CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
1.0.0 - Release 1

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Downloaded Version 1.0.0 See the Directory of published versions

## Example Bundle: Example ACH Monthly Submission Subject Bundle 3

Profile: NHSN Subject Bundle

Bundle bundle-example-ach-monthly-subject-ach-pass3 of type collection

Entry 1 - fullUrl = http://nhsnlink.org/fhir/MeasureReport/measurereport-example-individual-ach-monthly-pass3

Resource MeasureReport:

> Profile: DEQM Individual MeasureReport Profile

> DEQM Measure Scoring Extension: Cohort

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Acute sinusitis (disorder)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Enterocolitis due to Clostridium difficile

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Coverage: identifier = Member Number: 0945345; status = active; type = preferred provider organization policy; subscriberId = 7843574536; relationship = Self

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#100051035 (use: usual, ); type = Intermittent venous compression system pump (physical object)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104253a (use: usual, ); status = finished; class = inpatient acute (ActCode[9.0.0]#ACUTE); type = In-person encounter; period = 2024-02-02 16:43:00-0500 --> 2024-02-03 19:58:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104253a (use: usual, ); status = in-progress; class = short stay (ActCode[9.0.0]#SS); type = Hospital admission, elective (procedure); period = 2024-02-01 14:12:00-0500 --> 2024-02-02 16:43:00-0500; reasonCode = Diarrhea, unspecified

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888833 (use: usual, ); status = not-done; category = Inpatient; medication[x] = ->0.4 ML enoxaparin sodium 100 MG/ML Prefilled Syringe; effective[x] = 2024-02-02 21:04:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888321 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Metronidazole 500 MG; effective[x] = 2024-02-01 21:02:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888322 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Metronidazole 500 MG; effective[x] = 2024-02-02 21:09:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888323 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Metronidazole 500 MG; effective[x] = 2024-02-03 09:09:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Community; reported[x] = true; medication[x] = ->Ciprofloxacin 500 MG; authoredOn = 2024-02-01 19:15:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888833 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.4 ML enoxaparin sodium 100 MG/ML Prefilled Syringe; authoredOn = 2024-02-02 12:21:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888832 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Metronidazole 500 MG; authoredOn = 2024-02-01 20:33:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Clostridioides difficile (organism)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Body height

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Body weight

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Pass3 ACH(official) Female, DoB: 2007-10-08 ( MRN: 1601191903010308 (use: usual, ))

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Procedure Transfusion of red blood cells (procedure)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Clostridioides difficile toxin A [Presence] in Stool by Immunoassay

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082905,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:45; type = Bloody stool specimen (specimen); receivedTime = 2024-02-01 19:12:00-0500

> identifier: `http://example.org/fhir/measurereport/id`/123456789-pass3

> status: Complete

> type: Individual

> measure: NHSN dQM Acute Care Hospital Monthly Initial Populationversion: null1.0.0)

> subject: Pass1 ACH(official) Female, DoB: 2024-02-01 ( MRN: 1601191901010308 (use: usual, ))

> date: 2024-02-05 21:04:29+0000

> reporter: Organization Example NHSN Submitter

> period: 2024-01-05 00:00:00+0000 --> 2024-02-04 00:00:00+0000

> improvementNotation: Increased score indicates improvement

> > group

> > ### Populations

> > - | Code | Count
> > * | Initial Population | 1

> evaluatedResource:

