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

XML Format: QuestionnaireResponse-hai-questionnaireresponse-los-event

Raw xml 


<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="hai-questionnaireresponse-los-event"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaireresponse"/>
  </meta>
  <language value="en-US"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml" lang="en-US">
         <table xmlns:xsl="http://www.w3.org/1999/XSL/Transform" class="bare">
            <tr>
               <td>
                  <b>Id:</b>
               </td>
               <td>hai-questionnaireresponse-los-event</td>
            </tr>
            <tr>
               <td>
                  <b>Profile:</b>
               </td>
               <td>http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaireresponse</td>
            </tr>
            <tr>
               <td>
                  <b>Language:</b>
               </td>
               <td>en-US</td>
            </tr>
            <tr>
               <td>
                  <b>Identifier:</b>
               </td>
               <td>
                  <span title="Code system: urn:oid:2.16.840.1.113883.3.117.1.1.5.2.1.1.2">20202202</span>
               </td>
            </tr>
            <tr>
               <td>
                  <b>Questionnaire:</b>
               </td>
               <td>http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-event</td>
            </tr>
            <tr>
               <td>
                  <b>Status:</b>
               </td>
               <td>completed</td>
            </tr>
            <tr>
               <td>
                  <b>Subject:</b>
               </td>
               <td>
                  <a href="Patient-hai-patient-1.html">hai-patient-1</a>
               </td>
            </tr>
            <tr>
               <td>
                  <b>Author:</b>
               </td>
               <td>
                  <a href="Device-hai-authoring-device.html">hai-authoring-device</a>
               </td>
            </tr>
         </table>
         <br xmlns:xsl="http://www.w3.org/1999/XSL/Transform"/>
         <h2 xmlns:xsl="http://www.w3.org/1999/XSL/Transform">QuestionnaireResponse Answers</h2>
         <ul xmlns:xsl="http://www.w3.org/1999/XSL/Transform" style="list-style:none;">
            <li>
               <span style="font-weight:bold">Facility ID</span> [<span style="font-style:italic">facility</span>]: 
        <span style="text-decoration:underline">urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:9W</span>
            </li>
            <li>
               <span style="font-weight:bold">Event Number</span> [<span style="font-style:italic">event-number</span>]: 
        <span style="text-decoration:underline">urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.3:31</span>
            </li>
            <li>
               <span style="font-weight:bold">Event Type</span> [<span style="font-style:italic">event-type</span>]: 
        <ul>
                  <span style="text-decoration:underline">
                     <li>Late-onset neonatal sepsis (disorder)</li>
                     <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a>
                     </li>
                     <li>Code: 765107002</li>
                  </span>
               </ul>
            </li>
            <li>
               <span style="font-weight:bold">Date of Event</span> [<span style="font-style:italic">date-of-event</span>]: 
        <span style="text-decoration:underline">2018-01-02</span>
            </li>
            <li>
               <span style="font-weight:bold">Facility Location</span> [<span style="font-style:italic">facility-location</span>]: 
        <ul>
                  <span style="text-decoration:underline">
                     <li>Medical/Surgical Critical Care</li>
                     <li>Code system: <a href="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.259">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.259</a>
                     </li>
                     <li>Code: 1029-8</li>
                  </span>
               </ul>
            </li>
            <li>
               <span style="font-weight:bold">Date Admitted to Facility:</span> [<span style="font-style:italic">date-admitted-to-facility</span>]: 
        <span style="text-decoration:underline">2018-01-01</span>
            </li>
            <li>
               <span style="font-weight:bold">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.</span> [<span style="font-style:italic">inborn-outborn-observation</span>]: 
        <span style="text-decoration:underline">false</span>
            </li>
            <li>
               <span style="font-weight:bold">Risk Factors</span> [<span style="font-style:italic">risk-factors</span>]: 
        <ul style="list-style:none;">
                  <li>
                     <span style="font-weight:bold">Risk Factor: Central line present prior to event, including umbilical catheter</span> [<span style="font-style:italic">risk-factor-central-line</span>]: 
        <span style="text-decoration:underline">true</span>
                  </li>
                  <li>
                     <span style="font-weight:bold">Risk Factor: Birth weight (grams)</span> [<span style="font-style:italic">risk-factor-birth-weight</span>]: 
        <span style="text-decoration:underline">700g</span>
                  </li>
                  <li>
                     <span style="font-weight:bold">Gestational age known: set true if known and false if unknown</span> [<span style="font-style:italic">gestational-age-known</span>]: 
        <span style="text-decoration:underline">true</span>
                  </li>
                  <li>
                     <span style="font-weight:bold">Risk Factor: Gestational age (days)</span> [<span style="font-style:italic">risk-factor-gestational-age</span>]: 
