Query check CCI TISS discontinuous ETT: Difference between revisions

(16 intermediate revisions by the same user not shown)

Line 1:

{{Data Integrity Check

|DIC_summary=~~___~~

|DIC_summary={{TISS w Nr | ETT Present (TISS Item)}} should start with an {{TISS w Nr | Insertion of ETT (TISS Item)}} and end with an {{TISS w Nr | Planned extubation (TISS Item)}} or {{TISS w Nr | Unplanned extubation (TISS Item)}}.

~~Any marked~~ TISS Item in {{TISS w Nr | ~~Planned extubation~~ (TISS Item)}} ~~or in~~ {{TISS w Nr | ~~Unplanned~~ extubation (TISS Item)}} ~~must have the~~ {{TISS w Nr | ~~ETT Present~~ (TISS Item)}} ~~on the same date~~.

|DIC_related_concepts=Insertion of ETT (TISS Item); Planned extubation (TISS Item); Unplanned extubation (TISS Item)

|DIC_firmness=soft check

|DIC_timing=complete

|DIC_coding=query ''check_CCI_TISS_discontinuous_ETT''

|DIC_implementation_date=2021-11-10

|DIC_status=~~ready to implement~~

|DIC_status=implemented

|DIC_app=CCMDB.accdb

|DIC_backlogged=No

}}

This query checks for some scenarios around intubation that are possible, but are entered erroneously often enough to make it worth warning about them. It is implemented as a soft check, so collectors can click past it.

~~This query checks for some scenarios around intubation~~ that ~~are possible, but are entered erroneously often enough to make~~ it ~~worth warning about them~~. ~~It is implemented as~~ a soft check, ~~so collectors can click~~ past it.

=== Could happen in case of Tracheostomy creation in procedure suite ===

There might be no extubation if pt has a trach ({{TISS w Nr | Trach Tube Present (TISS Item)}}) created ([[Tracheostomy creation]]), since that would be done in OR and part of it would be the extubation. Since this would be a soft check, the collector could just OK past it if this is the case.

~~{{Discuss |~~

== The check ==

* Should we include a request to add a comment in notes when clicking past this to preempt future follow-up? [[User:Ttenbergen|Ttenbergen]] 13:36, 2021 November 10 (CST)

}}

== ~~Relevant codes~~ ==

=== intubation or extubation ===

*{{TISS w Nr | Planned extubation (TISS Item)}}

Line 26:

Line 25:

*{{TISS w Nr | Invasive Mechanical Ventilation (TISS Item)}}

== ~~the check~~ ==

=== conditions ===

* if previous date has no {{TISS w Nr | ETT Present (TISS Item)}} and today date has {{TISS w Nr | ETT Present (TISS Item)}} then {{TISS w Nr |Insertion of ETT (TISS Item)}} should be marked

** Error: No ETT_1, Has ETT_2, No intubation_2

* if previous date has {{TISS w Nr | ETT Present (TISS Item)}} and today date has no {{TISS w Nr | ETT Present (TISS Item)}} then previous date of the {{TISS w Nr |Unplanned extubation (TISS Item)}} or {{TISS w Nr | Planned extubation (TISS Item)}} should be entered

** Error: ETT_2, No ETT_3, no extub_2

* if previous date has {{TISS w Nr | ETT Present (TISS Item)}} and today date has {{TISS w Nr | ETT Present (TISS Item)}} and {{TISS w Nr |Insertion of ETT (TISS Item)}} are marked then today date of {{TISS w Nr |Unplanned extubation (TISS Item)}} or {{TISS w Nr | Planned extubation (TISS Item)}} should be marked

** Error: ETT_2, ETT_3, intub_3, no extub_2, no extub_3

** Error: ETT_2, ETT_3, extub_2, no intub_2, no intub_3

Another scenario:

*yesterday I have ETT

*today you t40 new insertion marked,

*but there is no extubation either yesterday or today

~~== remaining questions ==~~

Another scenario:

