Effective April 1, 2009, the following Core Measure Indicators will be retired and will no longer require data collection:
• AMI- 6: Acute myocardial infarction patients without beta-blocker contraindications who received a beta-blocker within 24 hours after hospital arrival.
• Pneumonia (PN-1): Oxygenation Assessment
• Pneumonia (PN-5b): Initial Antibiotic Received Within 4 hours of Hospital Arrival.
Changes/Clarifications effective April 1, 2009:
• In the past, any general statement telling the patient to go to the ER if symptoms worsen was adequate. Now, patient discharge instructions must include a description reflecting signs and symptoms of worsening heart failure. The preprinted heart failure discharge instructions address this adequately.
• Inf- 2- Antibiotic selection for hysterectomy cases:
Clindamycin + Aminoglycoside or Clndamycin + Quinolone or Clindamycin + Aztreonam OR Metronidazole + Aminoglycoside or Metronidazole + Quinolone OR Clindamycin monotherapy OR Metronidazole monotherapy
• The code 68.31, Supracervical Laparoscopic Hysterectomy was added to the list of procedure codes.
**If a procedure is done entirely by Laparoscope, the case is excluded from all SCIP measures. ***
• Infection Prior to Anesthesia
Purulence or pus is consistent with infection/abscess and will be considered an infection or suspected/possible infection prior to anesthesia.
Bacteria in urine without documentation of infection or suspected/possible infection will not be considered an infection.
• Beta-Blocker During the Perioperative Period
If it is documented that the patient took a beta-blocker prior to arrival, there must be a date/time to indicate when the last dose of the beta-blocker was taken, unless there is documentation it was taken on the day of surgery.
• Reason for Not Administering VTE Prophylaxis
Documented blood transfusion intraoperatively will be considered an acceptable reason for not ordering pharmacological VTE post op. This will not be considered an acceptable reason for not using mechanical VTE Prophylaxis.
Continuous IV heparin therapy within 24 hours before or after surgery will be considered an acceptable reason for not ordering both pharmacological VTE or mechanical VTE Prophylaxis. Blood salvage is not considered an acceptable reason for not ordering/administering VTE Prophylaxis.
• Doripenem has been added as an additional antipseudonomal beta-lactam option for patients with Pseudomonas Risk.