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 
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<QuestionnaireResponse xmlns="http://hl7.org/fhir"> <id value="hai-questionnaireresponse-opc-ssi-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-opc-ssi-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">20202206</span> </td> </tr> <tr> <td> <b>Questionnaire:</b> </td> <td>http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-ssi-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-id</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">Date of encounter</span> [<span style="font-style:italic">encounter-date</span>]: <span style="text-decoration:underline">2018-08-05</span> </li> <li> <span style="font-weight:bold">Infection details</span> [<span style="font-style:italic">infection-details</span>]: <ul style="list-style:none;"> <li> <span style="font-weight:bold">Event Type</span> [<span style="font-style:italic">event-type</span>]: <ul> <span style="text-decoration:underline"> <li>Surgical Site Infection</li> <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a> </li> <li>Code: 433202001</li> </span> </ul> </li> <li> <span style="font-weight:bold">Date of event</span> [<span style="font-style:italic">event-date</span>]: <span style="text-decoration:underline">2018-08-06</span> </li> <li> <span style="font-weight:bold">NHSN Procedure Code Category</span> [<span style="font-style:italic">nhsn-procedure-code-category</span>]: <ul> <span style="text-decoration:underline"> <li>Appendix surgery</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: 2108-9</li> </span> </ul> </li> <li> <span style="font-weight:bold">Primary CPT Procedure Code</span> [<span style="font-style:italic">primary-cpt-procedure-code</span>]: <ul> <span style="text-decoration:underline"> <li>Laparoscopic Procedures on the Appendix</li> <li>Code system: <a href="http://www.ama-assn.org/go/cpt">http://www.ama-assn.org/go/cpt</a> </li> <li>Code: 44970</li> </span> </ul> </li> <li> <span style="font-weight:bold">Procedure Id</span> [<span style="font-style:italic">procedure-id</span>]: <span style="text-decoration:underline">urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.5:21987654321</span> </li> <li> <span style="font-weight:bold">Surgical Site Infection (SSI) Level</span> [<span style="font-style:italic">ssi-level</span>]: <ul> <span style="text-decoration:underline"> <li>Superficial incisional primary SSI</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: 1620-4</li> </span> </ul> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis</span> [<span style="font-style:italic">criteria-of-diagnosis</span>]: <ul style="list-style:none;"> <li> <span style="font-weight:bold">Criteria of Diagnosis: Abscess</span> [<span style="font-style:italic">criteria-of-diagnosis-abscess</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Redness</span> [<span style="font-style:italic">criteria-of-diagnosis-redness</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Fever</span> [<span style="font-style:italic">criteria-of-diagnosis-fever</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Heat</span> [<span style="font-style:italic">criteria-of-diagnosis-heat</span>]: <span style="text-decoration:underline">true</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Purulent drainage</span> [<span style="font-style:italic">criteria-of-diagnosis-incision-purulent-drainage</span>]: <span style="text-decoration:underline">true</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Wound spontaneously dehisced</span> [<span style="font-style:italic">criteria-of-diagnosis-wound-dehisced</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Incision deliberately opened</span> [<span style="font-style:italic">criteria-of-diagnosis-incision-opened</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Other evidence of infection found on invasive procedure, gross anatomic exam, or histopathologic exam</span> [<span style="font-style:italic">criteria-of-diagnosis-evidence-found</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Localized swelling</span> [<span style="font-style:italic">criteria-of-diagnosis-localized-swelling</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Pain or tenderness</span> [<span style="font-style:italic">criteria-of-diagnosis-pain-tenderness</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Organism Identified</span> [<span style="font-style:italic">criteria-of-diagnosis-organism-identified</span>]: <span style="text-decoration:underline">true</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Culture or non-culture based testing not performed</span> [<span style="font-style:italic">criteria-of-diagnosis-testing-not-performed</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Imaging test evidence of infection</span> [<span style="font-style:italic">criteria-of-diagnosis-imaging-test</span>]: <span style="text-decoration:underline">false</span> </li> <li> <span style="font-weight:bold">Criteria of Diagnosis: Diagnosis of superficial SSI by surgeon or attending physician</span> [<span style="font-style:italic">criteria-of-diagnosis-physician-diagnosis</span>]: <span style="text-decoration:underline">false</span> </li> </ul> </li> <li> <span style="font-weight:bold">Surveillence method type (active/passive) through which the SSI was detected</span> [<span style="font-style:italic">ssi-detection-method-type</span>]: <ul> <span style="text-decoration:underline"> <li>Active SSI Detection Method</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: 1309-4</li> </span> </ul> </li> <li> <span style="font-weight:bold">Surveillence method through which the SSI was detected</span> [<span style="font-style:italic">ssi-detection-method</span>]: <ul> <span style="text-decoration:underline"> <li>Review of patient's medical record</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: 1321-9</li> </span> </ul> </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>Staphylococcus, coagulase negative (organism)</li> <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a> </li> <li>Code: 116197008</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> </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>Life form of parasite (organism)</li> <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a> </li> <li>Code: 103535006</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>Second</li> <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a> </li> <li>Code: 81170007</li> </span> </ul> </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>Acid-fast bacillus</li> <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a> </li> <li>Code: 243365003</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>Third</li> <li>Code system: <a href="http://snomed.info/sct">http://snomed.info/sct</a> </li> <li>Code: 70905002</li> </span> </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="20202206"/> </identifier> <questionnaire value="http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-ssi-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-id"/> <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="encounter-date"/> <text value="Date of encounter"/> <answer> <valueDate value="2018-08-05"/> </answer> </item> <item> <linkId value="infection-details"/> <text value="Infection details"/> <item> <linkId value="event-type"/> <text value="Event Type"/> <answer> <valueCoding> <system value="http://snomed.info/sct"/> <code value="433202001"/> <display value="Surgical Site Infection"/> </valueCoding> </answer> </item> <item> <linkId value="event-date"/> <text value="Date of event"/> <answer> <valueDate value="2018-08-06"/> </answer> </item> <item> <linkId value="nhsn-procedure-code-category"/> <text value="NHSN Procedure Code Category"/> <answer> <valueCoding> <system value="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277"/> <code value="2108-9"/> <display value="Appendix surgery"/> </valueCoding> </answer> </item> <item> <linkId value="primary-cpt-procedure-code"/> <text value="Primary CPT Procedure Code"/> <answer> <valueCoding> <system value="http://www.ama-assn.org/go/cpt"/> <code value="44970"/> <display value="Laparoscopic Procedures on the Appendix"/> </valueCoding> </answer> </item> <item> <linkId value="procedure-id"/> <text value="Procedure Id"/> <answer> <valueUri value="urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.5:21987654321"/> </answer> </item> <item> <linkId value="ssi-level"/> <text value="Surgical Site Infection (SSI) Level"/> <answer> <valueCoding> <system value="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277"/> <code value="1620-4"/> <display value="Superficial incisional primary SSI"/> </valueCoding> </answer> </item> <item> <linkId value="criteria-of-diagnosis"/> <text value="Criteria of Diagnosis"/> <item> <linkId value="criteria-of-diagnosis-abscess"/> <text value="Criteria of Diagnosis: Abscess"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-redness"/> <text value="Criteria of Diagnosis: Redness"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-fever"/> <text value="Criteria of Diagnosis: Fever"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-heat"/> <text value="Criteria of Diagnosis: Heat"/> <answer> <valueBoolean value="true"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-incision-purulent-drainage"/> <text value="Criteria of Diagnosis: Purulent drainage"/> <answer> <valueBoolean value="true"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-wound-dehisced"/> <text value="Criteria of Diagnosis: Wound spontaneously dehisced"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-incision-opened"/> <text value="Criteria of Diagnosis: Incision deliberately opened"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-evidence-found"/> <text value="Criteria of Diagnosis: Other evidence of infection found on invasive procedure, gross anatomic exam, or histopathologic exam"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-localized-swelling"/> <text value="Criteria of Diagnosis: Localized swelling"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-pain-tenderness"/> <text value="Criteria of Diagnosis: Pain or tenderness"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-organism-identified"/> <text value="Criteria of Diagnosis: Organism Identified"/> <answer> <valueBoolean value="true"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-testing-not-performed"/> <text value="Criteria of Diagnosis: Culture or non-culture based testing not performed"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-imaging-test"/> <text value="Criteria of Diagnosis: Imaging test evidence of infection"/> <answer> <valueBoolean value="false"/> </answer> </item> <item> <linkId value="criteria-of-diagnosis-physician-diagnosis"/> <text value="Criteria of Diagnosis: Diagnosis of superficial SSI by surgeon or attending physician"/> <answer> <valueBoolean value="false"/> </answer> </item> </item> <item> <linkId value="ssi-detection-method-type"/> <text value="Surveillence method type (active/passive) through which the SSI was detected"/> <answer> <valueCoding> <system value="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277"/> <code value="1309-4"/> <display value="Active SSI Detection Method"/> </valueCoding> </answer> </item> <item> <linkId value="ssi-detection-method"/> <text value="Surveillence method through which the SSI was detected"/> <answer> <valueCoding> <system value="http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277"/> <code value="1321-9"/> <display value="Review of patient's medical record"/> </valueCoding> </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="116197008"/> <display value="Staphylococcus, coagulase negative (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> <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="103535006"/> <display value="Life form of parasite (organism)"/> </valueCoding> </answer> </item> <item> <linkId value="pathogen-ranking"/> <text value="Pathogen Ranking"/> <answer> <valueCoding> <system value="http://snomed.info/sct"/> <code value="81170007"/> <display value="Second"/> </valueCoding> </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="243365003"/> <display value="Acid-fast bacillus"/> </valueCoding> </answer> </item> <item> <linkId value="pathogen-ranking"/> <text value="Pathogen Ranking"/> <answer> <valueCoding> <system value="http://snomed.info/sct"/> <code value="70905002"/> <display value="Third"/> </valueCoding> </answer> </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>