> - Condition Acute sinusitis (disorder)
> - Condition Enterocolitis due to Clostridium difficile
> - Coverage: identifier = Member Number: 0945345; status = active; type = preferred provider organization policy; subscriberId = 7843574536; relationship = Self
> - Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#100051035 (use: usual, ); type = Intermittent venous compression system pump (physical object)
> - Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104253a (use: usual, ); status = finished; class = inpatient acute (ActCode[9.0.0]#ACUTE); type = In-person encounter; period = 2024-02-02 16:43:00-0500 --> 2024-02-03 19:58:00-0500
> - Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104253a (use: usual, ); status = in-progress; class = short stay (ActCode[9.0.0]#SS); type = Hospital admission, elective (procedure); period = 2024-02-01 14:12:00-0500 --> 2024-02-02 16:43:00-0500; reasonCode = Diarrhea, unspecified
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888833 (use: usual, ); status = not-done; category = Inpatient; medication[x] = ->0.4 ML enoxaparin sodium 100 MG/ML Prefilled Syringe; effective[x] = 2024-02-02 21:04:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888321 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Metronidazole 500 MG; effective[x] = 2024-02-01 21:02:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888322 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Metronidazole 500 MG; effective[x] = 2024-02-02 21:09:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888323 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Metronidazole 500 MG; effective[x] = 2024-02-03 09:09:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Community; reported[x] = true; medication[x] = ->Ciprofloxacin 500 MG; authoredOn = 2024-02-01 19:15:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888833 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.4 ML enoxaparin sodium 100 MG/ML Prefilled Syringe; authoredOn = 2024-02-02 12:21:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888832 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Metronidazole 500 MG; authoredOn = 2024-02-01 20:33:00-0500
> - Observation Clostridioides difficile (organism)
> - Observation Body height
> - Observation Body weight
> - Pass3 ACH(official) Female, DoB: 2007-10-08 ( MRN: 1601191903010308 (use: usual, ))
> - Procedure Transfusion of red blood cells (procedure)
> - ServiceRequest Clostridioides difficile toxin A [Presence] in Stool by Immunoassay
> - Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082905,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:45; type = Bloody stool specimen (specimen); receivedTime = 2024-02-01 19:12:00-0500

Entry 2 - fullUrl = http://nhsnlink.org/fhir/Patient/patient-example-ach-monthly-pass3

Resource Patient:

> Profile: Cross-Measure Patient Profile

> Security Label: Restricted (Details: Confidentiality code R = 'Restricted')

> Pass3 ACH(official) Female, DoB: 2007-10-08 ( MRN: 1601191903010308 (use: usual, ))

> Active: | true
> Contact Detail | ACHtestcase@testcase.com 5678 Sesame Lansing Lansing MI 48864 US
> Language: | Chinese
> US Core Ethnicity Extension: | ombCategory: Race & Ethnicity - CDC 2186-5: Not Hispanic or Latino text: Non Hispanic or Latino
> US Core Birth Sex Extension | M
> US Core Race Extension: | ombCategory: Race & Ethnicity - CDC 2028-9: Asian text: White

Entry 3 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ach-monthly-pass3-acute

Resource Encounter:

> Profile: ACH Monthly Event Encounter

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/10005104253a (use: usual, )

> status: completed

> class: inpatient acute

> type: Critical care visit

> subject: Pass3 ACH

> ### Locations

> - | Location | Period
> * | ACH Monthly Medical Critical Care | 2024-02-02 16:43:00-0500 --> 2024-03-02 19:58:00-0500

Entry 4 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ach-monthly-pass3-short-stay

Resource Encounter:

> Profile: ACH Monthly Event Encounter

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/10005104253a (use: usual, )

> status: In Progress

> class: short stay

> type: Hospital Admission, Elective Procedure

> subject: Pass3 ACH

> ### Diagnoses

> - | Condition
> * | No display for Encounter.diagnosis.condition (reference: ->Enterocolitis due to Clostridium difficile)

> ### Locations

> - | Location | Period
> * | ACH Monthly Medical-Surgical Ward | 2024-02-01 14:12:00-0500 --> 2024-02-02 16:43:00-0500

Entry 5 - fullUrl = http://nhsnlink.org/fhir/Coverage/coverage-example-ach-monthly-pass3

Resource Coverage:

