NHSN Healthcare Associated Infection (HAI) Reports
2.1.0 - STU 2.1 United States of America flag

This page is part of the Healthcare Associated Infection Implementation Guide (v2.1.0: STU2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Questionnaire: Questionnaire - Late Onset Sepsis/Meningitis Event (LOS)

Official URL: http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-event Version:
Active as of 2019-04-01 Computable Name: HAI_questionnaire_los_event
Other Identifiers: id: hai-questionnaire-los-event-v2

This Questionnaire instance defines the questions and possible answers in the Late Onset Sepsis/Meningitis Event (LOS) Report. It records a late onset sepsis/meningitis infection event. For Late Onset Sepsis/Meningitis Event Reports, a Medicaid beneficiary number may be present.

For further details on reporting healthcare-associated infections see the specific protocols and data collection forms on the NHSN website https://www.cdc.gov/nhsn/.

LinkIdTextCardinalityTypeDescription & Constraintsdoco
.. HAI_questionnaire_los_eventThis Questionnaire instance defines the questions and possible answers in the Late Onset Sepsis/Meningitis Event (LOS) Report. It records a late onset sepsis/meningitis infection event. For Late Onset Sepsis/Meningitis Event Reports, a Medicaid beneficiary number may be present. For further details on reporting healthcare-associated infections see the specific protocols and data collection forms on the NHSN website [https://www.cdc.gov/nhsn/](https://www.cdc.gov/nhsn/). Questionnairehttp://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-event
... facilityFacility ID1..1url
... event-numberEvent Number0..1url
... event-typeEvent Type1..1choiceValue Set: NHSNInfectionTypeCode
... date-of-eventDate of Event1..1date
... facility-locationFacility Location1..1choiceValue Set: NHSNHealthcareServiceLocationCode
... date-admitted-to-facilityDate Admitted to Facility:1..1date
... inborn-outborn-observationInborn/Outborn: If the infant was outborn (born at a location other than the reporting hospital), select true. If the infant was inborn (born at the reporting hospital) select false.1..1boolean
... risk-factorsRisk Factors1..1group
.... risk-factors-groupThis group contains risk factors such as central line present, birth weight, and gestational age.0..1display
.... risk-factor-central-lineRisk Factor: Central line present prior to event, including umbilical catheter0..1boolean
.... risk-factor-birth-weightRisk Factor: Birth weight (grams)1..1quantity
.... gestational-age-knownGestational age known: set true if known and false if unknown1..1boolean
.... risk-factor-gestational-ageRisk Factor: Gestational age (days)0..1quantityEnable When: gestational-age-known = true
... event-detailsEvent Details1..1group
.... event-details-groupThis group contains details aboout the late onset septis infection event.0..1display
.... infection-conditionSpecific Event1..1choiceValue Set: NHSNInfectionConditionCode
.... criteria-usedLaboratory Criteria Used1..1choiceValue Set: NHSNCriterionOfDiagnosisCode
.... diedDied1..1boolean
.... los-contributed-to-deathInfection contributed to death0..1booleanEnable When: died = true
.... discharge-dateDischarge Date0..1date
... findings-groupFindings Group1..*group
.... findings-group-descriptionThis group records whether infection organisms were identified and, if so, records details about them.0..1display
.... pathogen-identifiedPathogen Identified1..1choiceValue Set: NHSNPathogenCode
.... pathogen-rankingPathogen Ranking1..1choiceValue Set: NHSNPathogenRanking
.... drug-susceptibility-test-groupDrug Susceptibility Test Group0..*group
..... drug-susceptibility-test-group-descriptionThis group contains drug-susceptibility information such as the drug and the pathogen's susceptibility to it.0..1display
..... drug-susceptibility-testDrug Susceptibility Test1..1choiceValue Set: NHSNDrugSusceptibilityTestsCode
..... drug-susceptibility-test-interpretationDrug Susceptibility Test Interpretation0..1choiceValue Set: NHSNDrugSusceptibilityFindingCode
... nhsn-commentComments0..1textMax Length: 2000

doco Documentation for this format