NHSN Healthcare Associated Infection (HAI) Reports
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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 - Outpatient Procedure Component Denominator for Procedure - XML Representation

Active as of 2019-04-01

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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="hai-questionnaire-opc-proc-denom"/>
  <meta>
    <versionId value="11"/>
    <lastUpdated value="2023-02-24T01:35:54.128+00:00"/>
    <source value="#QYbd8C4welZ3TEoO"/>
    <profile
             value="http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire"/>
  </meta>
  <language value="en-US"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Placeholder</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-proc-denom"/>
  <identifier>
    <value value="hai-questionnaire-opc-proc-denom-v1"/>
  </identifier>
  <name value="HAI_questionnaire_opc_proc_denom"/>
  <title value="Outpatient Procedure Component Denominator for Procedure"/>
  <status value="active"/>
  <experimental value="false"/>
  <subjectType value="Patient"/>
  <date value="2019-04-01"/>
  <publisher value="HL7 International - Structured Documents Work Group"/>
  <contact>
    <name value="HL7 International - Structured Documents"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/structure"/>
    </telecom>
  </contact>
  <description
               value="This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Denominator for Procedure. This report records date on each patient having one of the NHSN procedures selected for monitoring.

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/).
"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
    <text value="United States of America"/>
  </jurisdiction>
  <code>
    <system value="http://loinc.org"/>
    <code value="51897-7"/>
    <display value="Healthcare Associated Infection report Document"/>
  </code>
  <item>
    <linkId value="facility-id"/>
    <text value="Facility ID"/>
    <type value="url"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="encounter-date"/>
    <text value="Date of encounter"/>
    <type value="date"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="risk-factors"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="51898-5"/>
      <display value="Risk factors Document"/>
    </code>
    <text value="Risk Factors"/>
    <type value="group"/>
    <required value="true"/>
    <repeats value="false"/>
    <item>
      <linkId value="risk-factors-group-description"/>
      <text
            value="This group contains procedure risk factors such as ASA class, diabetes mellitus, height, and weight."/>
      <type value="display"/>
    </item>
    <item>
      <linkId value="risk-factor-wound-class"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="420089007"/>
        <display value="CDC wound classification category"/>
      </code>
      <text value="Risk Factor: Wound class"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerValueSet
                      value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.9"/>
    </item>
    <item>
      <linkId value="risk-factor-endoscopy"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="423827005"/>
        <display value="Endoscopy"/>
      </code>
      <text value="Risk Factor: Endoscopy used"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-diabetes-mellitus"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="73211009"/>
        <display value="Diabetes mellitus"/>
      </code>
      <text value="Risk Factor: Diabetes mellitus"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-height"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="50373000"/>
        <display value="Body Height"/>
      </code>
      <text value="Risk Factor: height"/>
      <type value="quantity"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-weight"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="27113001"/>
        <display value="Body Weight"/>
      </code>
      <text value="Risk Factor: weight"/>
      <type value="quantity"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-asa-class"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="273270000"/>
        <display
                 value="American Society of Anesthesiologists physical status classification (assessment scale)"/>
      </code>
      <text value="Risk Factor: ASA Class"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <answerValueSet
                      value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.10"/>
    </item>
  </item>
  <item>
    <linkId value="procedure-details"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="51899-3"/>
      <display value="Details Document"/>
    </code>
    <text value="Procedure Details"/>
    <type value="group"/>
    <required value="true"/>
    <repeats value="false"/>
    <item>
      <linkId value="procedure-details-group-description"/>
      <text value="This group contains details about the procedure."/>
      <type value="display"/>
    </item>
    <item>
      <linkId value="procedure-id"/>
      <text value="Procedure ID"/>
      <type value="url"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="nhsn-procedure-code-category"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="29300-1"/>
        <display value="Procedure type"/>
      </code>
      <text value="NHSN Procedure Code Category"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <answerValueSet
                      value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.10.20.5.9.34"/>
    </item>
    <item>
      <linkId value="cpt-procedure-code"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="76448-0"/>
        <display value="CPT billing code"/>
      </code>
      <text value="CPT Procedure Code"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <answerValueSet value="http://hl7.org/fhir/ValueSet/cpt-all"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
        <valueCoding>
          <system value="http://unitsofmeasure.org"/>
          <code value="min"/>
          <display value="min"/>
        </valueCoding>
      </extension>
      <linkId value="procedure-duration"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="89875-9"/>
        <display value="Procedure duration"/>
      </code>
      <text value="Procedure duration (in minutes)"/>
      <type value="quantity"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
  </item>
  <item>
    <linkId value="general-anesthesia"/>
    <text value="General anesthesia"/>
    <type value="boolean"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="surgeon-code"/>
    <text value="Surgeon code"/>
    <type value="url"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="nhsn-comment"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="86468-6"/>
      <display value="Report Comment Section"/>
    </code>
    <text value="Comments"/>
    <type value="text"/>
    <required value="false"/>
    <repeats value="false"/>
    <maxLength value="2000"/>
  </item>
</Questionnaire>