BRR
Legacy: for any patient still on unit after Dec 31, 2018, code as: Targeted Temperature Management (TTM). No need to go back to change, just any NEW arrest after this date, apply new code. Trish Ostryzniuk 13:41, 2018 December 24 (CST)
| Projects | |
| Active?: | active |
| Program: | CC |
| Requestor: | Dr. Dean Bell/Dr. Kendiss Olafson |
| Collection start: | |
| Collection end: | |
BRR/XBR is an entry we use to identify whether patients are receiving therapeutic hypothermia Targeted Temperature Management (TTM) following a cardiac arrest according to the Cardiac Arrest Cooling Protocol. By identifying all patients that receive this therapy a further audit can be done to identify if therapy was appropriate or not. We do not track cooling for reasons other than cardiac arrest.
Guidelines / Collection Instructions
For any ICU patient with one of the following diagnoses:
or pre-ICD10:
Code in TMP follows:
- Project: Cooling
- item
- BRR (BRR stands for "Brrrr" as in shivering or cold)
- cooling protocol was applied at any point post arrest
- XBR - no cooling protocol applied
- BRR (BRR stands for "Brrrr" as in shivering or cold)
Do not code BRR or XBR when a cooling protocol is used to normalize temperature for any type of non-cardiac arrest patients.
CCI
Task Team Meeting - Rolling Agenda and Minutes#ICU Database Task Group Meeting – October 3, 2018 confirmed that we can stop collecting this when we start collecting CCI Targeted Temperature Management (TTM). We may want to import the old entries as CCI codes? Ttenbergen 00:19, 2018 October 10 (CDT)
Cross Checks
see Check BRR/XBR vs cardiac arrest dx
Background
Start Dates
- 2004 August 2004
- XBR and CCMDB.mdb cross checks were added to detect occasions where entry was just forgotten/missed March 19.09
- reviewed with Kendiss Olafson and Dean Bell.--TOstryzniuk 17:58, 26 August 2009 (CDT)
- cross-checks changed to include Unwitnessed Cardiac Arrest August 27.09
- moved from ICU Var 2 into TMP on Dec 18, 2014
Stop Date
2018 Dec 31
- Stop in TMP. All patient still in unit after this date, code as: Targeted Temperature Management (TTM)
Why the code XBR?
The rationale for the code XBR is to identify those patients who had a cardiac arrest but were not cooled regardless if they met criteria for cooling or not. XBR was implemented after an audit of cardiac arrest was done and it was found that there were several cardiac arrests coded that were missing code BRR. By leaving Variable 2 blank for a cardiac arrest, it is not clear to Kendiss or Julie whether a data collector missed tagging it or if indeed cooling was not applied. Coding XBR indicates to both Kendiss and Julie that a collector verfied that the cooling protocol was not applied.
removed 12 hr requirement
Discussed at task 2018-04-11: we are removing the 12 hr requirement because the use and application of the protocol has changed since inception and this restriction is no longer reasonable.
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