> Profile: ACH Monthly Event Coverage

> identifier: Member Number/0945345

> status: Active

> type: preferred provider organization policy

> subscriberId: 7843574536

> beneficiary: Pass3 ACH(official) Female, DoB: 2007-10-08 ( MRN: 1601191903010308 (use: usual, ))

> relationship: Self

Entry 6 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ach-monthly-pass3-problem

Resource Condition:

> Profile: ACH Monthly Event Condition

> clinicalStatus: Resolved

> verificationStatus: Confirmed

> category: Problem List Item

> code: Acute sinusitis

> subject: Pass3 ACH

> onset: 2024-01-21 07:32:00-0500

> abatement: 2024-02-02 16:43:00-0500

Entry 7 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ach-monthly-pass3

Resource Condition:

> Profile: ACH Monthly Event Condition

> clinicalStatus: Active

> verificationStatus: Confirmed

> category: Encounter Diagnosis

> code: Enterocolitis due to Clostridium difficile

> subject: Pass3 ACH

Entry 8 - fullUrl = http://nhsnlink.org/fhir/Device/device-example-ach-monthly-pass3-ivcs-pump

Resource Device:

> Profile: ACH Monthly Event Device

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/100051035 (use: usual, )

> type: Intermittent venous compression system pump

Entry 9 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass3-enoxaparin

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888833 (use: usual, )

> status: not-done

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888833 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.4 ML enoxaparin sodium 100 MG/ML Prefilled Syringe; authoredOn = 2024-02-02 12:21:00-0500

> ### Dosages

> - | Text | Site | Route | Dose
> * | 0.4ml subcutaneous once daily in abdomen | Subcutaneous tissue structure of anterior abdominal wall (body structure) | Oral | 4000 uL (Details: UCUM codeuL = 'uL')

Entry 10 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass3-metronidazole-1

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888321 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888832 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Metronidazole 500 MG; authoredOn = 2024-02-01 20:33:00-0500

> ### Dosages

> - | Text | Route | Dose
> * | 5mg tablet by mouth twice daily | Oral | 5 mg (Details: UCUM codemg = 'mg')

Entry 11 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass3-metronidazole-2

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888322 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888832 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Metronidazole 500 MG; authoredOn = 2024-02-01 20:33:00-0500

> ### Dosages

> - | Text | Route | Dose
> * | 5mg tablet by mouth twice daily | Oral | 5 mg (Details: UCUM codemg = 'mg')

Entry 12 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass3-metronidazole-3

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888323 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888832 (use: usual, ); status = active; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Metronidazole 500 MG; authoredOn = 2024-02-01 20:33:00-0500

> ### Dosages

> - | Text | Route | Dose
> * | 5mg tablet by mouth twice daily | Oral | 5 mg (Details: UCUM codemg = 'mg')

Entry 13 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass3-cipro

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888892 (use: usual, )

> status: Active

> intent: Plan

> category: Home Medication

> subject: Pass2 ACH

> encounter: Short Stay

> authoredOn: 2024-02-01 19:15:00-0500

> requester: Pass3 ACH(official) Female, DoB: 2007-10-08 ( MRN: 1601191903010308 (use: usual, ))

> recorder: Patient Identified

> > dosageInstruction

> > text: 500mg tablet by mouth twice daily

> > timing: 2 per 1 day

> > route: Oral

> > ### DoseAndRates

> > - | Type | Dose[x]
> > * | calculated | 500 mg (Details: UCUM codemg = 'mg')

Entry 14 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass3-enoxaparin

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888833 (use: usual, )

> status: Active

> intent: Order

> category: Inpatient Medication

> subject: Pass2 ACH

> encounter: Critical care visit

> authoredOn: 2024-02-02 12:21:00-0500

> requester: Pass3 ACH(official) Female, DoB: 2007-10-08 ( MRN: 1601191903010308 (use: usual, ))

> > dosageInstruction

> > text: 0.4ml subcutaneous once daily in abdomen

> > timing: Once per 1 day

> > site: Subcutaneous tissue structure of anterior abdominal wall (body structure)

