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 MeasureReport: MeasureReport - Example Individual ACH Monthly Pass2 - Hypo

Page standards status: Informative

Profile: DEQM Individual MeasureReport Profile

DEQM Measure Scoring Extension: Cohort

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104252a (use: usual, ); status = triaged; class = emergency (ActCode[9.0.0]#EMER); type = Emergency department patient visit; period = 2024-01-31 02:35:00-0500 --> 2024-01-31 22:02:00-0500; reasonCode = Pain in right lower leg

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Encounter: extension = eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3; identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104252b (use: usual, ); status = finished; class = inpatient encounter (ActCode[9.0.0]#IMP); type = Hospital admission (procedure); period = 2024-01-31 22:02:00-0500 --> 2024-02-02 16:22:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Coverage: identifier = Member Number: 93565936; status = active; type = health maintenance organization policy; subscriberId = 89345743; relationship = Self

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Diabetes mellitus type 2 (disorder)

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Thrombophlebitis of deep femoral vein (disorder)

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#100051034 (use: usual, ); type = Graduated compression elastic hosiery (physical object)

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Diagnostic Report for 'Doppler ultrasonography of vascular structure of right lower limb (procedure)' for '->Pass2 ACH'

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888893 (use: usual, ); status = completed; category = Outpatient; medication[x] = ->Dex4 4 gm chewable tablet X1; effective[x] = 2024-01-31 04:54:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-01 12:22:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-02 13:26:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888942 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 12:00:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888943 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 19:00:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888944 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 07:00:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888945 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 15:00:00-0500

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 = Outpatient; reported[x] = true; medication[x] = ->Dex4 4 gm chewable tablet X1; authoredOn = 2024-01-31 04:46:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; authoredOn = 2024-02-01 12:00:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500

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] = ->Metformin hydrochloride 1000 MG; authoredOn = 2024-01-31 04:22:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation aPTT in Blood by Coagulation assay

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Glucose [Mass/volume] in Capillary blood by Glucometer

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Glucose [Mass/volume] in Capillary blood by Glucometer

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Hemoglobin A1c/Hemoglobin.total in Blood

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Bacteria identified in Blood by Culture

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

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Procedure Percutaneous insertion of inferior vena cava filter (procedure)

Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest aPTT in Blood by Coagulation assay

Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Glucose [Mass/volume] in Capillary blood by Glucometer

Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Hemoglobin A1c [Mass/volume] in Blood

Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Hemoglobin [Mass/volume] in Venous blood

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500

Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 11:26:00-0500

identifier: `http://example.org/fhir/measurereport/id`/123456789-pass2

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:

- Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))
- Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104252a (use: usual, ); status = triaged; class = emergency (ActCode[9.0.0]#EMER); type = Emergency department patient visit; period = 2024-01-31 02:35:00-0500 --> 2024-01-31 22:02:00-0500; reasonCode = Pain in right lower leg
- Encounter: extension = eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3; identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104252b (use: usual, ); status = finished; class = inpatient encounter (ActCode[9.0.0]#IMP); type = Hospital admission (procedure); period = 2024-01-31 22:02:00-0500 --> 2024-02-02 16:22:00-0500
- Coverage: identifier = Member Number: 93565936; status = active; type = health maintenance organization policy; subscriberId = 89345743; relationship = Self
- Condition Diabetes mellitus type 2 (disorder)
- Condition Thrombophlebitis of deep femoral vein (disorder)
- Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#100051034 (use: usual, ); type = Graduated compression elastic hosiery (physical object)
- Diagnostic Report for 'Doppler ultrasonography of vascular structure of right lower limb (procedure)' for '->Pass2 ACH'
- MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888893 (use: usual, ); status = completed; category = Outpatient; medication[x] = ->Dex4 4 gm chewable tablet X1; effective[x] = 2024-01-31 04:54:00-0500
- MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-01 12:22:00-0500
- MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-02 13:26:00-0500
- MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888942 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 12:00:00-0500
- MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888943 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 19:00:00-0500
- MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888944 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 07:00:00-0500
- MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888945 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 15:00:00-0500
- MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Outpatient; reported[x] = true; medication[x] = ->Dex4 4 gm chewable tablet X1; authoredOn = 2024-01-31 04:46:00-0500
- MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; authoredOn = 2024-02-01 12:00:00-0500
- MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500
- 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] = ->Metformin hydrochloride 1000 MG; authoredOn = 2024-01-31 04:22:00-0500
- Observation aPTT in Blood by Coagulation assay
- Observation Glucose [Mass/volume] in Capillary blood by Glucometer
- Observation Glucose [Mass/volume] in Capillary blood by Glucometer
- Observation Hemoglobin A1c/Hemoglobin.total in Blood
- Observation Bacteria identified in Blood by Culture
- Observation Body weight
- Procedure Percutaneous insertion of inferior vena cava filter (procedure)
- ServiceRequest aPTT in Blood by Coagulation assay
- ServiceRequest Glucose [Mass/volume] in Capillary blood by Glucometer
- ServiceRequest Hemoglobin A1c [Mass/volume] in Blood
- ServiceRequest Hemoglobin [Mass/volume] in Venous blood
- Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500
- Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 11:26:00-0500