Healthcare-associated Infections HAI - Chapter 2 Pt. 2
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Questions and Answers

What is LOA?

The inpatient location where the patient was assigned on the date of event (DOE)

While conducting a medical chart review on the survey date, if a patient is in the radiology department and undergoing stent placement, would this patient be eligible for assignment of LOA for HAI events?

False

Define the Transfer Rule.

If the patient was in multiple locations, attribute the infection to the FIRST LOCATION the patient was housed THE DAY BEFORE the Date of Event (DOE).

The date of event (DOE) is Day 1 of the 14-day RIT.

<p>True</p> Signup and view all the answers

In which scenarios does the transfer rule not apply?

<p>SSI or LabID events</p> Signup and view all the answers

What is a SUTI?

<p>Symptomatic urinary tract infection</p> Signup and view all the answers

What are LabID events?

<p>LabID Event reporting option allows laboratory testing data to be used without clinical evaluation of the patient, and is less labor-intensive.</p> Signup and view all the answers

In an instance where a patient has been transferred to more than one location on the date of an infection, where would you attribute the infection?

<p>The first location in which the patient was housed the day before the infection's date of event</p> Signup and view all the answers

The operating room can be used as a location of attribution (LOA).

<p>False</p> Signup and view all the answers

What does SBAP stand for?

<p>Secondary BSI Attribution Period (SBAP)</p> Signup and view all the answers

Does the RIT carry over when a patient is discharged and readmitted to the same facility?

<p>NO</p> Signup and view all the answers

When determining RIT for a patient with endocarditis (ENDO), how is it calculated?

<p>The RIT for endocarditis (ENDO) is extended to include the remainder of the patient's current admission.</p> Signup and view all the answers

If a patient has been transferred to more than one location on the date of an infection, attribute the infection to the last location in which the patient was housed the day before the infection's date of event.

<p>False</p> Signup and view all the answers

Can a blood culture obtained during a site-specific infection's secondary BSI attribution period be added to the current site-specific infection?

<p>The BSI must be evaluated as a new BSI event.</p> Signup and view all the answers

If criteria for the same type of infection are met and the date of event is within the 14-day RIT, a new event is not identified or reported.

<p>True</p> Signup and view all the answers

Does a RIT carry over from one admission to another even if readmission is to the same facility?

<p>NO</p> Signup and view all the answers

A patient meets NHSN criteria for a SUTI (E Coli) and a blood specimen collected during the Secondary Attribution Period (SBAP) grows E Coli and Pseudomonas aeruginosa. Is this a SUTI with a secondary BSI?

<p>True</p> Signup and view all the answers

Where would Yolanda's Location of Attribution be after being transferred from the OR to the ICU on the 27th?

<p>Med Surg</p> Signup and view all the answers

Study Notes

Healthcare-associated Infections (HAI) - Summary Notes

  • LOA Definition: Inpatient location assigned on the date of event (DOE).

  • Transfer Eligibility: Patients in operating rooms (OR) or interventional radiology (IR) do not qualify for LOA assignment regarding HAIs.

  • Transfer Rule: Infection attributed to the first location the patient was housed the day before the DOE, particularly when transferred to multiple locations.

  • DOE Significance: The date of event (DOE) marks Day 1 of the 14-day Risk Identification Timeframe (RIT).

  • Exceptions to Transfer Rule: The Transfer Rule does not apply for Surgical Site Infections (SSI) or LabID events.

  • SUTI Definition: Symptomatic urinary tract infection (SUTI) signifies a defined infection type for tracking.

  • LabID Events: Reporting option that uses laboratory data to track multidrug-resistant organisms (MDROs) and C. difficile without requiring clinical evaluation.

  • Attribution of Infection: If a patient is transferred multiple times before the infection’s DOE, attribute to the first location on the previous day.

  • LOA Assignment: Operating rooms or IRs are not to be considered locations of attribution (LOA) for infections.

  • SBAP Explanation: Secondary Bloodstream Infection Attribution Period (SBAP) determines the timeframe for collecting blood specimens tied to primary site infections.

  • Device Association: Device association is established during RIT; events detected during this timeframe do not alter existing records.

  • LCBI Meaning: Laboratory Confirmed Bloodstream Infection (LCBI) defines confirmed bloodstream infections identified through laboratory tests.

  • RIT Applicability: RIT applies to both Present on Admission (POA) and Healthcare-associated Infection (HAI) determinations.

  • Infection Reporting Types: Include Bloodstream Infections (BSI), Urinary Tract Infections (UTI), and Pneumonia (PNEU), each limited to one infection reported during the RIT.

  • BSI with NEC: A bloodstream infection can be assigned as secondary to necrotizing enterocolitis (NEC) if criteria are met, despite not having site-specific specimens identified.

  • RIT on Readmission: RIT does not carry over from one admission to another, even if the patient returns to the same facility.

  • RIT for Endocarditis: The Risk Identification Timeframe (RIT) for endocarditis extends through the entire admission.

  • Attribution Rule Correction: When a patient has multiple transfers before the infection DOE, attribute to the first location on the previous day, not the last.

  • New BSI Evaluation: Blood cultures collected during a secondary BSI attribution period must be treated as separate BSI events if they do not match prior infections.

  • Event Reporting: If the same infection type criteria are met within a 14-day RIT, the event is not reported as a new occurrence.

  • Transfer Scenario: A patient meeting NHSN criteria for a SUTI with matching pathogens in secondary attribution can be classified as having both a SUTI and a secondary BSI.

  • Location of Attribution Case: If a patient initially in Med Surg is transferred to ICU after surgery and subsequently diagnosed with an ABUTI, the LOA remains Med Surg, as the infection occurred before the transfer.

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Explore key concepts related to healthcare-associated infections (HAI) through flashcards in Chapter 2 Part 2. Test your knowledge on inpatient location assignments and eligibility for HAI event reporting using real scenarios.

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