Attribution of infections: Difference between revisions

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There will always be a delay between an actual infection and the time at which the infection is confirmed by the lab, or manifests so it can be determined without lab clarification (for diagnoses where we allow that). Some of our reports "attribute" infections to units on which they happen if they are an [[Acquired Diagnosis]].
 
{{DiscussTask |
== Additional info ==
* I finally figured out how to ask this at task: I was worried that we might apply the delay at the data entry end and also at the reporting end (i.e. the delay might be included twice or not at all, so we need to phrase and then link this correctly so it's clear whether the delay is considered at collection or at reporting. Ttenbergen 21:37, 2020 August 27 (CDT)
*Some of our reports "attribute" infections to units on which they happen if they are an [[Acquired Diagnosis]].
}}
 
{{Discuss | Is the following correct, then:
<blockquote>This means that an infection discovered shortly after admission should not generally be coded as an [[Acquired Diagnosis]], since it likely happened before the patient arrived on the current ward, and should instead be coded as an [[Admit Diagnosis]]. To be consistent, we have rules on how long after admission to a unit an infection needs to be discovered before we would call it an [[Acquired Diagnosis]] instead of an [[Admit Diagnosis]]. <blockquote>
}}
== Diagnoses with specific attribution rules ==
== Diagnoses with specific attribution rules ==
We have specific attribution rules as documented in their pages for the following diagnoses:
We have specific attribution rules as documented in their pages for the following diagnoses:
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== Attribution for all other infections ==
== Attribution for all other infections ==
{{Discuss |
* There is usually a delay between the start of an actual infection and the time at which the infection is confirmed by the lab, or manifests so it can be determined without lab clarification (for diagnoses where we allow that).
*Is the following correct, then:
**But except for the infections listed above which have specific attribution rules, we designate the START/ONSET of an infection as:
<blockquote> A decided that an infection that is discovered '''within the first 48 hrs after admission''' should be coded as an [[Admit Diagnosis]], and an infection discovered after that as an [[Acquired Diagnosis]].
**When it is first noticed clinically, or was first identified by the lab -- whichever happens '''FIRST'''
</blockquote>
* A chronic-type infection (e.g. TB) which is first discovered in hospital BUT presumably was actually present on admission is governed by the rules of [[Template:ICD10 Guideline Como vs Admit]] -- i.e. coded as an [[Admit Diagnosis]].
}}
**But rarely, a person can acquire such a chronic-type infection in hospital, and if THAT is thought to have happened, then code it as an [[Acquired Diagnosis]].
*For an acute-type infection (e.g. bacterial cellulitis) first identified '''after''' admission (the start of the current [[PatientFollow Project]] profile) to choose [[Admit Diagnosis]] vs. [[Comorbid Diagnosis]], you should try to figure out whether it was actually present at admission or actually began after admission. 
**Typically there will be at least a guess by the team about this.  If not, then you can default to the guideline that if it was first discovered '''within the first 48 hrs after admission''' to code it as an [[Admit Diagnosis]], and if discovered >48 hrs after admission to code it as as an [[Acquired Diagnosis]].


=== attribution doesn't apply to colonization ===
== Attribution doesn't apply to colonization ==
See [[Colonized with organism (not infected)#Colonizations are not attributed to any units]]
See [[Colonized with organism (not infected)#Colonizations are not attributed to any units]]
===Cleanup===
{{TT|
When this is all settled, the details need to be integrated into [[Template: ICD10 Guideline Infection]], [[Lab and culture reports]], [[Infections in ICD10]] }}


== Related articles ==  
== Related articles ==  

Latest revision as of 12:14, 2023 July 5

Additional info

  • Some of our reports "attribute" infections to units on which they happen if they are an Acquired Diagnosis.

Diagnoses with specific attribution rules

We have specific attribution rules as documented in their pages for the following diagnoses:

Attribution for all other infections

  • There is usually a delay between the start of an actual infection and the time at which the infection is confirmed by the lab, or manifests so it can be determined without lab clarification (for diagnoses where we allow that).
    • But except for the infections listed above which have specific attribution rules, we designate the START/ONSET of an infection as:
    • When it is first noticed clinically, or was first identified by the lab -- whichever happens FIRST
  • A chronic-type infection (e.g. TB) which is first discovered in hospital BUT presumably was actually present on admission is governed by the rules of Template:ICD10 Guideline Como vs Admit -- i.e. coded as an Admit Diagnosis.
    • But rarely, a person can acquire such a chronic-type infection in hospital, and if THAT is thought to have happened, then code it as an Acquired Diagnosis.
  • For an acute-type infection (e.g. bacterial cellulitis) first identified after admission (the start of the current PatientFollow Project profile) to choose Admit Diagnosis vs. Comorbid Diagnosis, you should try to figure out whether it was actually present at admission or actually began after admission.
    • Typically there will be at least a guess by the team about this. If not, then you can default to the guideline that if it was first discovered within the first 48 hrs after admission to code it as an Admit Diagnosis, and if discovered >48 hrs after admission to code it as as an Acquired Diagnosis.

Attribution doesn't apply to colonization

See Colonized with organism (not infected)#Colonizations are not attributed to any units

Related articles

Related articles:
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