Release Notes:
Data Element
Version 2010A1
| Data Element Name: | Compromised |
|---|
| Collected For: | PN-6, PN-6a, PN-6b, |
|---|
| Definition: | For the purposes of PN-6, PN-6a and PN-6b, “Compromised” includes 2 concepts:
- The patient has a clinical condition that could cause an impaired immune system or put the patient at a higher risk for infection.
- A prior hospitalization within 14 days. The intent is to exclude possible nosocomial infections, i.e., The patient was discharged from an acute care facility for inpatient care to a non-acute setting (e.g., home, SNF, ICF or rehabilitation hospital), before the second admission to the same or different acute care facility
|
|---|
| Suggested Data Collection Question: | Is there documentation the patient had a compromising condition? |
|---|
| Format: | | Length: | 1 |
|---|
| Type: | Alphanumeric |
|---|
| Occurs: | 1 |
|---|
|
|---|
| Allowable Values: |
1 A compromising condition.
2 Prior hospitalization within 14 days
3 Both 1 and 2
4 None of the above/Unable to Determine
|
|---|
| Notes for Abstraction: |
- One time use or one course of systemic corticosteroids is not considered a compromising condition. Systemic corticosteroids listed as “home meds” or “current meds,” are considered “chronic,” unless there is documentation it is a one time course, or if it is listed as ‘PRN’.
- If there is documentation of chronic ‘steroids’, select “Yes.”
- All conditions listed in the inclusions list can be documented within the last three months OR as diagnosed for the first time during this hospital visit, with the exception of corticosteroid/prednisone therapy. Systemic corticosteriod/prednisone therapy must have occurred within the last three months prior to this hospitalization.
- If there is no timeframe documented in the medical record to indicate the condition has been present within the last 3 months (i.e., ‘history of’, etc.), select “No.”
EXCEPTIONS:
HIV, AIDS,Immunodeficiency syndromes and organ transplants do not require a timeframe, as once they are present they are always present.
- If there is physician/APN/PA documentation of “significant” or “marked” neutropenia, select “Yes.”
- If there is physician/advanced practice nurse/physician assistant (physician/APN/PA) documentation the patient is immunocompromised, select “Yes.”
|
|---|
| Suggested Data Sources: |
- Consultation notes
- Emergency department record
- History and physical
- Discharge summary
- Admission face sheet
- Nurse admission notes
|
|---|
| Additional Notes: |
|
|---|
| Guidelines for Abstraction: |
|---|
| Inclusion | Exclusion |
Within the Last 3 Months
- Leukemia
- Lymphocytic leukemia
- Lymphoma
- Marked neutropenia
- Malignancy
- Myelogenic leukemia
- Myeloma
- Myelodysplasia
- Pancytopenia
- Radiation therapy
- Significant neutropenia
- Systemic Chemotherapy
- Systemic Corticosteroid/Predisone Therapy
- Systemic immunosuppresssive therapy
No Timeframe Necessary
- Acquired Immune Deficiency Syndrome
- AIDS
- AIDS Related Complex
- Any “Immunodeficiency Syndrome”
- ARC
- Chronic Lymphocytic Leukemia (CLL)
- Congenital or hereditary Immunodeficiency
- HIV+
- HIV
- Organ Transplant
Refer to Appendix C, Table 2.2 for a comprehensive list of Immunosuppressive medications and Table 2.15 for a list of Systemic Corticosteroids.
|
- Any skin cancers without documentation of chemotherapy or radiation therapy within the last three months
- Any steroid therapy that is not systemic (i.e., inhaler, eyedrops, topical, etc.)
- Any steroids administered via epidural/spinal injections
|
|
Compromised
Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)
|