Healthcare Associated Infection Reports, FHIR STU 2 Ballot - US Realm Implementation Guide CI Build

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

QuestionnaireResponse: hai-questionnaireResponse-opc-proc-denom

This QuestionnaireResponse instance is an example of a completed Outpatient Procedure Component Denominator for Procedure and is in response to the Questionnaire instance defining this report.

Example Outpatient Procedure Component Denominator for Procedure

Authoring and Facility Information

Authoring Device Id: 2.16.840.1.113883.3.117.1.1.5.1.1.2:anAuthorID
Facility ID urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1
Event Number urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.3:31
Date of encounter 2018-12-23

Patient

Patient ID Medical Record Number: 12345
Social Security # 12345
Medicaid # 959595
Patient Last Name Nuclear
Patient First Name Ned
Gender Male
Date of Birth 1954-11-25
Ethnicity Not Hispanic or Latino
Race White

Risk Factors

Wound class CDC Class II/Clean-contaminated
Endoscopy used true
Diabetes mellitus false
height 168 cm
height 68 kg
ASA Class ASA physical status class 1

Procedure Details

NHSN Procedure Code Category 2108-9: Appendix surgery
CPT Procedure Code 44970: Laparoscopic Procedures on the Appendix
Procedure duration 90 min
General anesthesia true
Surgeon code urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1.1:987654

Comment

Comment NHSN text comment that is less than 2000 characters.