        <span style="text-decoration:underline">276d</span>
                  </li>
               </ul>
            </li>
            <li>
               <span style="font-weight:bold">Event Details</span> [<span style="font-style:italic">event-details</span>]: 
        <ul style="list-style:none;">
                  <li>
                     <span style="font-weight:bold">Specific Event</span> [<span style="font-style:italic">infection-condition</span>]: 
        <ul>
                        <span style="text-decoration:underline">
                           <li>Neonatal Laboratory Confirmed Bloodstream Infection (NLCBI 2)</li>
                           <li>Code system: <a href="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277</a>
                           </li>
                           <li>Code: 3067-6</li>
                        </span>
                     </ul>
                  </li>
                  <li>
                     <span style="font-weight:bold">Laboratory Criteria Used</span> [<span style="font-style:italic">criteria-used</span>]: 
        <ul>
                        <span style="text-decoration:underline">
                           <li>Recognized pathogen from one or more blood cultures</li>
                           <li>Code system: <a href="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277</a>
                           </li>
                           <li>Code: 1951-3</li>
                        </span>
                     </ul>
                  </li>
                  <li>
                     <span style="font-weight:bold">Died</span> [<span style="font-style:italic">died</span>]: 
        <span style="text-decoration:underline">true</span>
                  </li>
                  <li>
                     <span style="font-weight:bold">Infection contributed to death</span> [<span style="font-style:italic">los-contributed-to-death</span>]: 
        <span style="text-decoration:underline">false</span>
                  </li>
                  <li>
                     <span style="font-weight:bold">Discharge Date</span> [<span style="font-style:italic">discharge-date</span>]: 
        <span style="text-decoration:underline">2018-01-12</span>
                  </li>
               </ul>
            </li>
            <li>
               <span style="font-weight:bold">Findings Group</span> [<span style="font-style:italic">findings-group</span>]: 
        <ul style="list-style:none;">
                  <li>
                     <span style="font-weight:bold">Pathogen Identified</span> [<span style="font-style:italic">pathogen-identified</span>]: 
        <ul>
                        <span style="text-decoration:underline">
                           <li>Clostridium symbiosum (organism)</li>
                           <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a>
                           </li>
                           <li>Code: 48321006</li>
                        </span>
                     </ul>
                  </li>
                  <li>
                     <span style="font-weight:bold">Pathogen Ranking</span> [<span style="font-style:italic">pathogen-ranking</span>]: 
        <ul>
                        <span style="text-decoration:underline">
                           <li>First</li>
                           <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a>
                           </li>
                           <li>Code: 255216001</li>
                        </span>
                     </ul>
                  </li>
                  <li>
                     <span style="font-weight:bold">Drug Susceptibility Test Group</span> [<span style="font-style:italic">drug-susceptibility-test-group</span>]: 
        <ul style="list-style:none;">
                        <li>
                           <span style="font-weight:bold">Drug Susceptibility Test</span> [<span style="font-style:italic">drug-susceptibility-test</span>]: 
        <ul>
                              <span style="text-decoration:underline">
                                 <li>Clarithro Susc Islt</li>
                                 <li>Code system: <a href="http://loinc.org">http://loinc.org</a>
                                 </li>
                                 <li>Code: 18907-6</li>
                              </span>
                           </ul>
                        </li>
                        <li>
                           <span style="font-weight:bold">Drug Susceptibility Test Interpretation</span> [<span style="font-style:italic">drug-susceptibility-test-interpretation</span>]: 
        <ul>
                              <span style="text-decoration:underline">
                                 <li>Resistant</li>
                                 <li>Code system: <a href="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation">http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation</a>
                                 </li>
                                 <li>Code: R</li>
                              </span>
                           </ul>
                        </li>
                     </ul>
                  </li>
               </ul>
            </li>
            <li>
               <span style="font-weight:bold">Comments</span> [<span style="font-style:italic">nhsn-comment</span>]: 
        <span style="text-decoration:underline">NHSN text comment that is less than 2000 characters.</span>
            </li>
         </ul>
      </div>
  </text>
  <identifier>
    <system value="urn:oid:2.16.840.1.113883.3.117.1.1.5.2.1.1.2"/>
    <value value="20202202"/>
  </identifier>
  <questionnaire
                 value="http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-event"/>
  <status value="completed"/>
  <subject>
    <reference value="Patient/hai-patient-1"/>
