NHSN Healthcare Associated Infection (HAI) Reports
2.1.0 - STU 2.1
NHSN Healthcare Associated Infection (HAI) Reports
2.1.0 - STU 2.1
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
| Active as of 2019-04-01 |
{
"resourceType" : "Questionnaire",
"id" : "hai-questionnaire-los-event",
"meta" : {
"versionId" : "13",
"lastUpdated" : "2023-02-24T01:35:54.069+00:00",
"source" : "#TutCpWfFornPy4FG",
"profile" : [
"http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire"
]
},
"language" : "en-US",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Placeholder</div>"
},
"url" : "http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-event",
"identifier" : [
{
"value" : "hai-questionnaire-los-event-v2"
}
],
"name" : "HAI_questionnaire_los_event",
"title" : "Late Onset Sepsis/Meningitis Event (LOS)",
"status" : "active",
"experimental" : false,
"subjectType" : [
"Patient"
],
"date" : "2019-04-01",
"publisher" : "HL7 International - Structured Documents Work Group",
"contact" : [
{
"name" : "HL7 International - Structured Documents",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/structure"
}
]
}
],
"description" : "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.\n\nFor 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/).\n",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US",
"display" : "United States of America"
}
],
"text" : "United States of America"
}
],
"code" : [
{
"system" : "http://loinc.org",
"code" : "51897-7",
"display" : "Healthcare Associated Infection report Document"
}
],
"item" : [
{
"linkId" : "facility",
"text" : "Facility ID",
"type" : "url",
"required" : true,
"repeats" : false
},
{
"linkId" : "event-number",
"text" : "Event Number",
"type" : "url",
"required" : false,
"repeats" : false
},
{
"linkId" : "event-type",
"text" : "Event Type",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerValueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.20"
},
{
"linkId" : "date-of-event",
"text" : "Date of Event",
"type" : "date",
"required" : true,
"repeats" : false
},
{
"linkId" : "facility-location",
"text" : "Facility Location",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerValueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.19"
},
{
"linkId" : "date-admitted-to-facility",
"text" : "Date Admitted to Facility:",
"type" : "date",
"required" : true,
"repeats" : false
},
{
"linkId" : "inborn-outborn-observation",
"code" : [
{
"system" : "http://snomed.info/sct",
"code" : "445087001",
"display" : "Born before arrival to hospital (situation)"
}
],
"text" : "Inborn/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.",
"type" : "boolean",
"required" : true,
"repeats" : false
},
{
"linkId" : "risk-factors",
"code" : [
{
"system" : "http://loinc.org",
"code" : "51898-5",
"display" : "Risk factors Document"
}
],
"text" : "Risk Factors",
"type" : "group",
"required" : true,
"repeats" : false,
"item" : [
{
"linkId" : "risk-factors-group",
"text" : "This group contains risk factors such as central line present, birth weight, and gestational age.",
"type" : "display"
},
{
"linkId" : "risk-factor-central-line",
"code" : [
{
"system" : "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code" : "1006-6",
"display" : "central line including umbilical catheter"
}
],
"text" : "Risk Factor: Central line present prior to event, including umbilical catheter",
"type" : "boolean",
"required" : false,
"repeats" : false
},
{
"linkId" : "risk-factor-birth-weight",
"code" : [
{
"system" : "http://snomed.info/sct",
"code" : "364589006",
"display" : "Birth Weight"
}
],
"text" : "Risk Factor: Birth weight (grams)",
"type" : "quantity",
"required" : true,
"repeats" : false
},
{
"linkId" : "gestational-age-known",
"text" : "Gestational age known: set true if known and false if unknown",
"type" : "boolean",
"required" : true,
"repeats" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding" : {
"system" : "http://unitsofmeasure.org",
"code" : "d",
"display" : "d"
}
}
],
"linkId" : "risk-factor-gestational-age",
"code" : [
{
"system" : "http://loinc.org",
"code" : "76516-4",
"display" : "Gestational age--at birth"
}
],
"text" : "Risk Factor: Gestational age (days)",
"type" : "quantity",
"enableWhen" : [
{
"question" : "gestational-age-known",
"operator" : "=",
"answerBoolean" : true
}
],
"required" : false,
"repeats" : false
}
]
},
{
"linkId" : "event-details",
"code" : [
{
"system" : "http://loinc.org",
"code" : "51899-3",
"display" : "Details Document"
}
],
"text" : "Event Details",
"type" : "group",
"required" : true,
"repeats" : false,
"item" : [
{
"linkId" : "event-details-group",
"text" : "This group contains details aboout the late onset septis infection event.",
"type" : "display"
},
{
"linkId" : "infection-condition",
"text" : "Specific Event",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerValueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3196"
},
{
"linkId" : "criteria-used",
"text" : "Laboratory Criteria Used",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerValueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3195"
},
{
"linkId" : "died",
"code" : [
{
"system" : "http://snomed.info/sct",
"code" : "419099009",
"display" : "dead"
}
],
"text" : "Died",
"type" : "boolean",
"required" : true,
"repeats" : false
},
{
"linkId" : "los-contributed-to-death",
"text" : "Infection contributed to death",
"type" : "boolean",
"enableWhen" : [
{
"question" : "died",
"operator" : "=",
"answerBoolean" : true
}
],
"required" : false,
"repeats" : false
},
{
"linkId" : "discharge-date",
"text" : "Discharge Date",
"type" : "date",
"required" : false,
"repeats" : false
}
]
},
{
"linkId" : "findings-group",
"code" : [
{
"system" : "http://loinc.org",
"code" : "18769-0",
"display" : "Microbial susceptibility tests Set"
}
],
"text" : "Findings Group",
"type" : "group",
"required" : true,
"repeats" : true,
"item" : [
{
"linkId" : "findings-group-description",
"text" : "This group records whether infection organisms were identified and, if so, records details about them.",
"type" : "display"
},
{
"linkId" : "pathogen-identified",
"text" : "Pathogen Identified",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerValueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.16"
},
{
"linkId" : "pathogen-ranking",
"text" : "Pathogen Ranking",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerValueSet" : "http://hl7.org/fhir/us/hai/ValueSet/nhsn-pathogen-ranking"
},
{
"linkId" : "drug-susceptibility-test-group",
"text" : "Drug Susceptibility Test Group",
"type" : "group",
"repeats" : true,
"item" : [
{
"linkId" : "drug-susceptibility-test-group-description",
"text" : "This group contains drug-susceptibility information such as the drug and the pathogen's susceptibility to it.",
"type" : "display"
},
{
"linkId" : "drug-susceptibility-test",
"text" : "Drug Susceptibility Test",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerValueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.15"
},
{
"linkId" : "drug-susceptibility-test-interpretation",
"text" : "Drug Susceptibility Test Interpretation",
"type" : "choice",
"required" : false,
"repeats" : false,
"answerValueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.13"
}
]
}
]
},
{
"linkId" : "nhsn-comment",
"code" : [
{
"system" : "http://loinc.org",
"code" : "86468-6",
"display" : "Report Comment Section"
}
],
"text" : "Comments",
"type" : "text",
"required" : false,
"repeats" : false,
"maxLength" : 2000
}
]
}
IG © 2020+ HL7 International - Structured Documents Work Group. Package hl7.fhir.us.hai#2.1.0 based on FHIR 4.0.1. Generated 2023-09-06
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