Query check CCI InExtubation consistent

Data Integrity Checks
Summary:	Any marked TISS Item T40 - Insertion of ETT (TISS Item) or in T22 - ETT Present (TISS Item) must have at least one marked TISS item either in T28 - Planned extubation (TISS Item) or in T29 - Unplanned extubation (TISS Item)
Related:	Insertion of ETT (TISS Item), Planned extubation (TISS Item), Unplanned extubation (TISS Item)
Firmness:	hard check
Timing:	always
App:	Centralized data front end.accdb
Coding:
Uses L Problem table:	not entered
Status:	ready to implement
Implementation Date:	2018-10-25
Backlogged:	true

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Any marked TISS Item T40 - Insertion of ETT (TISS Item) or in T22 - ETT Present (TISS Item) must have at least one marked TISS item either in T28 - Planned extubation (TISS Item) or in T29 - Unplanned extubation (TISS Item)

Query1 - Insertion of ETT and Extubation consistency

• A = Total the number of days T40 - Insertion of ETT (TISS Item) are marked per patient
• B = Total the number of days T28 - Planned extubation (TISS Item) and T29 - Unplanned extubation (TISS Item) are marked per patient
• The difference between A and B can be -1, 0, 1. Other values will be questionable.

this cross check would not know the difference between (on one day, intubated, extubated, and reintubated) vs (intubated and then extubated); while this hopefully not too common of a thing, would it cause false positives for Pagasa to run after? Ttenbergen 11:33, 2018 October 29 (CDT) yes that is correct because both have a difference of zero. Using the cut off GTE Abs(2) will get true negatives and not false positives. This query considers only the counts and not the dates which will have numerous scenarios and too complicated to define. For those having a difference of -1,0,1 , there are also the possibility for incorrect sequence of dates of intubation or extubation - this is not captured in the query. If you have other suggestions, let us know.--JMojica 12:19, 2018 October 29 (CDT) What I was trying to say is that I am worried this would be a false positive, which will then create work load for Pagasa and/or Collectors to confirm. Do we really want cross checks that bring up potential errors? We have talked about this before, but never really come up with a general answer. Should we take it to task meeting? Ttenbergen 23:45, 2018 October 29 (CDT) Are you saying I should use "difference between A and B can be -2, -1, 0, 1, 2. Other values will be questionable? The basic scenarios are 1. no new insert and no extubation (0-0=0) , 2. no new insert and then extubated - this assumes currently with tube and then extubated (0-1=-1), 3. insert new tube and no extubation(1-0=1), 4) insert new tube and then extubated (1-1=0). When there are 2 insertions, the valid number of extubations =1,2,3 even if occurring at same or different days as insertion day, the difference will either be -1,0,1. Same holds true with 3 insertions or 4 insertions. there will be definite errors if the difference is >= 2 or <= -2. Having 1 insertion and 3 extubations or 3 insertions and 1 extubation are not possible and are errors. Scenario: Pt arrives intubated. On day 1, they are extubated. On day 2 they are intubated, extubated and then intubated again on the same day, which will look on TISS as one insertion on that day and one removal. If you then had a removal the next day you will have an error because you have a count of 3 extubations with only 1 intubation. yes, this scenario if indeed correct has to be checked with the dates and also not that frequent. I found a case of 3 days extubations and 1 day insertion which is questionable because the 2nd day extubation (4/18/2018) is not the same day as the insertion day (4/16/2018) and the 3rd extubation day is 4/23/2018 - is there a missing insertion before 4/23 or an extra extubation 4/18 or 4/23? Actually, the most common cases are either extubations >= 2 and zero intubations or zero extubation and intubations >= 2 which we assume as missed bubble that is why -2 and 2 are not included in the acceptable values. When I discussed with Trish the scenario you have cited, she said we still need an audit so we are aware and clear about the cases of two insertions done in a day.--JMojica 10:19, 2018 November 21 (CST) I will have to sit down with this and work through it.

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