| Package | hl7.fhir.us.hai-ltcf |
| Resource Type | Questionnaire |
| Id | hai-ltcf-questionnaire-mdro-cdi-summary |
| FHIR Version | R4 |
| Source | http://hl7.org/fhir/us/hai-ltcf/https://build.fhir.org/ig/HL7/HAI-LTCF/Questionnaire-hai-ltcf-questionnaire-mdro-cdi-summary.html |
| URL | http://hl7.org/fhir/us/hai-ltcf/Questionnaire/hai-ltcf-questionnaire-mdro-cdi-summary |
| Version | 1.1.0 |
| Status | draft |
| Date | 2023-04-19T14:40:23+00:00 |
| Name | HAI_LTCF_questionnaire_mdro_cdi_summary |
| Title | MDRO and CDI LabID Event Reporting Monthly Summary Data for LTCF |
| Realm | us |
| Authority | hl7 |
| Description | This Questionnaire instance defines the questions and possible answers in the following CDC NHSN forms: * [Denominators for LTCF (CDC 57.142](https://www.cdc.gov/nhsn/forms/57.142_DenominatorLTCF_BLANK.pdf) * [MDRO and CDI Monthly Monitoring for LTCF (CDC 57.139)](https://www.cdc.gov/nhsn/forms/57.139_MDROMonthlyReporting_LTCF_BLANK.pdf) * [Prevention Process Measures Form for LTCF (CDC 57.143)](https://www.cdc.gov/nhsn/forms/57.143_ProcessMeasureSummaryforLTCF_BLANK.pdf) |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
| LinkId | Text | Cardinality | Type |
Description & Constraints
|
|---|---|---|---|---|
  HAI_LTCF_questionnaire_mdro_cdi_summary |
This Questionnaire instance defines the questions and possible answers in the following CDC NHSN forms: | Questionnaire | http://hl7.org/fhir/us/hai-ltcf/Questionnaire/hai-ltcf-questionnaire-mdro-cdi-summary#1.1.0 | |
  facility-id |
Facility ID | 1..1 | url | |
report-period-start |
First Day of Period Reported | 1..1 | date | |
|
report-period-end |
Last Day of Period Reported | 1..1 | date | |
facility-location-code |
Facility Location Code | 1..1 | choice | Value Set: NHSNHealthcareServiceLocationCode |
summary-data-group |
Summary Data Group | 1..1 | group | |
  summary-data-group-display |
The Summary Data Group is a set of summary data for a population in the defined NHSN protocol. | 0..1 | display | |
| summary-data-group-denom |
Summary Data Group - Denominator | 1..1 | group | |
| summary-data-group-denom-display |
The Summary Data Group - Denominator is a set of summary data reported using the CDC NHSN form: Denominators for LTCF (CDC 57.142). | 0..1 | display | |
 total-resident-days |
Resident Days | 1..1 | quantity | |
| urinary-catheter-days |
Urinary Catheter Days | 1..1 | quantity | |
 new-antibiotic-starts-for-uti-indication |
New Antibiotic Starts for UTI Indication | 1..1 | integer | |
 number-urine-cultures-ordered |
Number of Urine Cultures Ordered | 1..1 | integer | |
| summary-data-group-mdro-cdi |
Summary Data Group - MDRO/CDI | 1..1 | group | |
| summary-data-group-mdro-cdi-display |
The Summary Data Group - MDRO/CDI is a set of summary data reported using the CDC NHSN form: MDRO and CDI Monthly Monitoring for LTCF (CDC 57.139). | 0..1 | display | |
| resident-days |
Resident Days | 1..1 | quantity | |
| resident-admissions |
Resident Admissions | 1..1 | integer | |
| number-admissions-on-c-diff-treatment |
Number of admissions on C. difficile treatment | 1..1 | integer | |
| number-c-diff-treatment-starts |
Number of C. difficile treatment starts | 1..1 | integer | |
| summary-data-group-prevention-process-measures |
Summary Data Group - Prevention Process Measures | 1..1 | group | |
 summary-data-group-prevention-process-measures-display |
The Summary Data Group - Prevention Process Measures is a set of summary data reported using the CDC NHSN form: Prevention Process Measures Form for LTCF (CDC 57.143). | 0..1 | display | |
| hand-hygiene-performed |
Hand Hygiene Performed | 1..1 | integer | |
| hand-hygiene-indicated |
Hand Hygiene Indicated | 1..1 | integer | |
| gown-and-gloves-used |
Gown and Gloves Used | 1..1 | integer | |
| gown-and-gloves-indicated |
Gown and Gloves Indicated | 1..1 | integer | |
|
report-no-events-group |
Report no events | 0..1 | group | |
