HealthcareAssociatedInfectionReports Implementation Guide CI Build

This page is part of the Healthcare Associated Infection Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Questionnaire: hai-questionnaire-los-denom

Late Onset Sepsis/Meningitis Denominator

This Questionnaire instance defines the questions and possible answers in the Late Onset Sepsis/Meningitis Event (LOS) Denominator. This report records the denominator information for neonatal component late onset sepsis and meningitis (LOS/Men).

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/.

Questionnaire Details

Id: hai-questionnaire-los-denom
Profile: http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire
Language: en-US
Url: http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-denom
Identifier: hai-questionnaire-los-denom-v1
Version: Version: 2.0.0
Name: HAI_questionnaire_los_denom
Status: draft
Experimental: false
Subject Type: Patient (Source Patient Resource (US Core Patient))
Date: 2019-04-01
Publisher: HL7 Structured Documents Work Group
Jurisdiction: Code: US
Code:
  • Healthcare Associated Infection report Document
  • Code system: http://loinc.org
  • Code: 51897-7


Questionnaire Items (* required)

  • * Year and month data collected for this location [date-collected] (date)
  • * Facility ID [facility] (url)
  • * Date Admitted to Facility [date-admitted-to-facility] (date)
  • * Location Within Facility Encounter [location-within-facility-encounter-group] (group)
    • This group contains information detailing an encounter at a location within the facility. It contains the patient's location within the facility, the date admitted or transferred to that location, the disposition of the infant and, if the infant was discharged, transferred, or expired, the date on which this occurred is recorded. If the infant had no location change, no date is recorded. [location-within-facility-encounter-group-description] (display)
    • * Facility Location Type [facility-location-type] (choice)
    • * Facility Location [facility-location] (url)
    • * Date admitted or transferred to location [location-admit-transfer-date] (date)
    • * Disposition of infant [infant-disposition] (choice)
    • Disposition date if discharged, transferred, or expired [disposition-date] (date)
      • Enable when: infant-disposition = "183665006" or
        infant-disposition = "266751003" or
        infant-disposition = "371828006"
  • * Risk Factors [risk-factors] (group)
    • This group contains risk factors such as birth weight and gestational age. [risk-factors-group-description] (display)
    • * Risk Factor: Birth weight (grams) [risk-factor-birth-weight] (quantity)
    • * Gestational age known: set true if known and false if unknown [gestational-age-known] (boolean)
    • Risk Factor: Gestational age (days) [risk-factor-gestational-age] (quantity)
      • Enable when: gestational-age-known = "true"
  • Comments [nhsn-comment] (text)