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| ==Purpose==
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| The [[:Category:Critical Care QI Team | Critical Care QI Team]] is monitoring [[Central Line Related Blood stream Infection (CLR-BSI) | Central Line Infections]] and [[VAP]]s in the ICUs. This project is in collaboration with [[CCVSM]] which is a cross Canada ICU collaborative project.
| | |explanation=was replaced by [[Central Line Related Blood stream Infection (CLR-BSI)]] / [[VAP]] as part of move to [[ICD10]] |
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| == Specs ==
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| ==='''ICU'''===
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| ==== Dates ====
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| * Start Date: '''Saturday August 22, 2009'''
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| * End Date: NONE - Continued project with the [[CCVSM]] cross Canada Collaborative--[[User:TOstryzniuk|TOstryzniuk]] 16:53, 4 October 2010 (CDT)
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| * Units Collecting: '''all ICU's''' in the Region.
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| * STB_CICU or STB_CCU do not submit [http://ltc.umanitoba.ca/wikis/ccmdb/index.php/QA_Infection#Line_Count_Form_used_by_ICU.27sCentral Line count forms].
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| ==='''Medicine''' wards===
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| * part B only - The "Diagnosis" of a Central Line Infection
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| ==== Dates ====
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| * Start Date: '''Monday October 19, 2009'''
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| * End Date: NONE. Ongoing project for [[CCVSM]] cross Canada Collaborative.--[[User:TOstryzniuk|TOstryzniuk]] 16:51, 4 October 2010 (CDT)
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| * Units Collecting: Medicine wards: HSC, STB, VIC, GRA
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| **Med wards do not submit [http://ltc.umanitoba.ca/wikis/ccmdb/index.php/QA_Infection#Line_Count_Form_used_by_ICU.27sCentral Line count forms].
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| ==Data Collection Instructions==
| | This article has been split into the following two to clear up instructions: |
| === A. [[VAP]]===
| | * [[QA Infection CLI]] |
| If an ICU patient has a '''Complication''' of '''[[VAP]]''', the following entry must be made in the L_TmpV2 file:
| | * [[QA Infection VAP]] |
| * Project: '''QAInf''' | |
| * Item: '''[[VAP]] Infection'''
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| * Infx Dt:
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| ** If patient acquires VAP on the unit: | |
| *** Date of infection (no time) is the '''date POSITIVE SPUTUM CULTURE''' was '''sent to micro lab'''; if no positive sputum culture, than not a VAP
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| ** If patient is ADMITTED with a VAP from another ICU
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| *** then VAP date should be left blank
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| * Go to [[VAP]] article for more information about VAP.
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| '''The site where the VAP had "first" occurred at is the site that must get the credit for where this complication had occurred.'''
| | Leaving info about the cross-checks here because they are done together. |
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| ====NOTE====
| | {{Data Integrity Check List}} |
| VAP cannot be coded as a complication on a Medicine ward but can be used as an Admitting diagnosis if patient came from an ICU and requires ongoing treatment for this problem. If resolved in the ICU, don't code as an admitting DX to you ward.
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| ===B. [[Central Line Related Blood stream Infection (CLR-BSI) | Central Line Infection]]=== | | == Related articles == |
| #If a patient develops a '''Complication''' of '''[[Central Line Related Blood stream Infection (CLR-BSI) | Central Line Infection]]''' while in your unit, the following entry must be made in the L_TmpV2 file:
| | {{Related Articles}} |
| #*Project: '''QAInf'''
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| #*Item: '''[[Central Line Related Blood stream Infection (CLR-BSI) | Central Line Infection]]'''
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| #*DATE of infection (no time) is the date '''positive''' blood culture was '''sent''' to micro lab.
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| #*if '''no''' positive culture than '''not''' a CLR-BSI
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| #Patient already has a CLR-BSI present on admission to your unit:
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| #*in the admitting diagnosis field, enter Central Line Infection.
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| #*do not enter the DATE of positive culture in the Temp Studies field.
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| #*if the patient is from another ICU in the city, email the collector at that site to check if CLR_BSI was captured as a "complication" at that site.
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| '''The site where the CLR-BSI had "first" occurred at is the site that must get the credit for where this complication had occurred.'''
| | [[Category: QAInfection]] |
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| *Go to [[Central Line Related Blood stream Infection (CLR-BSI) | Central Line Infection]] article for more information about CLR-BSI.
