Pneumonia, ventilator-associated (VAP): Difference between revisions
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*If >70 years old, altered mental status without another recognized cause | *If >70 years old, altered mental status without another recognized cause | ||
3. Chest imaging (X-ray) study or studies showing at least ONE of the following 3 things, that must be new & persistent OR progressive and persistent: (CDC WORDING CHANGE). | 3. Chest imaging (X-ray) study or studies showing at least ONE of the following 3 things, that must be new & ''persistent'' OR ''progressive and persistent'': (CDC WORDING CHANGE). | ||
*Infiltrate | *Infiltrate | ||
*Consolidation | *Consolidation | ||
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*Patients might be treated for infection with these pathogens, but we should still not code them as VAP. In that case you might be able to code it as a '''[[Hospital-acquired pneumonia (HAP) in ICD10]]''' or '''[[Community-acquired pneumonia (CAP) in ICD10]]'''. | *Patients might be treated for infection with these pathogens, but we should still not code them as VAP. In that case you might be able to code it as a '''[[Hospital-acquired pneumonia (HAP) in ICD10]]''' or '''[[Community-acquired pneumonia (CAP) in ICD10]]'''. | ||
==MRSA colonized== | ==MRSA colonized== | ||
Is this still valid? It is cut and pasted below and taken from the old guidelines. | Is this still valid? It is cut and pasted below and taken from the old guidelines.{{Discussion}} | ||
{{DiscussAllan |Does MRSA still not exclude?}} | {{DiscussAllan |Does MRSA still not exclude?}} | ||
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== CXR's== | == CXR's== | ||
{{DiscussAllan |VAP missed because follow up CXR's after initial infiltrate not done. Criteria says: new and persistent or progressive and persistent infiltrates. If QA team wants improved VAP recordings maybe attendings need to be reminded to do those follow up CXR's on the cases that they think have VAP?}} | |||
{{ | *Some VAP can be occasionally missed because the doctors are not always doing the follow up CXR's after the intial infiltrate and identification of pathogen. If the infiltrate need to be new and persistent or progressive and persistent, if those follow up CXR's are not done we can't code a VAP even if it is a probable VAP. If the QA people want to improve VAP recording by data collectors than maybe attendings need to be reminded to do those follow up CXR's on the cases that they think have VAP? Just a thought.[[User:GHall|GHall]] 10:42, 2018 April 5 (CDT){{Discussion}} | ||
Some VAP can be occasionally missed because the doctors are not always doing the follow up CXR's after the intial infiltrate and identification of pathogen. If the infiltrate need to be new and persistent or progressive and persistent, if those follow up CXR's are not done we can't code a VAP even if it is a probable VAP. If the QA people want to improve VAP recording by data collectors than maybe attendings need to be reminded to do those follow up CXR's on the cases that they think have VAP? Just a thought.[[User:GHall|GHall]] 10:42, 2018 April 5 (CDT) | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||