*{{TISS w Nr | Planned extubation (TISS Item)}} or {{TISS w Nr | Unplanned extubation (TISS Item)}} can only be marked when both

*ett2 not null

** 1) {{TISS w Nr | Insertion of ETT (TISS Item)}} is marked on same day '''and'''

*intub3 not null

** 2) {{TISS w Nr | ETT Present (TISS Item)}} is marked in previous day.

*extub2 null

* ~~the sequence is being intub yesterday and the next day extub then new insertion on same day.~~

*extub3 null

~~{{DJ |~~

* ~~Most intubated patients eventually get extubated without getting intubated again; this check would flag every one of them! Is that actually what you want, or am I misunderstanding this one?~~

}}

*{{TISS w Nr | Planned extubation (TISS Item)}} or {{TISS w Nr | Unplanned extubation (TISS Item)}} can only be marked when both

Line 47:

Line 51:

**2) {{TISS w Nr | ETT Present (TISS Item)}} is not marked the next day.

* the sequence is today new insertion then extub and tomorrow has no tube.

~~{{DJ |~~

* I don't even understand when this check would ever make sense... what do you mean with this one?

}}

Another scenario

*new insertion today

*tomorrow there is no ETT present

*there needs to be an extub present today

== Log ==

* 2021-11-10

* 2022-08-11 - tweaked the query to only run 1000 days back and to not include future dates (for a long-LOS pt the query was giving error "The query cannot be completed. Either the size of the query result is larger than the maximum size of a database (2GB), or there is not enough temporary storage space on the disk to store the query result.")

* 2022-02-09 - updated to broaden criteria 3 to not require ett3 to be any specific value; added criteria 5

* 2022-01-11 - updated to link days by Pat_ID properly

* 2022-01-10 - updated to work right with param parameter

* 2022-01-06 - activated as soft check

* 2021-11-10 - implemented query but not calling it from code yet, want Lisa or someone to check on this

== Related articles ==

@@ Line 1: / Line 1: @@
 {{Data Integrity Check
-|DIC_summary=___
+|DIC_summary={{TISS w Nr | ETT Present (TISS Item)}} should start with an {{TISS w Nr | Insertion of ETT (TISS Item)}} and end with an {{TISS w Nr | Planned extubation (TISS Item)}} or {{TISS w Nr | Unplanned extubation (TISS Item)}}.
-Any marked TISS Item in {{TISS w Nr | Planned extubation (TISS Item)}} or in {{TISS w Nr | Unplanned extubation (TISS Item)}} must have the {{TISS w Nr | ETT Present (TISS Item)}} on the same date.
+|DIC_related_concepts=Insertion of ETT (TISS Item); Planned extubation (TISS Item); Unplanned extubation (TISS Item)
-|DIC_related_concepts=Insertion of ETT (TISS Item);  Planned extubation (TISS Item); Unplanned extubation (TISS Item)
 |DIC_firmness=soft check
+|DIC_timing=complete
 |DIC_coding=query ''check_CCI_TISS_discontinuous_ETT''
 |DIC_implementation_date=2021-11-10
-|DIC_status=ready to implement
+|DIC_status=implemented
 |DIC_app=CCMDB.accdb
+|DIC_backlogged=No
 }}
+This query checks for some scenarios around intubation that are possible, but are entered erroneously often enough to make it worth warning about them. It is implemented as a soft check, so collectors can click past it.
-This query checks for some scenarios around intubation that are possible, but are entered erroneously often enough to make it worth warning about them. It is implemented as a soft check, so collectors can click past it.
+=== Could happen in case of Tracheostomy creation in procedure suite ===
+There might be no extubation if pt has a trach ({{TISS w Nr | Trach Tube Present (TISS Item)}}) created ([[Tracheostomy creation]]), since that would be done in OR and part of it would be the extubation. Since this would be a soft check, the collector could just OK past it if this is the case.
-{{Discuss |
+== The check ==
-* Should we include a request to add a comment in notes when clicking past this to preempt future follow-up? [[User:Ttenbergen|Ttenbergen]] 13:36, 2021 November 10 (CST)
-}}
-== Relevant codes ==
 === intubation or extubation ===
 *{{TISS w Nr | Planned extubation (TISS Item)}}
@@ Line 26: / Line 25: @@
 *{{TISS w Nr | Invasive Mechanical Ventilation (TISS Item)}}
-== the check ==
+=== conditions ===
 * if previous date has no {{TISS w Nr | ETT Present (TISS Item)}} and today date has {{TISS w Nr | ETT Present (TISS Item)}} then {{TISS w Nr |Insertion of ETT (TISS Item)}} should be marked
+** Error: No ETT_1, Has ETT_2, No intubation_2
 * if previous date has {{TISS w Nr | ETT Present (TISS Item)}} and today date has no {{TISS w Nr | ETT Present (TISS Item)}} then previous date of the {{TISS w Nr |Unplanned extubation (TISS Item)}} or {{TISS w Nr | Planned extubation (TISS Item)}} should be entered
+** Error: ETT_2, No ETT_3, no extub_2
 * if previous date has {{TISS w Nr | ETT Present (TISS Item)}} and today date has {{TISS w Nr | ETT Present (TISS Item)}} and {{TISS w Nr |Insertion of ETT (TISS Item)}} are marked then today date of {{TISS w Nr |Unplanned extubation (TISS Item)}} or {{TISS w Nr | Planned extubation (TISS Item)}} should be marked
+** Error: ETT_2, ETT_3, intub_3, no extub_2, no extub_3
+** Error: ETT_2, ETT_3, extub_2, no intub_2, no intub_3
+Another scenario:
+*yesterday I have ETT
+*today you t40 new insertion marked,
+*but there is no extubation either yesterday or today
-== remaining questions ==
+Another scenario:
-*{{TISS w Nr | Planned extubation (TISS Item)}} or {{TISS w Nr | Unplanned extubation (TISS Item)}} can only be marked when both
+*ett2 not null
-** 1) {{TISS w Nr | Insertion of ETT (TISS Item)}} is marked on same day '''and'''
+*intub3 not null
-** 2) {{TISS w Nr | ETT Present (TISS Item)}} is marked in previous day.
+*extub2 null
-*  the sequence is being intub yesterday and the next day extub then new insertion on same day.
+*extub3 null
-{{DJ |
-* Most intubated patients eventually get extubated without getting intubated again; this check would flag every one of them! Is that actually what you want, or am I misunderstanding this one?
-}}
 *{{TISS w Nr | Planned extubation (TISS Item)}} or {{TISS w Nr | Unplanned extubation (TISS Item)}} can only be marked when both
@@ Line 47: / Line 51: @@
 **2) {{TISS w Nr | ETT Present (TISS Item)}} is not marked the next day.
 * the sequence is today new insertion then extub and tomorrow has no tube.
-{{DJ |
-* I don't even understand when this check would ever make sense... what do you mean with this one?
-}}
+Another scenario
+*new insertion today
+*tomorrow there is no ETT present
+*there needs to be an extub present today
 == Log ==
-* 2021-11-10
+* 2022-08-11 - tweaked the query to only run 1000 days back and to not include future dates (for a long-LOS pt the query was giving error "The query cannot be completed. Either the size of the query result is larger than the maximum size of a database (2GB), or there is not enough temporary storage space on the disk to store the query result.")
+* 2022-02-09 - updated to broaden criteria 3 to not require ett3 to be any specific value; added criteria 5
+* 2022-01-11 - updated to link days by Pat_ID properly
+* 2022-01-10 - updated to work right with param parameter
+* 2022-01-06 - activated as soft check
+* 2021-11-10 - implemented query but not calling it from code yet, want Lisa or someone to check on this
 == Related articles ==