Initial NIHSS Score Date

Specifications Manual for Joint Commission National Quality Measures (v2016B1)

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Release Notes:
Data Element
Version 2016B1

Data Element Name:

Initial NIHSS Score Date

Collected For:

CSTK-01,

Definition:

The month, date, and year that the NIHSS score was first performed at this hospital. The NIH stroke scale measures several aspects of brain function, including consciousness, vision, sensation, movement, speech, and language. The NIH stroke scale serves several purposes, but its main use in clinical medicine is during the assessment of whether or not the degree of disability caused by a given stroke merits treatment with t-PA.

Suggested Data Collection Question:

What is the date that the NIHSS score was first performed at this hospital?

Format:

Length:	10-MM-DD-YYYY (includes dashes) or UTD
Type:	Date
Occurs:	1

Allowable Values:

MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (2012-Current Year)
UTD = Unable to Determine

Notes for Abstraction:

Use the date that the NIHSS score was first performed. If a discrepancy exists in date documentation from different sources, choose the earliest date. If there are two or more initial NIHSS score dates (either different NIHSS assessments or corresponding with the sameassessment), enter the earliest date.
If the initial NIHSS score date is unable to be determined from medical record documentation, select UTD.
The medical record must be abstracted as documented (taken at face value). When the date documented is obviously in error (not a valid date/format) and no other documentation is found that provides this information, the abstractor should select UTD.
Example:
Documentation indicates the initial NIHSS date was 03-42-20xx. No other documentation in the medical record provides a valid date. Since the initial NIHSS date is outside of the range listed in the Allowable Values for Day, it is not a valid date and the abstractor should select UTD.
Note: Transmission of a case with an invalid date as described above will be rejected from the Joint Commissions Data Warehouse. Use of UTD for Initial NIHSS Score Date allows the case to be accepted into the warehouse.

Suggested Data Sources:

Consultation notes
Emergency department record
History and physical
Nursing flow sheet
Progress notes
Admitting note
Nursing assessment

Additional Notes:

Guidelines for Abstraction:

Inclusion	Exclusion
None	None

Initial NIHSS Score Date

Specifications Manual for Joint Commission National Quality Measures (v2016B1)
Discharges 01-01-17 (1Q17) through 06-30-17 (2Q17)