Attribution of infections: Difference between revisions

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(OK, I think I finally figured out how to explain what I am asking here.)
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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.  
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 |
* 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)
}}
{{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 ==
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* [[Template:ICD10 Guideline Iatrogenic]] deals with attribution of surgical infections
* [[Template:ICD10 Guideline Iatrogenic]] deals with attribution of surgical infections
* [[Nosocomial infection, NOS]]
* [[Nosocomial infection, NOS]]
{{Discuss |
* there may be others dx right now that my search for 48 did not find because maybe they use a 12 hr or 17 hour... rule. Collectors, can you think of any? Ttenbergen 15:38, 2020 March 25 (CDT)
}}


== Attribution for all other infections ==
== Attribution for all other infections ==
 
{{Discuss |
{{Discuss | who = Julie | question = * Julie, the above question specifically affects some projects you work with as well - do you think unifying this rule will be a problem for any of them?
*Is the following correct, then:
** if there are specific rules already in place (e.g. VAP, CLI, etc.) we should follow them. Those which don't have perhaps those are the ones we can unify. --[[User:JMojica|JMojica]] 14:51, 2020 March 20 (CDT)
<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]].
*** Whatever such a rule would be should be written in [[Template: ICD10 Guideline Infection]] so that users of infection codes are aware of it. Also, we would want to make sure that "attribution" as a concept doesn't get muddled - if we search for that there are several hits. And in [[Lab and culture reports]]...
*** Allan confirmed that all the attributions should be the same and can be moved into that infection template. Ttenbergen 14:09, 2018 October 29 (CDT)
**** This will mean that I pull the 48hr rule out of the following and instead put it into [[Template:ICD10 Guideline Infection]] that is applied to all infections, and/or [[Infections in ICD10]] which is referenced by the template. If I interpret this right I would write it as
<blockquote> An infection doesn't become apparent the moment it happens; 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 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]].
</blockquote>
</blockquote>
Does anyone think making this one rule for all will be a problem?
}}
}}


=== 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===
{{DT |
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 ==  

Revision as of 21:37, 2020 August 27

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.

  • 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)
  • SMW


  • Cargo


  • Categories

{{Discuss | Is the following correct, then:

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.

Diagnoses with specific attribution rules

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

Attribution for all other infections

  • Is the following correct, then:

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.

  • SMW


  • Cargo


  • Categories

attribution doesn't apply to colonization

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

Cleanup

When this is all settled, the details need to be integrated into Template: ICD10 Guideline Infection, Lab and culture reports, Infections in ICD10

  • SMW


  • Cargo


  • Categories

Related articles

Related articles: