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| The DC Treatment field (discontinuation of treatment or DC TX) should be coded in the Critical Care program only if life-support treatment is terminated. The field is on the "''Reg & ADL & Var''" tab on the [[Patient Viewer]] in [[CCMDB.mdb]]. | | The concept encoded by this is slightly different than other [[:Category:End-of-life related data|End-of-life related data]] so it can not be transferred into new fields that encode related concepts, so we will keep it in the [[Centralized_data.accdb]]'s [[L Log table]]. It has been removed from [[CCMDB.accdb]]. |
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| === DC TX & Transfer Ready Date/time === | | {{Todo |
| *If the unit physician discontinues life-support treatment (withdraws therapy) on a patient and death is immediate, then '''[[Admit, Transfer and Discharge date and time#Transfer_Date_and_Time|Transfer ready]]''' '''should be left blank'''. This field is not for recording the date and time when discontinuation of life support process started. | | | who = Tina |
| ** is this true even if the transfer ready date was entered much sooner, e.g. a patient was transfer ready and deteriorated several days later? Isn't what we really want just to say the second part: do not use the transfer ready date to indicate dc tx time? Ttenbergen 09:47, 2013 July 4 (CDT) {{discussion}}
| | | todo_added = 2022-06-30 |
| | | todo_action = 2023-05-04 |
| | | question = _dev_CFE_Data |
| | * The field has a length of 50 and should be reduced to 2 now that that's the longest content. |
| | }} |
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| Pts who become ACPC and expire in hospital 3 days to one month after comfort care is ordered.
| | {{LegacyContent |
| * I would like to know where this type of patients fits in. Example: a patient who has co- morbids and is admitted with pneumonia and does not improve or deteriorates. The decision is made to provide comfort care only (ACPC). This patient lives three days to one month in hospital and then dies. Does this patient need a transfer ready date?
| | |explanation=stopped collection in Medicine |
| **I currently code pts who become ACPC and then die within 48 hours as D/C treatment and do not fill out the transfer ready space. If the patient lives longer than 48 hours I will code the patient as [[Palliative Care]] and fill the transfer ready space when the order of ACPC is written. Many of my admitted pts come to the hospital to die and I'm not sure if these patients fit into the transfer/overstay predictor project. Please let me know how you code these cases.Judy Kublick 11:32, 2012 September 24 (CDT)~~
| | |successor= various tmp and dx codes relating to [[palliative patient]]s and [[:category:End-of-life related data|End-of-life related data]] |
| | |content= |
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| *If a unit physician discontinues life-support treatment and a patient does not die immediately and is placed on a transfer/ready list, and then passes away PRIOR TO being transferred out of the ICU unit, then [[Admit, Transfer and Discharge date and time#Transfer_Date_and_Time|Transfer ready]] should '''not''' be recorded.
| | {{Data_element |
| | | field_name = R_dc_treat |
| | | element_description = "DC" for critical care patients if life-support treatment is terminated, blank for all others. |
| | | in_table = L_Log table |
| | | data_type = string |
| | | datafield_length=50 |
| | | program_collecting = CC |
| | | created_raw = Raw |
| | | data_element_sort_index = 12 |
| | | data_element_end_date = 2022-05-10 |
| | }} |
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| *If a patient '''arrests''' in the unit and CPR is unsuccessful, the date and time of stopping CPR should '''not''' be recorded for [[Admit, Transfer and Discharge date and time#Transfer_Date_and_Time|Transfer ready]].
| | This field was also collected in Medicine until 2013-07-04. Collection stopped because the distinction is not clear enough for coding on a medicine ward. |
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| | Defined as terminal withdrawal with expectation of death of: |
| | * invasive mechanical ventilation (ET tube or trach) |
| | * vasopressors or inotropes |
| | * [[ECMO, VV]], [[ECMO, VA]] |
| | * VAD (Ventricular assistive device) |
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| | == See Also == |
| | See: [[Comfort Care]] |
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| == Legacy Information == | | == Log == |
| This field was also collected in Medicine until 2013-07-04. Collection stopped because the distinction is not clear enough for coding on a medicine ward.
| | * 2022-05-10 removed from collection screen |
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| | == Related articles == |
| | {{Related Articles}} |
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| == confusion ==
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| Shirley added the following to an old version of the article so I reverted to the newest version and am adding the comment here:
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| * This D/C treatment is now more confusing than ever?Trish do you want us to code D/C pt on a medicine ward or is it just for critical care? Please clarify Thanks shirley 13:37, 2013 July 4 (CDT) {{discussion}}
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| ** We discontinue treatment on patients all the time on Medicine. Vital signs are no longer taken, all meds are stopped except for maybe scopalamine & morphine for comfort measures, no bloodwork is drawn, death is imminent. Why can we not have/use D/C TX? It does not only happen in ICU.--[[User:CMarks|CMarks]] 12:58, 2013 July 31 (CDT)
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| On H4 I will get pts from MICU that they have D/C TX on and come down to die because of bed shortages, and I also get the strokes come in to H4H that are severe enough to D/C tx on --[[User:PStein|PStein]] 09:05, 2013 August 1 (CDT)
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| [[Category:Data Collection Guide]] | | [[Category:Data Collection Guide]] |
| [[Category:Registry Data]] | | [[Category:Registry Data]] |
| | [[Category:End-of-life related data]] |
| | }} |