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Question: NIHSS Score Clarification

This is follow up to a prior question: "Need Initial NIHSS Score clarification";.

If there is an initial NIHSS score of 14 done at my hospital for example at 0700 on 4/15/15, would I select "yes" for initial NIHSS score and 4/15/15 at 0700 for the date and time fields?

If there was a score of 29, done at an outside hospital before transferring the patient here, would I enter "29" in the "initial NIHSS score at arrival" space, since the abstraction guidelines state to use the "earliest" score and may use scores obtained prior to arrival from a transferring hospital?

Is this correct? This is confusing.

Answer:

1. If there is an NIHSS score of 14 done at your hospital for example at 0700 on 4/15/15, and no other NIHSS scores done at your hospital, then select "YES" for "Initial NIHSS Score Performed" and enter 4/15/15 at 0700 for the score date and time.

2. If there was a score of 29, done at an outside hospital before transferring the patient to your hospital, enter "29" in the "Initial NIHSS Score at Hospital Arrival" field, unless there was an even earlier score, e.g. score done by EMS to choose from for the initial NIHS score. Abstraction guidelines for this data element instruct to use the "earliest" score. Scores obtained prior to arrival from a transferring hospital or EMS may be used.

There is NO relationship between "Initial NIHSS Score at Hopsital Arrival" and the 3 NIHSS data elements collected for the CSTK-01 measure. "Initial NIHSS Score at Hopsital Arrival" are patient-level data collected to build the risk-adjustment model needed for the outcome measures CSTK-05 and CSTK-08. This data element is NOT used to calculate any of the measure rates.

"Initial NIHSS Score Performed", "Initial NIHSS Score Date", and "Initial NIHSS Score Time" are collected for CSTK-01 and used to calculate the measure rate for this measure. There is a relationship between these 3 data elements.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK-01, Initial NIHSS Score Performed
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