Release Notes:
Data Element
Version 2010B
| Data Element Name: | Identified Pathogen |
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| Collected For: | PN-6, PN-6a, PN-6b, |
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| Definition: | Documentation that results of a positive culture or diagnostic test for a pathogen were available upon arrival or within 24 hours after arrival to the hospital. For the purposes of this measure, a positive diagnostic test for a pathogen is defined as any of the following:
- Known positive culture (blood, urine, sputum, wound, etc.)
- Positive urinary antigen test for Streptococcus pneumoniae or Legionella pneumophilia
- Positive Polymerase Chain Reaction (PCR) test for Legionella pneumophilia
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| Suggested Data Collection Question: | Is there documentation that results of a positive culture or diagnostic test for a pathogen were available upon arrival or within 24 hours after arrival to the hospital? |
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| Format: | | Length: | 1 |
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| Type: | Alphanumeric |
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| Occurs: | 1 |
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| Allowable Values: |
Y (Yes) There is documentation that results of a positive culture or diagnostic test for a pathogen were available upon arrival or within 24 hours after arrival to the hospital.
N (No) There is no documentation that results of a positive culture or diagnostic test for a pathogen were available upon arrival or within 24 hours after arrival to the hospital or unable to determine from medical record documentation.
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| Notes for Abstraction: |
- If a culture is drawn prior to arrival or within 24 hours of arrival but results documenting a pathogen are not available within 24 hours of arrival, - Select “No.”
- Gram stain results alone are not acceptable – a pathogen must be identified.
Example:
Sputum reveals gram positive cocci, but an organism has not been identified, - Select “No.”
- Any physician/advanced practice nurse/physician assistant (physician/APN/PA) documentation of a known pathogen within 24 hours of arrival, - Select “Yes”
Example:
Physician documents in the ED H&P, “chronic history of pseudomonas”
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| Suggested Data Sources: |
- Consultation notes
- Emergency department record
- History and physical
- Laboratory report
- Progress notes
- Physician orders
- Admitting physician orders
- Physician admitting note
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| Additional Notes: |
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| Guidelines for Abstraction: |
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| Inclusion | Exclusion | |
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- Tests collected/drawn but not available/reported within 24 hours after arrival to the hospital
- Gram stain results that do not list a pathogen
Examples:
- gram stain
- positive cocci
- Gram negative rods
- normal flora
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Identified Pathogen
Specifications Manual for Joint Commission National Quality Core Measures (2010B)
Discharges 10-01-10 (4Q10) through 03-31-11 (1Q11)
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