|Submitted By: Sheila Abner / CDC/NHSN|
|Data Element Information|
|Use Case Description(s)|
|Use Case Description||Surgical site infections are reported to NHSN as part of nationwide healthcare-associated infections surveillance. Data reported to NHSN on surgical site infections associated with colon and abdominal hysterectomy operative procedures are submitted to CMS.
Data elements associated with orders for isolation / transmission precautions (status of patient on the following types of isolation precautions: contact, airborne, droplet) are needed for public health reporting on patients with suspected cases of contagious diseases. Feedback is requested regarding the most appropriate class for these data elements. Another option might be Encounter or possibly part of a new class such as Service Request.
|Estimate the breadth of applicability of the use case(s) for this data element||Beginning 15 years ago with 300 hospitals, NHSN now serves approximately 25,000 medical facilities tracking HAIs. Current participants include acute care hospitals, long-term acute care hospitals, psychiatric hospitals, rehabilitation hospitals, outpatient dialysis centers, ambulatory surgery centers, and nursing homes, with hospitals and dialysis facilities representing the majority of facilities reporting data. Participation among the other facility types is expected to continue to grow in coming years.|
|Link to use case project page||https://www.cdc.gov/nhsn/index.html|
|Maturity of Use and Technical Specifications for Data Element|
|Applicable Standard(s)||Location of Procedure: HSLOC (https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/hsloc.html)
Transmission-based precautions: SNOMED CT
|Additional Specifications||CDA IG: HL7 CDA® R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3 - US Realm (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=426)
FHIR IG: Healthcare Associated Infection Reports Implementation Guide CI Build (http://hl7.org/fhir/us/hai/)
|Current Use||Extensively used in production environments|
|Extent of exchange||5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.|
|Restrictions on Standardization (e.g. proprietary code)||none known|
|Restrictions on Use (e.g. licensing, user fees)||none known|
|Privacy and Security Concerns||none known|
|Estimate of Overall Burden||Moderate burden. Orders for isolation are currently irregularly implemented, so there is a need for more consistent documentation. Implementing appropriate transmission-based precautions is important for individual patient care as well as facility infection control. Easy access to isolation status of a patient for situational awareness is critical.|
|Other Implementation Challenges||none known|
Activity performed for or on a patient as part of the provision of care.
Time and/or date a procedure is performed.
Examples include but are not limited to vaccine or medication administration times, surgery start time, and time ultrasound performed.