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 1

Profile: NHSN Subject Bundle

Bundle bundle-example-ach-monthly-subject-ach-pass1 of type collection

Entry 1 - fullUrl = http://nhsnlink.org/fhir/MeasureReport/measurereport-example-individual-ach-monthly-pass1

Resource MeasureReport:

> Profile: DEQM Individual MeasureReport Profile

> DEQM Measure Scoring Extension: Cohort

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Pass1 ACH(official) Female, DoB: 2024-02-01 ( MRN: 1601191901010308 (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#10005104251 (use: usual, ); status = in-progress; class = inpatient acute (ActCode[9.0.0]#ACUTE); type = Hospital admission (procedure); period = 2024-02-01 16:02:00-0500 --> 2024-02-04 19:00:00-0500; reasonCode = Fever, unspecified

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Coverage: identifier = Member Number: 084536836; status = active; type = subsidized health program; subscriberId = 98435938934; relationship = Child; period = 2020-08-01 --> (ongoing)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Bacteremia (finding)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#1000510341 (use: usual, ); type = Central venous catheter, device (physical object)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888111 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->vancomycin Injectable Solution 50MG; effective[x] = 2024-02-02 14:34:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888811 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->vancomycin Injectable Solution 50MG; authoredOn = 2024-02-02 13:43:00-0500

> 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 Serratia marcescens DNA [Presence] in Specimen by NAA with probe detection

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Gestational age--at birth

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

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Procedure Placement procedure (procedure)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Procedure Drainage of Spinal Canal, Percutaneous Approach, Diagnostic

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

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Differential panel - Cerebral spinal fluid

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082901,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:41; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500

> 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 = Cerebrospinal fluid specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500

> identifier: `http://example.org/fhir/measurereport/id`/123456789-pass1

> 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:

> - Pass1 ACH(official) Female, DoB: 2024-02-01 ( MRN: 1601191901010308 (use: usual, ))
> - Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104251 (use: usual, ); status = in-progress; class = inpatient acute (ActCode[9.0.0]#ACUTE); type = Hospital admission (procedure); period = 2024-02-01 16:02:00-0500 --> 2024-02-04 19:00:00-0500; reasonCode = Fever, unspecified
> - Coverage: identifier = Member Number: 084536836; status = active; type = subsidized health program; subscriberId = 98435938934; relationship = Child; period = 2020-08-01 --> (ongoing)
> - Condition Bacteremia (finding)
> - Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#1000510341 (use: usual, ); type = Central venous catheter, device (physical object)
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888111 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->vancomycin Injectable Solution 50MG; effective[x] = 2024-02-02 14:34:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888811 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->vancomycin Injectable Solution 50MG; authoredOn = 2024-02-02 13:43:00-0500
> - Observation Bacteria identified in Blood by Culture
> - Observation Serratia marcescens DNA [Presence] in Specimen by NAA with probe detection
> - Observation Gestational age--at birth
> - Observation Body weight
> - Procedure Placement procedure (procedure)
> - Procedure Drainage of Spinal Canal, Percutaneous Approach, Diagnostic
> - ServiceRequest Bacteria identified in Blood by Culture
> - ServiceRequest Differential panel - Cerebral spinal fluid
> - Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082901,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:41; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500
> - 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 = Cerebrospinal fluid specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500

Entry 2 - fullUrl = http://nhsnlink.org/fhir/Patient/patient-example-ach-monthly-pass1

Resource Patient:

> Profile: Cross-Measure Patient Profile

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

> Active: | true | Deceased: | false
> Contact Detail | ph: 999-999-9999(Home) 456 Alphabet Street Lansing MI 48864 US (home)
> Language: | English (United States)
> Next-of-Kin: | Mom Parent 456 Alphabet Street Lansing MI 48864
> US Core Ethnicity Extension: | ombCategory: Race & Ethnicity - CDC 2135-2: Hispanic or Latino text: Hispanic or Latino
> US Core Birth Sex Extension | M
> US Core Race Extension: | ombCategory: Race & Ethnicity - CDC 2054-5: Black or African American text: Black or African American

Entry 3 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ach-monthly-pass1

Resource Encounter:

> Profile: ACH Monthly Event Encounter

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/10005104251 (use: usual, )

> status: In Progress

> class: inpatient acute

> type: Hospital Admission

> subject: Pass1 ACH

> ### Diagnoses

> - | Condition
> * | No display for Encounter.diagnosis.condition (reference: ->Thrombophlebitis)

> ### Locations

> - | Location | Period
> * | ACH Monthly Neonatal critical care | 2024-02-01 16:02:00-0500 --> 2024-02-02 16:02:00-0500

Entry 4 - fullUrl = http://nhsnlink.org/fhir/Coverage/coverage-example-ach-monthly-pass1

Resource Coverage:

> Profile: ACH Monthly Event Coverage

> identifier: Member Number/084536836

> status: Active

> type: subsidized health program

> policyHolder: Mom Parent

> subscriberId: 98435938934

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

> relationship: Child

> period: 2020-08-01 --> (ongoing)

Entry 5 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ach-monthly-pass1

Resource Condition:

> Profile: ACH Monthly Event Condition

> clinicalStatus: Active

> verificationStatus: Confirmed

> category: Encounter Diagnosis

> code: Bacteremia

> subject: Pass1 ACH

Entry 6 - fullUrl = http://nhsnlink.org/fhir/Device/device-example-ach-monthly-pass1-central-line

Resource Device:

> Profile: ACH Monthly Event Device

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/1000510341 (use: usual, )

> type: Central venous catheter, device

Entry 7 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass1-vancomycin

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888111 (use: usual, )

