Dialysis Tasks: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
m (Text replacement - "ccmdb.accdb" to "CCMDB.accdb")
 
(39 intermediate revisions by 2 users not shown)
Line 1: Line 1:
Under our collection for [[tasks]] we collect ''hemodialysis'' and ''' peritoneal dialysis'''. Since the directions are largely the same, this article contains instructions for both.
{{LegacyContent
|explanation=discontinued as part of move to [[ICD10]]/[[CCI]].
|successor= CCI [[PD (Peritoneal dialysis)]], [[HD (Hemodialysis)]] and ICD10  [[Renal dialysis care, including dialysis itself]]
|content=


'''Only mark a task as performed if it was done during a patients stay on your ward'''. If a task was done '''prior''' to patient coming to your ward or '''after''' patient is transferred to another ward, it should be marked as ''no'' or '''none''' during the stay on your ward.
The Dialysis [[tasks|task]] encodes whether or not a medicine patient has a hemodialysis and or peritoneal dialysis. It is stored in the Diagnosis tab in [[CCMDB.accdb]] because that is the only way we could store it when we started to collect it.  


== Dialysis ==
Since the directions are largely the same, this article contains instructions for both.  
Patients who have underlying CRF are on chronic hemodialysis or peritoneal dialysis, if they go for a kidney transplant and develop a complication of rejection, hyper K+ or renal failure etc., post kidney transplant and subsequently require dialysis, this will be considered '''acute''' dialysis.


Not all pts with DX of ARF or CRF in comorbids have their dialysis during ward admission, particularly if they are a short stay (less than 4 days). Pt is sent to other wards for their dialysis, therefore it may be correct that there might not be a dialysis acute or chronic TASK is marked.
'''Only mark this task as performed if it was done during a patients stay on your ward'''.  
*If a task was done '''prior''' to patient coming to your ward or '''after''' patient is transferred to another ward, it should be marked as ''no'' or '''none''' during the stay on your ward.


=== Hemodialysis Task ===
Possible entries for Dialysis tasks:
* possible entries: (none, acute, chronic) 
*'''Hemodialysis:'''
** Acute – first time dialysis ever, during this hospital admission (page 32 in Dx code book). ACUTE dialysis is 1st time dialysis during this hosp admission.
**[[100200 - Hemodialysis None]]
** Chronic - dialysis which was being done on an outpatient basis prior to this hospitalization
**[[100201 - Hemodialysis Acute]]  (first time dialysis ever happened during this hospital admission)
**[[100202 - Hemodialysis Chronic]] (dialysis which was being done on an '''outpatient''' basis '''prior to''' this hospitalization)


=== Peritoneal Dialysis ===
*'''Peritoneal Dialysis:'''
* possible entries: (none, acute, chronic)
**[[100300 - Peritoneal None]]
** Acute – first time peritoneal dialysis ever, during this hospital admission  
**[[100301 - Peritoneal Acute]]  (first time dialysis ever happened during this hospital admission)
** Chronic - dialysis which was being done on an outpatient basis prior to this hospitalization or patient was doing on their own at home prior to this hospitalization
**[[100302 - Peritoneal Chronic]] (dialysis which was being done on an '''outpatient''' basis '''prior to''' this hospitalization or patient was doing on their own at home prior to this hospitalization)
 
== Special Cases ==
=== Peritoneal vs Hemodialysis ===
The two are not mutually exclusive, if both happen while the patient is on the ward, '''code both'''.


{{discussion}}
=== Acute vs Chronic ===
=== Acute vs Chronic ===
If a patient has both chronic and acute dialysis during the same admission (e.g. after a transplant), then '''code the acute dialysis'''.  
If a patient has both chronic and acute dialysis during the same admission (e.g. after a transplant), then '''code the acute dialysis'''.


=== CRF after transplant ===
=== Dialysis outside the unit ===
If [[CRF]] is coded as per instructions (i.e. don't code CRF for patients with a working kidney transplant) then these patients will not be flagged for missing tasks.
How should dialysis outside unit be coded? Following moved here:
Pt is sent to other wards for their dialysis, therefore it may be correct that there might not be a dialysis acute or chronic TASK is marked.


== Dialysis Examples ==
=== Mix of acute/chronic and/or hemo and peritoneal dialysis ===
'''Example 1''':
Scenario: Medical patient was a chronic h.d. patient prior to admission. The patient was switched to p.d. For my admission I put h.d. chronic, and p.d. acute.  
*I have a patient that was admitted to my floor from another medical floor. The patient was a chronic h.d. patient prior to admisssion. A week or two after admission (while still on the first medical floor), the patient was switched to p.d. For my admission I put h.d. chronic, and p.d. acute. This patient has now switched back and forth between h.d., and p.d. on an almost weekly basis. How do I code the dialysis tasks now that she has gone back and forth with both?--[[User:DPageNewton|DPageNewton]] 15:55, 15 October 2008 (CDT)
Patient switches back and forth between h.d., and p.d.  
**''HD Chronic & PD Acute or not mutally exclusive therefore you can mark both in TASKS if both are occurring while patient is on your ward''.--[[User:TOstryzniuk|TOstryzniuk]] 00:40, 19 November 2008 (CST)
Coding:''HD Chronic & PD Acute are not mutually exclusive therefore you can mark both in TASKS if both are occurring while patient is on your ward''.-


'''Example 2''':
=== dialysis during same hospitalization but not on current ward ===
*Patient came from ER with CRF and was receiving outpatient peritoneal dialysis (PD). Pt developed shock and was sent to ICU where he had Hemodialysis. On your ward the pt had peritoneal dialysis done once before going to ICU.
*Patient came from ER with CRF and was receiving outpatient peritoneal dialysis (PD). Pt developed shock and was sent to ICU where he had Hemodialysis. On your ward the pt had peritoneal dialysis done once before going to ICU.
**''You would mark CHRONIC PD as a TASK. You would not mark ACUTE HD. This is being done during his ICU stay''.
**''You would mark CHRONIC PD as a TASK. You would not mark ACUTE HD. This is being done during his ICU stay''.


