@Paul Jankauskas Hi Paul, please feel free to review this before we go over it with CDC tomorrow! Everything in red is what we plan to ask during the call and we would also like to collect the elements we would include in each drop down list (i.e. Antimicrobial routes, microbio specimen types, etc.) Please note that columns in the tables should be read vertically and are not correlated to other columns in the table.

Survey Schema Draft

9/14/2022

Eligibility for PPS = patient is admitted to facility by 8am on the day of the survey

Total (n) (arbitrary): 100

Step 1: Collect admission date and surgery

• What is the date of admission? (needs to be admitted at the facility for 48+ hours)

• Has the patient had surgery since date of admission?

Numerator (arbitrary): 90; Denominator (arbitrary): 100

Step 2: Collect all antimicrobials ordered for patients admitted greater than 48 hours or post-surgery since admission

If patient is on antimicrobials, collect name of the antimicrobial, route, indication of all antimicrobials in a table and move on to Step 3

If someone had surgery and was on a prophylactic antibiotic and didn’t have micro/radiology – would they get routed to SSI and maybe UTI (if catheter was present) get cut early?

• If on antimicrobials, collect previous admission information on the last 30 days (Do we only want admission or previous hospitalization/medical treatment?)

  • Collect date and reason for admission
    
    

Numerator (arbitrary): 80; Denominator (arbitrary): 100

Step 3: Invasive Devices (lines and intubation), microbiology, and radiology

• Microbiology ordered in the last 7 days (Y/N)

• Lines present for last 7 days (Y/N)

• Radiology for last 7 days (Y/N)

  • Should we include a drop down for type of radiology? Idea: only ask for chest x-ray interpretation if the patient is in PPS for admission date, ask for other x-ray interpretation for surgery route
    
    If the invasive device was ordered at a previous facility, should we still collect/document that data in the PPS?

Is there an exit point for Step 3? I.e. No to all 3, lines that don’t lead to HAI

Can microorganism be a drop down? Specimen source can determine microorganism dropdown options
for UTI – should we include dipstick/urine in the microbiology table or ask in the UTI block?

Numerator (arbitrary): 75; Denominator (arbitrary): 100

Need to determine triggers in Step 3 to route patient to necessary module blocks (Micro: specimen type, radiology interpretation, catheter)

Step 4: HAI specific questions

If you meet any of the following criteria in each module, patient will get routed to all applicable HAI question blocks

PN Case Determination

• Are the following symptoms present? (drop down, check all that apply)

  • Leukopenia

  • Fever

  • Cough

  • Gas Exchange

  • Sputum

  • Wheezing

  • No symptoms present

UTI Case Determination

• Was a dipstick/urine analysis performed? (Y/N)

  • If yes, was leukocyte esterase and/or nitrate present? -> this could lead to UTI-C
    
    

• Are the following symptoms present? (drop down, check all that apply)

  • Fever

  • Urgency

  • Frequency

  • Dysuria

  • Suprapubic tenderness

  • No symptoms present

BSI Case Determination

• Are the following symptoms present?

  • Fever

  • Chills

  • Hypotension

  • No symptoms present

SSI Case Determination

• Has the patient undergone surgery in the past 30 days? (Y/N) – Do we care if the patient had a prior surgery/caught an HAI from a surgery that happened in a different facility? Currently this question would only be asked to people who have had a surgery since their admission date? Options: eliminate or ask everyone
  
  

• Does the patient have an open wound? (Y/N)

  • If yes, what is the location of the open wound? (drop down) -> lead to classification

  • If no, did the physician diagnose an SSI? (Y/N)

• Are the following symptoms present?

  • Drainage (specify purulent?)

  • Fever

  • Pain or Tenderness

  • Localized Swelling

  • Redness or Heat

  • No symptoms present

Rates of patients surveyed for identified HAIs:

PN: Numerator (arbitrary): 50; Denominator (arbitrary): 100

BSI: Numerator (arbitrary): 40; Denominator (arbitrary): 100

UTI: Numerator (arbitrary): 35; Denominator (arbitrary): 100

SSI: Numerator (arbitrary): 20; Denominator (arbitrary): 100

**Please note, the total patient number in each of the specific HAI Module may overlap (e.g., there can be patients which are surveyed for all 4 HAIs, 3 of the HAIs or 1-2 of the HAIs)

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