QA Infection

Purpose

The Critical Care QI Team is monitoring Central Line Infections and VAPs in the ICUs. This project is in collaboration with CCVMS which is a cross Canada ICU collaborative project.

Data Collection Instructions

Nov 1.13 - Hi everyone: RE: TMP entries

• Please do not enter date and time for studies into TMP until you have actually confirmed a DX of VAP or CLI exists. Please don't use the TMP as a note section for reminders to yourself. Use the Notes field on you laptop. Each week when you send data, any INCOMPLETE files are also sent to TMPV2 database. So if you put in a TMP CLI or VAP as only reminder to self then when Julie is asked for reports on CLI or VAP, she picks this up for her report from the TMPV2 database. This affect the data in that it reduces the number days between CLI dates. We have no way of knowing that this only a reminder for you not a confirmed CLI or VAP. Trish Ostryzniuk 15:33, 2013 November 1 (CDT )

A. VAP

If patient is admitted with a VAP from another ICU then don't enter a Tmp entry.

If an ICU patient has a Complication of VAP, the following entry must be made in the L_TmpV2 file:

• Project: QAInf
• Item: VAP Infection
• Infx Dt: Date of infection is the date POSITIVE SPUTUM CULTURE was sent to micro lab; if no positive sputum culture, than not a VAP
• time: no time is collected for this project

Go to VAP article for more information about VAP.

The site where the VAP had "first" occurred at is the site that must get the credit for where this complication had occurred.

B. Central Line Infection

1. If a patient develops a Complication of Central Line Infection while in your unit, the following entry must be made in the L_TmpV2 file:
   • Project: QAInf
   • Item: CLI

CLI Call Basil Evan if MICU/SICU/IICU phone:787-8794

1. • DATE of infection (no time) is the date positive blood culture was sent to micro lab.
   • if no positive culture than not a CLR-BSI
2. Patient already has a CLR-BSI present on admission to your unit:
   • in the admitting diagnosis field, enter Central Line Infection.
   • do not enter the DATE of positive culture in the Temp Studies field.
   • 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.

The site where the CLR-BSI had "first" occurred at is the site that must get the credit for where this complication had occurred.

• Go to Central Line Infection article for more information about CLR-BSI.

Specs

ICU

Dates

• Start Date: Saturday August 22, 2009
• End Date: NONE - Continued project with the CCVSM cross Canada Collaborative--TOstryzniuk 16:53, 4 October 2010 (CDT)
• Units Collecting: all ICU's in the Region. Exlcudes STB_CICU & CCU.

Medicine wards

• part B only - The "Diagnosis" of a Central Line Infection

• I do not think Basil Evan wants to know about medicine ward CLI's but want to clarify: do we still put CLI complication in tmp file as well as in diagnostic complications for medicine?--LKolesar 14:27, 2016 November 1 (CDT)
  • you are right, part B makes no sense, must refer to an earlier layout of the instructions... checking w Trish. Ttenbergen 16:59, 2016 November 3 (CDT)

Dates

• Start Date: Monday October 19, 2009
• End Date: NONE. Ongoing project for CCVSM cross Canada Collaborative.--TOstryzniuk 16:51, 4 October 2010 (CDT)
• Units Collecting: Medicine wards: HSC, STB, VIC, GRA

Template:CCMDB Data Integrity Checks

Tmp Checker will check for the following:

Dx but no tmp

If Complication Diagnosis is one of:

• Central line infection (code 86)
• VAP (code 39)

then

• L_TmpV2 entry with project "ICU Infection Audit" with date needed

Tmp but no dx

If "QAInf" entry is present in L_TmpV2 then

• program must be "CC"
• the corresponding diagnosis must exist

DtTm has to be min 48hrs after admission

uses query s_tmp_QAInf_LT_48_hrs_after_admit DtTm of QAInf entry has to be at least 48hrs after patient admission unless the inf_dttm is blank.

Send mode

Data for all patients meeting requirements for this study, including patients you are not sending this batch, will be sent to TMPV2.mdb every time complete patients are sent. This is why there multiple rows of data for same patients in TMPV2.mdb (something to keep in mind when doing a query in Access. Statistician requires this data for reporting to ICU Quality team as soon as it is available.