Query check CCI TISS discontinuous ETT

Data Integrity Checks
Summary:	T22 - ETT Present (TISS Item) should start with an T40 - Insertion of ETT (TISS Item) and end with an T28 - Planned extubation (TISS Item) or T29 - Unplanned extubation (TISS Item).
Related:	Insertion of ETT (TISS Item), Planned extubation (TISS Item), Unplanned extubation (TISS Item)
Firmness:	soft check
Timing:	always
App:	CCMDB.accdb
Coding:	query check_CCI_TISS_discontinuous_ETT
Uses L Problem table:	not relevant for this app
Status:	ready to implement
Implementation Date:	2021-11-10
Backlogged:	true

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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.

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

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Relevant codes

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)

the check

• 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

• 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

• 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

remaining questions

• 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.

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?

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• 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.

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

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Log

• 2021-11-10