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Release Notes:
Data Element
Version 2010A1

Data Element Name: Pseudomonas Risk
Collected For: PN-6, PN-6a, PN-6b,
Definition:Risk of pseudomonas is defined as any patient who has documentation of one of the following by the physician/advanced practice nurse/physician assistant (physician/APN/PA):
  • Bronchiectasis documented as a possible consideration. Bronchiectasis is defined as chronic dilatation of a bronchus or bronchi, with a secondary infection that usually involves the lower portion of the lung. Dilatation may be in an isolated segment or spread throughout the bronchi.
  • Physician/APN/PA documented pseudomonal risk
Structural lung disease AND documented history of repeated antibiotics or chronic systemic corticosteroid use.
Suggested Data Collection Question:Does the patient have risk of pseudomonas?
Allowable Values:

Y    (Yes)   The patient has risk of pseudomonas as indicated by documentation of one or more of the above conditions.

N   (No)   The patient has no risk of pseudomonas as indicated by none of the above conditions being documented in the medical record or unable to determine from medical record documentation.

Notes for Abstraction:
  • Repeated antibiotics and/or chronic systemic corticosteriod can be for any reason. It does not have to be linked to the structural lung disease. Example: Patient is taking chronic steroids for Lupus and they also have COPD.”
  • For the purposes of this data element, structural lung disease includes:
    • Chronic Bronchitis
    • COPD
    • Emphysema
    • Interstitial lung disease
    • Pulmonary Fibrosis
    • Restrictive lung disease
  • One time use or one course of antibiotics or systemic corticosteroids is not considered chronic.
  • 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’.
  • “Repeated antibiotics” are defined as documentation of multiple “rounds” or “courses” of antibiotics.
  • If there is documentation of chronic ‘steroids’, select “Yes.”
Suggested Data Sources:
  • Consultation notes
  • Emergency department record
  • History and physical
  • Progress notes
  • Admitting physician orders
  • Admitting progress notes
  • Physician admission note

“Home meds” or “current meds” do not require documentation by a physician/APN/PA; other data sources may be used.

Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
  • Need to evaluate for
  • Possible
  • Probable
  • Questionable
  • Rule/out bronchiectasis

Pseudomonal Risk:

  • Pseudomonal risk
  • Structural lung disease with multiple rounds of antibiotics
  • Structural lung disease with chronic systemic corticosteroid use
  • Structural lung disease with long-term systemic corticosteroid use

Refer to Appendix C, Table 2.15 for a comprehensive list of Systemic Corticosteroids.

  • Doubt bronchiectasis
  • Respiratory problems without mention of bronchiectasis

Pseudomonal Risk

  • Structural lung disease with no documentation of a history of repeated antibiotic use or chronic systemic corticosteroid use.

Pseudomonas Risk
Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)