View source for NHSN HAI R2D2.2 Comments

==Instructions==
'''30th September 2014 - NHSN R2D2.1 Available for Comments'''

An update has been made to the NHSN Healthcare Associated Infection Reports, Release 2, US Realm, September 2013, 2nd DSTU Ballot (NHSN HAI R2D2). This update is available to HL7 members here http://www.hl7.org/documentcenter/public/wg/structure/20140924_Draft_for_Comment_CDAR2_IG_HAIRPT_R2_D2_1_2014SEPT_V2.zip as a point release named NHSN HAI R2D2.1 for commenting prior to reconciliation and publication. As a DSTU update, this new version will not go through the usual HL7 balloting process but will use the [http://gforge.hl7.org/gf/download/docmanfileversion/7482/10824/Guidance-to-Work-Groups-on-DSTU-Updates20130819.docx DSTU Update process] with industry review on the HL7 wiki. The full list of changes in this release is documented in the update and can be summarized as:
#No reports were added or removed. 
#Eleven new templates were added:
##	Antimicrobial Coated Catheter Used Observation
##	Bacterial Isolate Tested for Carbapenemase Observation
##	Blood Collection Location
##	Carbapenemase Test Observation
##	Carbapenemase Test Organizer
##	Carbapenemase Type Identified Observation
##	Contraindication Type Observation
##	Last Physical Overnight Location
##	Other Facility Discharge Encounter
##	Positive Test for Carbapenemase Observation
##	Primary C. Difficile Testing Method This Quarter
#One new value set was added:
##	NHSNArDrugSuscTestsCode (2.16.840.1.114222.4.11.7230)

During the two week comment period running from 1st October 2014 - 14th October 2014, please submit your comments below including at least your name, item, existing wording, proposed wording, and comment. Thank you.

==Comments==
''Enter your comments below this line.''

From Brett Marquard:


'''Antimicrobial Coated Catheter Used Observation'''

''I recognize you can conform to problem observation, but I am wondering if it makes sense. My initial reaction is this should stand on its own.''

<div style="color: red">'''Disposition:''' Persuasive</div> 
<div style="color: red">'''Disposition comment:''' Remove conformance to Problem Observation</div>


'''Bacterial Isolate Tested for Carbapenemase Observation'''

''same question as above'' 

<div style="color: red">'''Disposition:''' Persuasive</div> 
<div style="color: red">'''Disposition comment:''' Remove conformance to Problem Observation</div>


'''Blood Collection Location''' 

''same as above.'' 

<div style="color: red">'''Disposition:''' Persuasive</div> 
<div style="color: red">'''Disposition comment:''' Remove conformance to Problem Observation</div>


'''Carbapenemase Test Observation'''
'' 
Why is the id forced to NA?. I would expect this to have an id. 

<div style="color: red">'''Disposition:''' Not persuasive</div>
<div style="color: red">'''Disposition Comment:''' NHSN does not collect any ID information therefore this is hardcoded as NA.</div>


Please create value set for CONF:1129-30389. Or remove. 

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition comment:''' Will create value set as suggested.</div>


Why is the value NA? What is effectiveTime NA? Do you want to add text to the entry description that this is just to record the test was done, no results are provided. I would think at minimum you would want time…

<div style="color: red">'''Disposition:''' Persuasive with mod</div>
<div style="color: red">'''Disposition comment:''' Because this template conforms to C-CDA template Result Observation and that template has a SHALL effectiveTime and NHSN does not collect the time information (and vendors do not have the information to send.) we have historically set the effectiveTime to NA. We will add text to the entry description as suggested.</div>
<div style="color: red">'''This comment has been withdrawn by the commenter.</div>


Do you want to add a STATIC date to NHSNCarbaTestMethod?''

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition comment:''' Yes, we will add a date...</div>


'''Carbapenemase Type Identified Observation –''' 

''Why no effectiveTime or id?''

<div style="color: red">'''Disposition:''' Not persuasive</div>
<div style="color: red">'''Disposition comment:''' Same reasons as above - NHSN does not collect any of this information and vendors do not have the information to send.</div>


'''Contraindication Type Observation''' 

Spelling of section is off. 

<div style="color: red">'''Disposition:''' Withdraw</div>
<div style="color: red">'''Disposition comment:''' Talked to Brett and he can't find spelling error</div>


Drop conformance to problem observation

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition Comment:''' Will remove conformance</div>


'''Contraindicated Observation''' 

The negationInd and entryRelationship here is very confusing. I recommend writing out a few sentences here describing what you are trying to say…

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition Comment:''' Will add description as suggested.</div>


'''Last Physical Overnight Location –''' 

''I don’t think the use of Encounter is correct here – encounter/code should be encounter type “last physical overnight’ doesn’t is unclear.. An Act wrapping the encounter would be better…''

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition Comment:''' Will wrap with act as suggested</div>


'''Other Facility Discharge Encounter'''

''same issues as last physical encounter.''

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition Comment:''' Will wrap with act as suggested</div>


'''Positive Test for Carbapenemase Observation'''

''Why does this conform to problem observation instead of result? Why is this a standalone template? Did you consider a conforms to the carbapenamase test observation?''

<div style="color: red">'''Disposition:''' Persuasive with mod</div>
<div style="color: red">'''Disposition comment:''' Will change conformation to Result observation.  No this shouldn't conform to Carbapenamase Test Observation as that template identifies the test and NHSN doesn't identify which test was positive - only that there was a positive test and what carbapenamase type was identified in the positive test.</div>


'''Primary C. Difficile Testing Method This Quarter'''

''drop conforms to.'' 

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition comment:''' Will remove conforms to </div>


'''NHSNArDrugSuscTestsCode (2.16.840.1.114222.4.11.7230)''' 

''do you want to add a STATIC date?''

<div style="color: red">'''Disposition:''' Persuasive</div>
<div style="color: red">'''Disposition comment:''' Will add date.</div>