> > route: Oral

> > ### DoseAndRates

> > - | Type | Dose[x]
> > * | calculated | 4000 uL (Details: UCUM codeuL = 'uL')

Entry 15 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass3-metronidazole

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888832 (use: usual, )

> status: Active

> intent: Order

> category: Inpatient Medication

> subject: Pass2 ACH

> encounter: Short Stay

> authoredOn: 2024-02-01 20:33:00-0500

> requester: Pass3 ACH(official) Female, DoB: 2007-10-08 ( MRN: 1601191903010308 (use: usual, ))

> > dosageInstruction

> > text: 5mg tablet by mouth twice daily

> > timing: 2 per 1 day

> > route: Oral

> > ### DoseAndRates

> > - | Type | Dose[x]
> > * | calculated | 5 mg (Details: UCUM codemg = 'mg')

Entry 16 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass3-cdiff

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest Clostridioides difficile toxin A [Presence] in Stool by Immunoassay

> status: Final

> category: Laboratory

> code: C. Diff.

> subject: Pass3 ACH

> encounter: Hospital Admission, Short Stay

> effective: 2024-02-01 19:02:00-0500

> issued: 2024-02-02 15:30:00-0500

> value: Positive (qualifier value)

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082905,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:45; type = Bloody stool specimen (specimen); receivedTime = 2024-02-01 19:12:00-0500

Entry 17 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass3-vitals-height

Resource Observation:

> Profile: ACH Monthly Event Observation - Vital Signs

> status: Final

> category: Vital Signs

> code: Height

> subject: Pass3 ACH

> encounter: Short Stay

> effective: 2024-02-01 19:21:00-0500

> issued: 2024-02-01 19:21:00-0500

> value: 176.8 cm (Details: UCUM codecm = 'cm')

Entry 18 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass3-vitals-weight

Resource Observation:

> Profile: ACH Monthly Event Observation - Vital Signs

> status: Final

> category: Vital Signs

> code: Weight

> subject: Pass3 ACH

> encounter: Short Stay

> effective: 2024-02-01 19:21:00-0500

> issued: 2024-02-01 19:21:00-0500

> value: 54.4 kg (Details: UCUM codekg = 'kg')

Entry 19 - fullUrl = http://nhsnlink.org/fhir/Procedure/procedure-example-ach-monthly-pass3-transfusion

Resource Procedure:

> Profile: ACH Monthly Event Procedure

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/100051035264 (use: usual, )

> status: Completed

> code: Transfusion of red blood cells (procedure)

> subject: Pass3 ACH

> encounter: Critical care visit

Entry 20 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-monthly-pass3-cdiff

Resource ServiceRequest:

> Profile: ACH Monthly Event ServiceRequest

> identifier: Placer Identifier/1019631826 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> code: No display for ServiceRequest.code (concept: Clostridioides difficile toxin A [Presence] in Stool by Immunoassay)

> quantity: 1

> subject: Pass3 ACH

> encounter: Hospital Admission, Short Stay

> occurrence: Code , Events: 2024-02-01 18:12:00-0500 , Count 1 times, Once

> authoredOn: 2024-02-01 18:12:00-0500

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082905,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:45; type = Bloody stool specimen (specimen); receivedTime = 2024-02-01 19:12:00-0500

Entry 21 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-monthly-pass3-stool

Resource Specimen:

> Profile: ACH Monthly Event Specimen

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798.32`/C104082905, `urn:oid:2.16.840.1.113883.19.5.1.798.800`/C10408290:45

> type: Bloody stool specimen (specimen)

> subject: Pass3 ACH

> receivedTime: 2024-02-01 19:12:00-0500

> ### Collections

> - | Collected[x] | BodySite
> * | 2024-02-01 19:02:00-0500 | No display for Specimen.collection.bodySite (concept: Entire rectum (body structure))