Data Element

Information from the submission form

Device Settings
Description
Patient-specific settings associated with a device.

Comment

Unified Comment from CDC

CDC considers this element to be high priority and strongly recommends its inclusion in the USCDI V3.

Device Settings - separate out data elements

We strongly recommend splitting out Device Type, Device Status, and Device Route as separate data elements. This will facilitate identification of mechanically ventilated patients, which is essential for informing severity of illness for routine public health surveillance and during pandemic response. For over a decade, Lantana has supported CDC’s National Healthcare Safety Network (NHSN) in routine public health surveillance for healthcare-associated infections (HAIs) and other healthcare-related harms, and more recently in building surveillance capacity for COVID-19 pandemic response. The COVID-19 pandemic illustrated the importance of knowledge of use of invasive mechanical ventilation in a facility to inform data on the burden of the pandemic on health systems, including the severity of illness of affected patients. Invasive mechanical ventilation is an important clinical intervention for clinicians, clinical researchers and public health entities to track. Invasive mechanical ventilation can signify acute respiratory failure, which is an important clinical outcome associated with several other markers of care, including hospital capacity and resources.  Documentation of an artificial airway and use of a ventilator is part of standard clinical practice. Every patient on a ventilator will have the airway type documented (in addition to ventilator modes) in their clinical record of care. In most cases, patients being invasively ventilated will have an endotracheal tube documented as the route of oxygen delivery (as opposed to a face mask or nasal cannula) and this alone will be sufficient to find the patients who are on a ventilator.  In a few scenarios (use of a tracheostomy), additional information will be necessary to find these patients. A new data element to reflect airway device route/oxygen delivery route (“Device route”) would be sufficient for determining which patients are receiving invasive ventilation (vs oxygen alone vs non-invasive ventilation).  This is the least burdensome method of identifying patients who are invasively ventilated and does not require details about ventilator modes. This data element is already in extensive use in electronic health record systems and is captured as a regular part of clinical care.

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