*An ICU patient with ARF receiving '''acute''' hemodialysis in ICU, comes to your ward from the ICU and expires within a day or two. No dialysis was ever done for the short time patient was on your ward.
**''The hemodialysis task should be marked as '''none'''''.


'''Example 3''':
=== chronic PD patient being switched to HD ===
*Pt came from ER to your ward with CRF (on outpatient PD dialysis). Pt had to be switched to hemodialysis because of peritonitis.
*Pt came from ER to your ward with CRF (on outpatient PD dialysis). Pt had to be switched to hemodialysis because of peritonitis.
**''Peritoneal dialysis should be marked '''chronic''' if patient had peritoneal dialysis done one or more times while on your ward. Switched to hemodialysis which is new and should therefore be marked as '''acute'''''.
**''PD (Peritoneal dialysis) should be marked '''chronic''' if patient had peritoneal dialysis done one or more times while on your ward. Switched to hemodialysis which is new and should therefore be marked as '''acute'''''.
== Data Structure ==
the list of options is in [[s_AllDiagnoses table]] and the actual data is stored in [[L_Dxs table]].


== ICD10 / CCI ==
* These will move to [[CCI_Picklist]] collection as
** [[PD (Peritoneal dialysis)]]
** [[HD (Hemodialysis)]]
And ICD10 as
** [[Renal dialysis care, including dialysis itself]]


'''Example 4''':
== Cross checks ==
*An ICU patient with ARF receiving '''acute''' hemodialysis in ICU, comes to your ward from the ICU and expires within a day or two. No dialysis was ever done for the short time patient was on your ward.
* coding with ARF/CRF dxs - [[Check Renal Tasks]]
**''The hemodialysis task should be marked as '''none'''''.


==Data Integrity Rules ==
== See also ==
There are data integrity rules related to this task, see [[! Automated Data Integrity Checks#Checks for Medicine]] for more details.
* [[Renal Coding Considerations (old)]]


Also see a number of coding rules related to renal diagnoses, centralized info about them is in [[Renal Coding Considerations]].  
== Legacy ==
Task items replaced [[iTISS]] December 15, 2006.


[[Category: Data Integrity Rules]]
[[Category:Task Elements]]
[[Category: Task Elements]]
[[Category:Renal Problem (old)]]
[[Category: Renal Problem]]
}}

Latest revision as of 21:27, 2020 July 24

Legacy Content

This page contains Legacy Content.

Click Expand to show legacy content.

The Dialysis task encodes whether or not a medicine patient has a hemodialysis and or peritoneal dialysis. It is stored in the Diagnosis tab in CCMDB.accdb because that is the only way we could store it when we started to collect it.

Since the directions are largely the same, this article contains instructions for both.

Only mark this task as performed if it was done during a patients stay on your ward.

  • If a task was done prior to patient coming to your ward or after patient is transferred to another ward, it should be marked as no or none during the stay on your ward.

Possible entries for Dialysis tasks:

Special Cases

Peritoneal vs Hemodialysis

The two are not mutually exclusive, if both happen while the patient is on the ward, code both.

Acute vs Chronic

If a patient has both chronic and acute dialysis during the same admission (e.g. after a transplant), then code the acute dialysis.

Dialysis outside the unit

How should dialysis outside unit be coded? Following moved here: Pt is sent to other wards for their dialysis, therefore it may be correct that there might not be a dialysis acute or chronic TASK is marked.

Mix of acute/chronic and/or hemo and peritoneal dialysis

Scenario: Medical patient was a chronic h.d. patient prior to admission. The patient was switched to p.d. For my admission I put h.d. chronic, and p.d. acute. Patient switches back and forth between h.d., and p.d. Coding:HD Chronic & PD Acute are not mutually exclusive therefore you can mark both in TASKS if both are occurring while patient is on your ward.-

dialysis during same hospitalization but not on current ward

  • Patient came from ER with CRF and was receiving outpatient peritoneal dialysis (PD). Pt developed shock and was sent to ICU where he had Hemodialysis. On your ward the pt had peritoneal dialysis done once before going to ICU.
    • You would mark CHRONIC PD as a TASK. You would not mark ACUTE HD. This is being done during his ICU stay.
  • An ICU patient with ARF receiving acute hemodialysis in ICU, comes to your ward from the ICU and expires within a day or two. No dialysis was ever done for the short time patient was on your ward.
    • The hemodialysis task should be marked as none.

chronic PD patient being switched to HD

  • Pt came from ER to your ward with CRF (on outpatient PD dialysis). Pt had to be switched to hemodialysis because of peritonitis.
    • PD (Peritoneal dialysis) should be marked chronic if patient had peritoneal dialysis done one or more times while on your ward. Switched to hemodialysis which is new and should therefore be marked as acute.

Data Structure

the list of options is in s_AllDiagnoses table and the actual data is stored in L_Dxs table.

ICD10 / CCI

And ICD10 as

Cross checks

See also

Legacy

Task items replaced iTISS December 15, 2006.

Retrieved from "https://ccmdb.kuality.ca/index.php?title=Dialysis_Tasks&oldid=145426"