criteria of Diagnosis | Culture or non-culture based testing not performed | boolean | true | false |
| Criteria of Diagnosis | Imaging test evidence of infection | boolean | true | false |
| Criteria of Diagnosis | Diagnosis of superficial SSI by surgeon or attending physician | boolean | true | false |
| Infection Details | Surveillence method type (active/passive) through which the SSI was detected | choice | true | false |
| Infection Deatils | Surveillence method through which the SSI was detected | choice | true | false |
| Findings Group | group | true | true | |
| Findings Group | Pathogen Identified | choice | true | false |
| Findings Group | Pathogen Ranking | choice | true | false |
| Comments | text | false | false |
