Query check CCI TISS Intubation vs Intubated

Data Integrity Checks
Summary:	Any marked TISS Item in T28 - Planned extubation (TISS Item) or in T29 - Unplanned extubation (TISS Item) must have the T22 - ETT Present (TISS Item) on the same date.
Related:	Insertion of ETT (TISS Item), Planned extubation (TISS Item), Unplanned extubation (TISS Item)
Firmness:	hard check
Timing:	always
App:	CCMDB.accdb
Coding:	query check_CCI_TISS_Intubation_vs_Intubated
Uses L Problem table:	not relevant for this app
Status:	implemented
Implementation Date:	2021-01-28
Backlogged:	true

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implemented check details

If any of #intubation or extubation is present on a day, then at least one of #ETT or ventilation also need to be marked for that day.

intubation or extubation

• T28 - Planned extubation (TISS Item)
• T29 - Unplanned extubation (TISS Item)
• T40 - Insertion of ETT (TISS Item)

ETT or ventilation

• T22 - ETT Present (TISS Item)
• T18 - Invasive Mechanical Ventilation (TISS Item)

deferred / need discussion details

Julie had requested the following but there could be false positives; flagging for Task to decide if to defer or how to check.

1. if previous date has no T22 - ETT Present (TISS Item) and today date has T22 - ETT Present (TISS Item) then T40 - Insertion of ETT (TISS Item) should be marked
   • not necessarily, could have been done in OR or elsewhere
2. if previous date has T22 - ETT Present (TISS Item) and today date has no T22 - ETT Present (TISS Item) then previous date of the T29 - Unplanned extubation (TISS Item) or T28 - Planned extubation (TISS Item) should be entered
   • not necessarily, could have been done in OR or elsewhere
3. if previous date has T22 - ETT Present (TISS Item) and today date has T22 - ETT Present (TISS Item) and T40 - Insertion of ETT (TISS Item) are marked then today date of T29 - Unplanned extubation (TISS Item) or T28 - Planned extubation (TISS Item) should be marked
   • not necessarily, could have been done in OR or elsewhere

Julie requested

Moved here from Query TISS Errors ETT consistent which turned out to be a duplicate of this same issue.

extubate only when tube present

T28 - Planned extubation (TISS Item) or T29 - Unplanned extubation (TISS Item) can only be marked when T22 - ETT Present (TISS Item) is marked in same day.

new tube inserted

When T40 - Insertion of ETT (TISS Item)(T40) is marked, the T22 - ETT Present (TISS Item)(T22) must also be marked in same day.

extubate only when new tube inserted

T28 - Planned extubation (TISS Item) or T29 - Unplanned extubation (TISS Item) can only be marked when both 1) T40 - Insertion of ETT (TISS Item) is marked on same day and 2) T22 - ETT Present (TISS Item) is marked in previous day.

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

T28 - Planned extubation (TISS Item) or T29 - Unplanned extubation (TISS Item) can only be marked when both 1) T40 - Insertion of ETT (TISS Item) is marked on same day and 2) T22 - ETT Present (TISS Item) is not marked the next day.

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

1 A patient might arrive intubated, so there would be no intubation. Does this check really make sense? Ttenbergen 23:23, 2019 March 25 (CDT) I have revised the conditions, pls check if they now make sense.--JMojica 16:38, 2019 July 9 (CDT) Actually, no: Someone can arrive intubated from another ICU and then be extubated their first day here. I don't see how Insertion can be included in these two. Ttenbergen 20:13, 2020 December 2 (CST) Julie and Tina discussed this, but Julie wonders how common these false positives would be. Are they rare enough to add at least a soft cross-check for this? Ttenbergen 16:22, 2021 September 2 (CDT)

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• 2021-01-28 - Query implemented