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1、Nursing Report Card Metrics - NDNQI Definitions March 2012Fall/per 1,000 Patient Days:A patient fall is an unplanned descent to the floor with or without injury to the patient, and occurs on an NDNQI eligible reporting nursing unit. * Include falls when a patient lands on a surface where you wouldnt
2、 expect to find a patient. All unassisted and assisted (see definition below) falls are to be included whether they result from physiological reasons (fainting) or environmental reasons (slippery floor). Also report patients that roll off a low bed onto a mat as a fall.Exclude falls by: Visitors Stu
3、dents Staff members Falls on other units not eligible for reporting Patients from eligible reporting units, however patient was not on unit at time of the fall (e.g., patient falls in radiology department)*The nursing unit area includes the hallway, patient room and patient bathroom. A therapy room
4、(e.g., physical therapy gym), even though physically located on the nursing unit is not considered part of the unit.Fall with Injury/per 1,000 Patient Days:When the initial fall report is written by the nursing staff, the extent of injury may not yet be known. Hospitals have 24 hours to determine th
5、e injury level, e.g., when you are awaiting diagnostic test results or consultation reports.Level of Injury: Nonepatient had no injuries (no signs or symptoms) resulting from the fall; if an x-ray, CT scan or other post fall evaluation results in a finding of no injury Minorresulted in application o
6、f a dressing, ice, cleaning of a wound, limb elevation, topical medication, pain, bruise or abrasion Moderateresulted in suturing, application of steri-strips/skin glue, splinting, or muscle/joint strain Majorresulted in surgery, casting, traction, required consultation for neurological (basilar sku
7、ll fracture, small subdural hematoma) or internal injury (rib fracture, small liver laceration) or patients with coagulopathy who receive blood products as a result of a fall Deaththe patient died as a result of injuries sustained from the fall (not from physiologic events causing the fall)Catheter-
8、Associated Urinary Tract Infection Rate:Indwelling Urinary CatheterA drainage tube that is inserted into the urinary bladder through the urethra, is left in place, and is connected to a closed collection system; also called a Foley catheter. Does not include straight in-and-out catheters.Healthcare-
9、associated Infection (HAI)A healthcare-associated infection (HAI) is a localized or systemic condition resulting from an adverse reaction to the presence of an infectious agent(s) or its toxins(s). There must be no evidence that the infection was present or incubating at the time of admission to the
10、 care setting.CAUTI For the purposes of this indicator, a CAUTI is defined as a urinary tract infection that: Meets the Centers for Disease Control (CDC) definition of one of the following types of urinary tract infections (See CAUTI Appendix for criteria):o Asymptomatic Bacteremic UTI (ABUTI)o Symp
11、tomatic UTI (SUTI) The associated patient had an indwelling urinary catheter at the time of or within 48 hours before the onset of the UTI.Example Patient has a Foley catheter in place on an inpatient unit. It is discontinued, and 4 days later the patient meets the criteria for UTI. This is not repo
12、rted as a CAUTI because the time since the Foley was indwelling exceeded 48 hours.Note There is no minimum period of time that the catheter must be in place in order for the UTI to be considered catheter-associated.Urinary Catheter Days (device days)The number of patients on a unit each day with an
13、indwelling catheter device, summed across all days of the month. Catheter day data should be collected at the same time each day. They should not be collected as a “running total” over the 24- hour period, but as a count of the patients with urinary catheters present on the unit at a given time. Whe
14、n catheter days are available from electronic databases, these sources may only be used as long as the counts are not substantially different (+/- 5%) from manual counts. To assist, the Device Day collection tool may be downloaded from the NDNQI website. Device day counts are inaccurate if the numbe
15、r device days exceed the number of patient days submitted for the unit each month.Data Collection ProcedureThe numerator and denominator should be collected concurrently. A trained infection control professional should determine daily those patients who meet the criteria for CAUTI (see CAUTI Appendi
16、x). In addition, patients with indwelling urinary catheters are followed for evidence of CAUTI for 48 hours after removal of the urinary catheter or for 48 hours after discharge from a unit. Record CAUTI events daily and sum across all the days in a month. Each CAUTI should be counted in the month of discovery. This date will be when the first clinical evidence appeared or the date the specimen used to meet the criterion was collected, whichever came first.EXCEPTION
