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 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:

1. No reports were added or removed.
2. Eleven new templates were added:
   1. Antimicrobial Coated Catheter Used Observation
   2. Bacterial Isolate Tested for Carbapenemase Observation
   3. Blood Collection Location
   4. Carbapenemase Test Observation
   5. Carbapenemase Test Organizer
   6. Carbapenemase Type Identified Observation
   7. Contraindication Type Observation
   8. Last Physical Overnight Location
   9. Other Facility Discharge Encounter
   10. Positive Test for Carbapenemase Observation
   11. Primary C. Difficile Testing Method This Quarter
3. One new value set was added:
   1. 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.

Disposition: Persuasive

Disposition comment: Remove conformance to Problem Observation

Bacterial Isolate Tested for Carbapenemase Observation

same question as above

Disposition: Persuasive

Disposition comment: Remove conformance to Problem Observation

Blood Collection Location

same as above.

Disposition: Persuasive

Disposition comment: Remove conformance to Problem Observation

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

Disposition: Not persuasive

Disposition Comment: NHSN does not collect any ID information therefore this is hardcoded as NA.

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

Disposition: Persuasive

Disposition comment: Will create value set as suggested.

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…

Disposition: Persuasive with mod

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.

Do you want to add a STATIC date to NHSNCarbaTestMethod?

Disposition: Persuasive

Disposition comment: Yes, we will add a date...

Carbapenemase Type Identified Observation –

Why no effectiveTime or id?

Disposition: Not persuasive

Disposition comment: Same reasons as above - NHSN does not collect any of this information and vendors do not have the information to send.

Contraindication Type Observation

Spelling of section is off.

Disposition: Withdraw

Disposition comment: Talked to Brett and he can't find spelling error

Drop conformance to problem observation

Disposition: Persuasive

Disposition Comment: Will remove conformance

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

Disposition: Persuasive

Disposition Comment: Will add description as suggested.

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…

Disposition: Persuasive

Disposition Comment: Will wrap with act as suggested

Other Facility Discharge Encounter

same issues as last physical encounter.

Disposition: Persuasive

Disposition Comment: Will wrap with act as suggested

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?

Disposition: Persuasive with mod

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.

Primary C. Difficile Testing Method This Quarter

drop conforms to.

Disposition: Persuasive

Disposition comment: Will remove conforms to

NHSNArDrugSuscTestsCode (2.16.840.1.114222.4.11.7230)

do you want to add a STATIC date?

Disposition: Persuasive

Disposition comment: Will add date.