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| ==Line Count Form used by ICU's==
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| {{discussion}}
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| * ''This seems like a totally different topic. Is there any reason not to spin it out into a different article?'' [[User:Ttenbergen|Ttenbergen]] 13:26, 27 June 2011 (CDT) Ttenbergen 17:10, 2012 October 1 (CDT)
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| **''Good piont but not really different topic because part of it is related to CLI rates above. Julie uses this information to calculate line infection rates. When we go to new TISS28 the plan is for this tally form will go away and so will this part of the article because items it will be obtained from TISS28''.[[User:TOstryzniuk|Trish Ostryzniuk]] 17:04, 2012 October 3 (CDT)
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| *Form is completed daily by CRN (charge nurse) or manager and FAXED to the Database Research office once per week (every Monday with previous weeks data).
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| *[[Data Processor]] makes a phone call to specific contact people in each ICU every week if the form is not submitted by Wednesday each week.
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| *[[Data Processor]] manually enters values from this form into an Access database on our office share drive X.
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| *The same form is used by ICU charge nurses for the QA [[ETT unschedule extubations]] project and for Central Line Infection Rate counting and [http://ltc.umanitoba.ca/wikis/ccmdb/index.php/QA_Infection_Audit#B._Central_Line_Related_Blood_stream_infection_.28CLR-BSI.29 QAInf ITEM B above.] & article [[Central Line Related Blood stream Infection (CLR-BSI) | Central Line Infection]]
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| **[[File:HSC NEW CentralLine ETTUBE Data Collection Form.pdf]] -- HSC Form
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| **[[File:IICU-NEW CentralLine ETTUBE Data Collection Form.pdf]] -- HSC-IICU Form
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| **[[File:NEW CentralLine ETTUBE Data Collection Form.pdf]] -- All other ICU's form This form is excluded for STB_CICU and STB_CCU & Medicine wards.
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| == {{Data Integrity Rules}} ==
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| [[Tmp Checker]] will check for the following:
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| === Dx but no tmp ===
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| If '''Complication Diagnosis''' is one of:
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| *[[Central Line Related Blood stream Infection (CLR-BSI) | Central line infection]] (code 86)
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| *[[VAP]] (code 39)
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| then
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| * L_TmpV2 entry with project "ICU Infection Audit" with date needed
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| === Tmp but no dx ===
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| If "QAInf" entry is present in [[L_TmpV2]] then
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| * program must be "CC"
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| * the '''corresponding''' diagnosis must exist
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| === DtTm has to be min 48hrs after admission ===
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| uses query ''s_tmp_QAInf_LT_48_hrs_after_admit''
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| DtTm of QAInf entry has to be '''at least 48hrs after patient admission''' unless the inf_dttm is blank.
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| == Data Integrity Rules Under Discussion ==
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| === VAP as AdmitDx but start date exists ===
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| {{Potential Change}}
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| *If VAP is in ADMIT DX (to ICU) which is possible when transferred from another ICU, a start Date is not needed in tmpV2.
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| ** could not the patient have arrived with a VAP and then developed a second one? [[User:Ttenbergen|Ttenbergen]] 16:21, 4 May 2011 (CDT)
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| ***Yes this is possible. Can be same or diff bug - found 10 cases from 2006 to present. It is also possible to have more than 1 acquired VAP (we have cases of this as well). [[User:JMojica|JMojica]] 17:27, 4 May 2011 (CDT)
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| ****Patient could of arrived from one ICU to another with a VAP and then developed another one with a different bug however, we will stick to the guidelines of "in a unit" for at least 48 hrs with a ET tube to be considered a VAP or a '''new VAP''' acquired in that unit. If cultures are sent on the same day of admission to the second ICU and it ends up being positive with a different pathogen, this pathogen was quite likely present PRIOR transferring to another ICU. We are therefore making it look like that the new unit is now responsible for acquired VAP within the first 2 days of admission, when in all likely hood the pathogen was already starting it's party over in the previous unit before transfer. --[[User:TOstryzniuk|TOstryzniuk]] 13:21, 6 May 2011 (CDT)
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| ***** Yes, but does it make sense to apply the check we are discussing? If not, please delete the section. If it does make sense, please explain. Also, do we just not want a date, or do we altogether not want a line in tmp? [[User:Ttenbergen|Ttenbergen]] 15:45, 3 June 2011 (CDT){{discussion}}
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| ****** Please clarify, and if this should be implemented, add to [[Change Priorities]]. Ttenbergen 17:09, 2012 October 1 (CDT)
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| == Send mode ==
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| Data for '''all''' patients meeting requirements for this study, including patients you are not sending this batch, will be sent every time complete patients are sent.
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| [[Category: Special_Short_Term_Projects]] | |
| [[Category: L_TmpV2 Data]] | | [[Category: L_TmpV2 Data]] |
| [[Category: Data Use]]
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| [[Category: All Projects]]
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| [[Category: QA]] | | [[Category: QA]] |
| | [[Category: VAP - Ventilator Associated Pneumonia]] |
| | }} |