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 Same Day Outcome Measures Event - XML Representation

Active as of 2019-04-01

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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="hai-questionnaire-opc-sdom-event"/>
  <meta>
    <versionId value="9"/>
    <lastUpdated value="2023-02-24T01:35:54.056+00:00"/>
    <source value="#9LTQ0tnXaxd53TP3"/>
    <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-sdom-event"/>
  <identifier>
    <value value="hai-questionnaire-opc-sdom-event-v1"/>
  </identifier>
  <name value="HAI_questionnaire_opc_sdom_event"/>
  <title
         value="Outpatient Procedure Component Same Day Outcome Measures Event Report"/>
  <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 Same Day Outcome Measures Event Report. It records data on each patient who experienced one or more of the same day outcome measures events.

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="date-of-encounter"/>
    <text value="Date of Encounter (Admission)"/>
    <type value="date"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="same-day-outcome-measures-event-details"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="51899-3"/>
      <display value="Details Document"/>
    </code>
    <text value="Same Day Outcome Measures Event Details"/>
    <type value="group"/>
    <required value="true"/>
    <repeats value="false"/>
    <item>
      <linkId
              value="same-day-outcome-measures-event-details-group-description"/>
      <text
            value="This group contains details about same-day outcome measures events."/>
      <type value="display"/>
    </item>
    <item>
      <linkId value="same-day-outcome-measure-patient-burn"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="125666000"/>
        <display value="Burn"/>
      </code>
      <text value="Same Day Outcome Measure: Patient Burn"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="same-day-outcome-measure-patient-fall"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="217082002"/>
        <display value="Accidental fall"/>
      </code>
      <text value="Same Day Outcome Measure: Patient fall"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="same-day-outcome-transfer-admission"/>
      <code>
        <system
                value="https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html"/>
        <code value="1645-1"/>
        <display value="Hospital transer/admission"/>
      </code>
      <text value="Same Day Outcome Measure: Hospital transfer/admission"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="same-day-outcome-measure-wrong-site"/>
      <code>
        <system
                value="https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html"/>
        <code value="1646-9"/>
        <display value="Wrong site"/>
      </code>
      <text value="Same Day Outcome Measure: Wrong site"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="same-day-outcome-measure-wrong-side"/>
      <code>
        <system
                value="https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html"/>
        <code value="1647-7"/>
        <display value="Wrong side"/>
      </code>
      <text value="Same Day Outcome Measure: Wrong side"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="same-day-outcome-measure-wrong-patient"/>
      <code>
        <system
                value="https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html"/>
        <code value="1648-5"/>
        <display value="Wrong patient"/>
      </code>
      <text value="Same Day Outcome Measure: Wrong patient"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="same-day-outcome-measure-wrong-procedure"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="370898007"/>
        <display value="Wrong surgical procedure performed on a patient"/>
      </code>
      <text value="Same Day Outcome Measure: Wrong procedure"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="same-day-outcome-measure-wrong-implant"/>
      <code>
        <system
                value="https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html"/>
        <code value="1649-3"/>
        <display value="Wrong implant"/>
      </code>
      <text value="Same Day Outcome Measure: Wrong implant"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
  </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>