| report-no-events-group-display |
The Report No Events Group contains statements that there are no events to report for a particular type of event. | 0..1 | display | |
 no-lab-id-uti-event |
Report No Events: UTI Event | 0..1 | boolean | |
| no-lab-id-event-mrsa |
Report No Events: LabID Event (All specimens): MRSA | 0..1 | boolean | |
| no-lab-id-event-mssa |
Report No Events: LabID Event (All specimens): MSSA | 0..1 | boolean | |
| no-lab-id-event-vre |
Report No Events: LabID Event (All specimens): VRE | 0..1 | boolean | |
| no-lab-id-event-cephr-klebsiella |
Report No Events: LabID Event (All specimens): CephR Klebsiella | 0..1 | boolean | |
| no-lab-id-event-mrsa-cre-e-coli |
Report No Events: LabID Event (All specimens): CRE-E. coli | 0..1 | boolean | |
| no-lab-id-event-mrsa-cre-enterobacter |
Report No Events: LabID Event (All specimens): CRE-Enterobacter | 0..1 | boolean | |
| no-lab-id-event-cre-klebsiella |
Report No Events: LabID Event (All specimens): CRE-Klebsiella | 0..1 | boolean | |
| no-lab-id-event-mdr-acinetobacter |
Report No Events: LabID Event (All specimens): MDR-Acinetobacter | 0..1 | boolean | |
| no-lab-id-event-c-difficile |
Report No Events: LabID Event (All specimens): C. difficile | 0..1 | boolean | |
|
Documentation for this format
|
||||
FHIR{
"resourceType": "Questionnaire",
"id": "hai-ltcf-questionnaire-mdro-cdi-summary",
"meta": {
"profile": [
"http://hl7.org/fhir/us/hai-ltcf/StructureDefinition/hai-ltc-population-summary-questionnaire"
]
},
"language": "en-US",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"url": "http://hl7.org/fhir/us/hai-ltcf/Questionnaire/hai-ltcf-questionnaire-mdro-cdi-summary",
"identifier": [
{
"value": "hai-ltcf-questionnaire-mdro-cdi-summary-v1.1"
}
],
"version": "1.1.0",
"name": "HAI_LTCF_questionnaire_mdro_cdi_summary",
"title": "MDRO and CDI LabID Event Reporting Monthly Summary Data for LTCF",
"status": "draft",
"experimental": false,
"subjectType": [
"Group"
],
"date": "2023-04-19T14:40:23+00:00",
"publisher": "HL7 Public Health Work Group (http://www.hl7.org/Special/committees/pher/index.cfm)",
"contact": [
{
"name": "HL7 International - Public Health",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/pher"
}
]
}
],
"description": "This Questionnaire instance defines the questions and possible answers in the following CDC NHSN forms: * [Denominators for LTCF (CDC 57.142](https://www.cdc.gov/nhsn/forms/57.142_DenominatorLTCF_BLANK.pdf) * [MDRO and CDI Monthly Monitoring for LTCF (CDC 57.139)](https://www.cdc.gov/nhsn/forms/57.139_MDROMonthlyReporting_LTCF_BLANK.pdf) * [Prevention Process Measures Form for LTCF (CDC 57.143)](https://www.cdc.gov/nhsn/forms/57.143_ProcessMeasureSummaryforLTCF_BLANK.pdf)",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
],
"code": [
{
"system": "http://loinc.org",
"code": "51897-7",
"display": "Healthcare Associated Infection report Document"
},
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1891-1",
"display": "Summary data reporting MDRO and CDI LabID Event for LTCF"
}
],
"item": [
{
"linkId": "facility-id",
"text": "Facility ID",
"type": "url",
"required": true,
"repeats": false
},
{
"linkId": "report-period-start",
"text": "First Day of Period Reported",
"type": "date",
"required": true,
"repeats": false
},
{
"linkId": "report-period-end",
"text": "Last Day of Period Reported",
"type": "date",
"required": true,
"repeats": false
},
{
"linkId": "facility-location-code",
"text": "Facility Location Code",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.19"
},
{
"linkId": "summary-data-group",
"code": [
{
"system": "http://loinc.org",
"code": "51900-9",
"display": "Population Summary note"
}
],
"text": "Summary Data Group",
"type": "group",
"required": true,
"repeats": false,
"item": [
{
"linkId": "summary-data-group-display",
"text": "The Summary Data Group is a set of summary data for a population in the defined NHSN protocol.",
"type": "display"
},
{
"linkId": "summary-data-group-denom",
"text": "Summary Data Group - Denominator",
"type": "group",
"required": true,
"repeats": false,
"item": [
{
"linkId": "summary-data-group-denom-display",
"text": "The Summary Data Group - Denominator is a set of summary data reported using the CDC NHSN form: [Denominators for LTCF (CDC 57.142](https://www.cdc.gov/nhsn/forms/57.142_DenominatorLTCF_BLANK.pdf).",
"type": "display"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "d",
"display": "d"
}
}
],
"linkId": "total-resident-days",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1345-8",
"display": "Total Resident Days"
}
],
"text": "Total Resident Days",
"type": "quantity",
"required": true,
"repeats": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "d",
"display": "d"
}
}
],
"linkId": "urinary-catheter-days",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1853-1",
"display": "Number of urinary catheter days"
}
],
"text": "Urinary Catheter Days",
"type": "quantity",
"required": true,
"repeats": false
},
{
"linkId": "new-antibiotic-starts-for-uti-indication",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1343-3",
"display": "New antibiotic starts for UTI indication"
}
],
"text": "New Antibiotic Starts for UTI Indication",
"type": "integer",
"required": true,
"repeats": false
},
{
"linkId": "number-urine-cultures-ordered",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1344-1",
"display": "Number of urine cultures ordered"
}
],
"text": "Number of Urine Cultures Ordered",
"type": "integer",
"required": true,
"repeats": false
}
]
},
{
"linkId": "summary-data-group-mdro-cdi",
"text": "Summary Data Group - MDRO/CDI",
"type": "group",
"required": true,
"repeats": false,
"item": [
{
"linkId": "summary-data-group-mdro-cdi-display",
"text": "The Summary Data Group - MDRO/CDI is a set of summary data reported using the CDC NHSN form: [MDRO and CDI Monthly Monitoring for LTCF (CDC 57.139)](https://www.cdc.gov/nhsn/forms/57.139_MDROMonthlyReporting_LTCF_BLANK.pdf).",
"type": "display"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "d",
"display": "d"
}
}
],
"linkId": "resident-days",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1369-8",
"display": "Resident days"
}
],
"text": "Resident Days",
"type": "quantity",
"required": true,
"repeats": false
},
{
"linkId": "resident-admissions",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1370-6",
"display": "Resident admissions"
}
],
"text": "Resident Admissions",
"type": "integer",
"required": true,
"repeats": false
},
{
"linkId": "number-admissions-on-c-diff-treatment",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1371-4",
"display": "Number of admissions on C. difficile treatment"
}
],
"text": "Number of admissions on C. difficile treatment",
"type": "integer",
"required": true,
"repeats": false
},
{
"linkId": "number-c-diff-treatment-starts",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1372-2",
"display": "Number of C. difficile treatment starts"
}
],
"text": "Number of C. difficile treatment starts",
"type": "integer",
"required": true,
"repeats": false
}
]
},
{
"linkId": "summary-data-group-prevention-process-measures",
"text": "Summary Data Group - Prevention Process Measures",
"type": "group",
"required": true,
"repeats": false,
"item": [
{
"linkId": "summary-data-group-prevention-process-measures-display",
"text": "The Summary Data Group - Prevention Process Measures is a set of summary data reported using the CDC NHSN form: [Prevention Process Measures Form for LTCF (CDC 57.143)](https://www.cdc.gov/nhsn/forms/57.143_ProcessMeasureSummaryforLTCF_BLANK.pdf).",
"type": "display"
},
{
"linkId": "hand-hygiene-performed",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1865-5",
"display": "Number of observations in which hand hygiene was performed"
}
],
"text": "Hand Hygiene Performed",
"type": "integer",
"required": true,
"repeats": false
},
{
"linkId": "hand-hygiene-indicated",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1864-8",
