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:	complete
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:	No

• Cargo

• SMW

• Categories:  

• form:

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.

Could happen in case of Tracheostomy creation in procedure suite

There might be no extubation if pt has a trach (T23 - Trach Tube Present (TISS Item)) created (Tracheostomy creation), since that would be done in OR and part of it would be the extubation. Since this would be a soft check, the collector could just OK past it if this is the case.

The check

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)

conditions

• 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
  • Error: No ETT_1, Has ETT_2, No intubation_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
  • Error: ETT_2, No ETT_3, no extub_2

• 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
  • Error: ETT_2, ETT_3, intub_3, no extub_2, no extub_3
  • Error: ETT_2, ETT_3, extub_2, no intub_2, no intub_3

remaining questions

If patient has T28 - Planned extubation (TISS Item) or T29 - Unplanned extubation (TISS Item) they have to have to also be intubated that 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 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? Julie explained: yesterday I have ETT today you t40 new insertion marked, but there is no extubation either yesterday or today ie. ett2 not null intub3 not null extub2 null extub3 null Meaning I could simply broaden my third criteria line by not also requiring ett3 to be not null

• SMW

• Cargo

• Categories

• 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? new insertion today tomorrow there is no ETT present there needs to be an extub present today added as criteria 5

• SMW

• Cargo

• Categories

Log

• 2022-02-09 - updated to broaden criteria 3 to not require ett3 to be any specific value
• 2022-01-11 - updated to link days by Pat_ID properly
• 2022-01-10 - updated to work right with param parameter
• 2022-01-06 - activated as soft check
• 2021-11-10 - implemented query but not calling it from code yet, want Lisa or someone to check on this