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-sdom-event

This QuestionnaireResponse instance is an example of a completed Outpatient Procedure Component Same Day Outcome Measures Event Report and is in response to the Questionnaire instance defining this report.

Example Outpatient Procedure Component Same Day Outcome Measures Event Report

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
First day of period reported 2018-06-01
Date of Encounter (Admission) 2018-08-05

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

Same Day Outcome Measures Event Details

Patient burn true
Patient fall true
Hospital transfer/admission false
Wrong site true
Wrong side false
Wrong patient false
Wrong procedure false
Wrong implant false

Comment

Comment NHSN text comment that is less than 2000 characters.