"display": "Number of observations in which hand hygiene was indicated"
}
],
"text": "Hand Hygiene Indicated",
"type": "integer",
"required": true,
"repeats": false
},
{
"linkId": "gown-and-gloves-used",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1867-1",
"display": "Number of observations in which gown and gloves were used"
}
],
"text": "Gown and Gloves Used",
"type": "integer",
"required": true,
"repeats": false
},
{
"linkId": "gown-and-gloves-indicated",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1866-3",
"display": "Number of observations in which the use of gown and gloves was indicated"
}
],
"text": "Gown and Gloves Indicated",
"type": "integer",
"required": true,
"repeats": false
}
]
}
]
},
{
"linkId": "report-no-events-group",
"code": [
{
"system": "http://loinc.org",
"code": "90252-8",
"display": "Report no events"
}
],
"text": "Report no events",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "report-no-events-group-display",
"text": "The Report No Events Group contains statements that there are no events to report for a particular type of event.",
"type": "display"
},
{
"linkId": "no-lab-id-uti-event",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1342-5",
"display": "Report No Events: UTI Event"
}
],
"text": "Report No Events: UTI Event",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-mrsa",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3030-4",
"display": "Report No Events: LabID Event (All specimens): MRSA"
}
],
"text": "Report No Events: LabID Event (All specimens): MRSA",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-mssa",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "1307-8",
"display": "Report No Events: LabID Event (All specimens): MSSA"
}
],
"text": "Report No Events: LabID Event (All specimens): MSSA",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-vre",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3033-8",
"display": "Report No Events: LabID Event (All specimens): VRE"
}
],
"text": "Report No Events: LabID Event (All specimens): VRE",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-cephr-klebsiella",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3036-1",
"display": "Report No Events: LabID Event (All specimens): CephR Klebsiella"
}
],
"text": "Report No Events: LabID Event (All specimens): CephR Klebsiella",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-mrsa-cre-e-coli",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3039-5",
"display": "Report No Events: LabID Event (All specimens): CRE-E. coli"
}
],
"text": "Report No Events: LabID Event (All specimens): CRE-E. coli",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-mrsa-cre-enterobacter",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3042-9",
"display": "Report No Events: LabID Event (All specimens): CRE-Enterobacter"
}
],
"text": "Report No Events: LabID Event (All specimens): CRE-Enterobacter",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-cre-klebsiella",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3045-2",
"display": "Report No Events: LabID Event (All specimens): CRE-Klebsiella"
}
],
"text": "Report No Events: LabID Event (All specimens): CRE-Klebsiella",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-mdr-acinetobacter",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3048-6",
"display": "Report No Events: LabID Event (All specimens): MDR-Acinetobacter"
}
],
"text": "Report No Events: LabID Event (All specimens): MDR-Acinetobacter",
"type": "boolean",
"required": false,
"repeats": false
},
{
"linkId": "no-lab-id-event-c-difficile",
"code": [
{
"system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
"code": "3051-0",
"display": "Report No Events: LabID Event (All specimens): C. difficile"
}
],
"text": "Report No Events: LabID Event (All specimens): C. difficile",
"type": "boolean",
"required": false,
"repeats": false
}
]
}
]
}