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Table 1 Definitions of paediatric nursing-sensitive outcomes

From: Evaluation of paediatric nursing-sensitive outcomes in an Australian population using linked administrative hospital data

Nursing-sensitive outcome

Numeratora

Denominator

Key exclusions

Lower respiratory tract infection (LRTI)

Lower respiratory tract infections, bronchiolitis (ICDb B97.0, B97.4, B97.89, > = J20.0 and < =J20.9, J21.0, J21.8, J21.9, J22., J85.1, J85.2, J86.0, J86.9)

All medical and surgical inpatients

MDC4-respiratory conditions

LOS > =3 days

All pneumonias

Gastrointestinal (GI) infection

Rota virus and other GI infections (ICD A02.2, > = A03.0 and < = A03.9, > = A04.0 and < = A04.9, A08.0, A08.1, A08.2, A08.3, A08.4, A09., A09.9)

All medical and surgical inpatients

Principal diagnoses of volume depletion, disorders of fluid and electrolytes or acid base

LOS > =5 days

(ICD E86., E87. > = E87.0 and < =E87.8)

MDC6-GI system

MDC18-infectious and parasitic

Pneumonia

Aspiration, post-operative, hypostatic, bacterial, broncho and unspecified pneumonias: (ICD > =J14. and < =J15.9, J18.0, J18.1, J18.2, J18.8, J18.9, J69.0, J69.8, J95.8, J95.9)

All medical and surgical inpatients

MDC4-respiratory conditions

All diagnoses of probable community acquired pneumonia (ICD > =J10. and < =J10.8, > = J11. and < =J11.8, =J12. and < =J12.9, J13., J15.7, J16.8, > = J17. and < =J17.8)

Aspiration pneumonia and epilepsy (ICD J69.0, 69.8, > = G40. and < =G40.9, > = G41. and < =G41.9)

All diagnoses of epilepsy found in 'look back’ period

Surgical wound infection

Surgical wounds, including surgery post traumatic injury plus those found in 30 day 'look forward period’ (ICD T79.3, T81.4, T81.41, T81.42)

All surgical inpatients

 

Total discharges only

Physiologic/metabolic derangement

Diabetic hyperosmolarity/acidosis: (ICD > E10.1, E 10.11, E11.1, E11.11, E15.)

All surgical inpatients

If principal diagnoses diabetes: (ICD > =E10 and < =E14, E15.)

Principal diagnosis of trauma and burns: (ICD > =S00. and < =T32.9)

Disorders of fluid, electrolytes, acid–base: (ICD E86., > = E87. and < =E87.8)

MDC5 circulatory system, MDC7 hepatobiliary and pancreas, MDC10 endocrine and metabolic disorders, MDC11 kidney and urinary tract

Shock from a procedure: (ICD T81.1)

Anuria/oliguria: (ICD R34.)

No procedure code

If principal diagnosis cardiac arrhythmia/arrest (ICD > =I46. And < I50.) or GI haemorrhage (ICD K92., K92.1, K92.2)

Sepsis

Septicaemia; bacteraemia (ICD > =A40. and < A42., A49.9, R78.81)

All medical and surgical inpatients

MDC17-cancer and all diagnosis of cancer in 2 year look back period

LOS > =3 days

Infection related admissions (DRG 2.0-4.2: B72Z, D63A, D63B, D64Z, D66A, D66B, E62A, E62B, E62C, F61Z, G07A, G07B, I64A, I64B, I67A, I67B, J11Z, J64B, L40Z, L41Z, L63C, M62A, M62B, N61Z, S63A, S63B, S64A, S64B, T01A, T01B, T01C, T60A, T60B, T61A, T61B, T64A, T64B)

Look back period for cancer

(DRG 5.0-6.0: B72A, B72B, D63A, D63B, D64Z, D66A, D66B, E62A, E62B, E62C, F61Z, G07A, G07B, I64A, I64B, I67A, I67B, J11Z, J64B, L40Z, L41Z, L63A, L63B, L63C, M62A, M62B, N61Z, S64B, S65A, S65B, S65C, T01A, T01B, T01C, T60A, T60B, T61A, T61B, T64A, T64B)

Postoperative cardiopulmonary complications

(ICD > =I26. and < = I26.99, I44.2, I46.0, I46.1, I46.9, > = I50. and < =I50.9, > = I97. and < =I97.9, J80., J81., > = J95. and < =J95.4, J95.8, > = J96. and < =J96.9, > = J98.0 and < =J98.3, R09.2, > = T80.0 and < =T80.2, T81.7, T81.72, T82.8, T82.9)

All surgical inpatients

MDC3-Ear, nose, mouth and throat conditions

MDC4-respiratory conditions

MDC5-circulatory conditions

Arrest/shock/respiratory failure

Arrest (respiratory, cardiac), respiratory failure, shock (ICD I46.0, I46.1, I46.9, J18.2, J80., J81., J95.1, J95.2, J96.0, J96.9, R09.2, > = R57.0 and < R58)

All medical and surgical inpatients

MDC4-respiratory conditions

MDC5-circulatory conditions

Procedures (ACHI 92042–00, 92052–00, 92053–00)

Central nervous system (CNS) complications

Coma and stupor; acute delirium; reactive confusion; reactive depression (ICD F05.0, F05.8, F05.9, F43.2, F43.9, F44.88, F51., R40.0, R40.1, R40.2, R40.4, R41.0, R41.8, R45.1, R45.4,)

All medical and surgical inpatients

MDC1-neurological

MDC19-mental illness

Age >6 months

MDC20-substance abuse

MDC21-injuries, poisoning and toxic effects of drugs

Any procedure of sleep study (ACHI 12203.00)

Central venous line (CVL) infection

Infection due to central venous catheter as per AHRQ (ICD > =T80.2 and < =T80.29, > = T82.7 and < = T82.79)

All medical and surgical inpatients

MDC17-cancer

Weight < 500gm

LOS > =2 days

Infectious disease

Coxsacchie virus (ICD B34.1) and LOS > =3

All medical and surgical inpatients

 

Pertussis (ICD A37.0, A37.1, A37.8 A37.9) and LOS > =7

LOS > =3, 7 or 14 days appropriate to incubation period

Other infections (ICD > =B01, B01.0 and < =B01.9, > = B05. and < =B05.9, B06.0, B06.8, B06.9, B08.4, B15.0 B15.9 > =B26.0 and < =B26.9) and LOS > =14

Pressure ulcer

Pressure ulcer (ICD L89)

All medical and surgical inpatients

All diagnosis of hemiplegia, paraplegia, paralysis; cerebral palsy; spina bifida. (ICD > =G80 and < =G84; > = Q05. and < =Q05.9 or > =Q07. and < =Q07.03)

LOS > =3 days

All diagnoses of paralysis found in look back period

Failure to rescue

Died in hospital

All medical and surgical inpatients

 
  

Pneumonia, sepsis, arrest/shock/respiratory failure, LRTI as above and GI bleed and DVT/PE

 
  1. Note. ICD = international classification of diseases; LOS = length of stay; MDC = major diagnostic category; ACHI = Australian classification of health interventions; AHRQ = agency for healthcare research and quality; DVT/PE = deep vein thrombosis/pulmonary embolus.
  2. Definitions amended from Needleman et al [8], and McCloskey [28].
  3. aAll numerators are based on secondary diagnosis only except surgical wound infection in look forward period.
  4. bICD codes are all ICD-10-AM (Australian Modified).
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BMC Health Services Research

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