> status: completed

> category: Inpatient

> subject: Pass1 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888811 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->vancomycin Injectable Solution 50MG; authoredOn = 2024-02-02 13:43:00-0500

> ### Dosages

> - | Text | Route | Dose
> * | 15mg/kg | IV | 15 mg/kg (Details: UCUM codemg/kg = 'mg/kg')

Entry 8 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass1-vancomycin

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888811 (use: usual, )

> status: Completed

> intent: Order

> category: Inpatient

> subject: Pass1 ACH

> encounter: Hospital Admission

> authoredOn: 2024-02-02 13:43:00-0500

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

> > dosageInstruction

> > text: 15mg/kg every 12 hours

> > timing: Once per 12 hours

> > route: IV

> > ### DoseAndRates

> > - | Type | Dose[x]
> > * | calculated | 15 mg/kg (Details: UCUM codemg/kg = 'mg/kg')

Entry 9 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass1-blood

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest Bacteria identified in Blood by Culture

> status: Final

> category: Laboratory

> code: Bacteria identified in Blood by Culture

> subject: Pass1 ACH

> encounter: Hospital Admission

> effective: 2024-02-02 18:12:00-0500

> issued: 2024-02-03 11:42:00-0500

> value: Staphylococcus capitis

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082901,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:41; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500

Entry 10 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass1-csf

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest Differential panel - Cerebral spinal fluid

> status: Final

> category: Laboratory

> code: Serratia marcescens DNA

> subject: Pass1 ACH

> encounter: Hospital Admission

> effective: 2024-02-02 18:13:00-0500

> issued: 2024-02-03 11:47:00-0500

> value: Detected (qualifier value)

> specimen: 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 = Cerebrospinal fluid specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500

Entry 11 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass1-gestational-age

Resource Observation:

> Profile: ACH Monthly Event Observation

> status: Final

> category: Exam

> code: Gestational age at birth

> subject: Pass1 ACH

> encounter: Hospital Admission

> effective: 2024-02-01 16:02:00-0500

> issued: 2024-02-01 16:02:00-0500

> value: 164 day (Details: UCUM coded = 'd')

Entry 12 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass1-vitals-weight

Resource Observation:

> Profile: ACH Monthly Event Observation - Vital Signs

> status: Final

> category: Vital Signs

> code: Weight

> subject: Pass1 ACH

> encounter: Hospital Admission

> effective: 2024-02-01 16:02:00-0500

> issued: 2024-02-01 16:02:00-0500

> value: 0.58 kg (Details: UCUM codekg = 'kg')

Entry 13 - fullUrl = http://nhsnlink.org/fhir/Procedure/procedure-example-ach-monthly-pass1-central-line

Resource Procedure:

> Profile: ACH Monthly Event Procedure

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/1000510352 (use: usual, )

> status: Completed

> code: Placement procedure (procedure)

> subject: Pass1 ACH

> encounter: Hospital Admission

Entry 14 - fullUrl = http://nhsnlink.org/fhir/Procedure/procedure-example-ach-monthly-pass1-lumbar

Resource Procedure:

> Profile: ACH Monthly Event Procedure

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/1000510352 (use: usual, )

> status: Completed

> code: Drainage of Spinal Canal, Percutaneous Approach, Diagnostic

> subject: Pass1 ACH

> encounter: Hospital Admission

> bodySite: Structure of superior articular process of lumbar vertebra

Entry 15 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-monthly-pass1-blood

Resource ServiceRequest:

> Profile: ACH Monthly Event ServiceRequest

> identifier: Placer Identifier/1019631821 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> code: No display for ServiceRequest.code (concept: Bacteria identified in Blood by Culture)

> quantity: 1

> subject: Pass1 ACH

> encounter: Hospital Admission

> occurrence: Code , Events: 2024-02-02 17:22:00-0500 , Count 1 times, Once

> authoredOn: 2024-02-02 17:22:00-0500

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082901,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:41; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500

Entry 16 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-monthly-pass1-csf

Resource ServiceRequest:

> Profile: ACH Monthly Event ServiceRequest

> identifier: Placer Identifier/1019631822 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> code: No display for ServiceRequest.code (concept: Differential panel - Cerebral spinal fluid)

> quantity: 1

> subject: Pass1 ACH

> encounter: Hospital Admission

> occurrence: Code , Events: 2024-02-02 17:22:30-0500 , Count 1 times, Once

> authoredOn: 2024-02-02 17:22:30-0500

> specimen: 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 = Cerebrospinal fluid specimen (specimen); receivedTime = 2024-02-02 18:20:00-0500

Entry 17 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-monthly-pass1-blood

Resource Specimen:

> Profile: ACH Monthly Event Specimen

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798.32`/C104082901, `urn:oid:2.16.840.1.113883.19.5.1.798.800`/C10408290:41

> type: Venous blood specimen (specimen)

> subject: Pass1 ACH

> receivedTime: 2024-02-02 18:20:00-0500

> ### Collections

> - | Collected[x] | BodySite
> * | 2024-02-02 18:12:00-0500 | No display for Specimen.collection.bodySite (concept: Heel structure (body structure))

Entry 18 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-monthly-pass1-csf

Resource Specimen:

> Profile: ACH Monthly Event 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: Cerebrospinal fluid specimen (specimen)

> subject: Pass1 ACH

> receivedTime: 2024-02-02 18:20:00-0500

> ### Collections

> - | Collected[x] | BodySite
> * | 2024-02-02 18:13:00-0500 | No display for Specimen.collection.bodySite (concept: Structure of superior articular process of lumbar vertebra (body structure))