    <display value="hai-patient-1"/>
  </subject>
  <author>
    <reference value="Device/hai-authoring-device"/>
    <display value="hai-authoring-device"/>
  </author>
  <item>
    <linkId value="facility"/>
    <text value="Facility ID"/>
    <answer>
      <valueUri value="urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:9W"/>
    </answer>
  </item>
  <item>
    <linkId value="event-number"/>
    <text value="Event Number"/>
    <answer>
      <valueUri value="urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.3:31"/>
    </answer>
  </item>
  <item>
    <linkId value="event-type"/>
    <text value="Event Type"/>
    <answer>
      <valueCoding>
        <system value="http://snomed.info/sct"/>
        <code value="765107002"/>
        <display value="Late-onset neonatal sepsis (disorder)"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="date-of-event"/>
    <text value="Date of Event"/>
    <answer>
      <valueDate value="2018-01-02"/>
    </answer>
  </item>
  <item>
    <linkId value="facility-location"/>
    <text value="Facility Location"/>
    <answer>
      <valueCoding>
        <system
                value="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.259"/>
        <code value="1029-8"/>
        <display value="Medical/Surgical Critical Care"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="date-admitted-to-facility"/>
    <text value="Date Admitted to Facility:"/>
    <answer>
      <valueDate value="2018-01-01"/>
    </answer>
  </item>
  <item>
    <linkId value="inborn-outborn-observation"/>
    <text
          value="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."/>
    <answer>
      <valueBoolean value="false"/>
    </answer>
  </item>
  <item>
    <linkId value="risk-factors"/>
    <text value="Risk Factors"/>
    <item>
      <linkId value="risk-factor-central-line"/>
      <text
            value="Risk Factor: Central line present prior to event, including umbilical catheter"/>
      <answer>
        <valueBoolean value="true"/>
      </answer>
    </item>
    <item>
      <linkId value="risk-factor-birth-weight"/>
      <text value="Risk Factor: Birth weight (grams)"/>
      <answer>
        <valueQuantity>
          <value value="700"/>
          <unit value="g"/>
        </valueQuantity>
      </answer>
    </item>
    <item>
      <linkId value="gestational-age-known"/>
      <text
            value="Gestational age known: set true if known and false if unknown"/>
      <answer>
        <valueBoolean value="true"/>
      </answer>
    </item>
    <item>
      <linkId value="risk-factor-gestational-age"/>
      <text value="Risk Factor: Gestational age (days)"/>
      <answer>
        <valueQuantity>
          <value value="276"/>
          <unit value="d"/>
        </valueQuantity>
      </answer>
    </item>
  </item>
  <item>
    <linkId value="event-details"/>
    <text value="Event Details"/>
    <item>
      <linkId value="infection-condition"/>
      <text value="Specific Event"/>
      <answer>
        <valueCoding>
          <system
                  value="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277"/>
          <code value="3067-6"/>
          <display
                   value="Neonatal Laboratory Confirmed Bloodstream Infection (NLCBI 2)"/>
        </valueCoding>
      </answer>
    </item>
    <item>
      <linkId value="criteria-used"/>
      <text value="Laboratory Criteria Used"/>
      <answer>
        <valueCoding>
          <system
                  value="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277"/>
          <code value="1951-3"/>
          <display value="Recognized pathogen from one or more blood cultures"/>
        </valueCoding>
      </answer>
    </item>
    <item>
      <linkId value="died"/>
      <text value="Died"/>
      <answer>
        <valueBoolean value="true"/>
      </answer>
    </item>
    <item>
      <linkId value="los-contributed-to-death"/>
      <text value="Infection contributed to death"/>
      <answer>
        <valueBoolean value="false"/>
      </answer>
    </item>
    <item>
      <linkId value="discharge-date"/>
      <text value="Discharge Date"/>
      <answer>
        <valueDate value="2018-01-12"/>
      </answer>
    </item>
  </item>
  <item>
    <linkId value="findings-group"/>
    <text value="Findings Group"/>
    <item>
      <linkId value="pathogen-identified"/>
      <text value="Pathogen Identified"/>
      <answer>
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="48321006"/>
          <display value="Clostridium symbiosum (organism)"/>
        </valueCoding>
      </answer>
    </item>
    <item>
      <linkId value="pathogen-ranking"/>
      <text value="Pathogen Ranking"/>
      <answer>
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="255216001"/>
          <display value="First"/>
        </valueCoding>
      </answer>
    </item>
    <item>
      <linkId value="drug-susceptibility-test-group"/>
      <text value="Drug Susceptibility Test Group"/>
      <item>
        <linkId value="drug-susceptibility-test"/>
        <text value="Drug Susceptibility Test"/>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="18907-6"/>
            <display value="Clarithro Susc Islt"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="drug-susceptibility-test-interpretation"/>
        <text value="Drug Susceptibility Test Interpretation"/>
        <answer>
          <valueCoding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/>
            <code value="R"/>
            <display value="Resistant"/>
          </valueCoding>
        </answer>
      </item>
    </item>
  </item>
  <item>
    <linkId value="nhsn-comment"/>
    <text value="Comments"/>
    <answer>
      <valueString value="NHSN text comment that is less than 2000 characters."/>
    </answer>
  </item>
</QuestionnaireResponse>