[BULK] RE: infection prevention
Happy Friday!
Our Infection Prevention team documents in their software. Anything documented in the medical record is discoverable in court.
Sincerely,
Cara Belnap MS, RN, CCDS
Lead Clinical Documentation Specialist | Health Information Management
St. Luke's Health System | 190 E Bannock St. | Boise, ID 83712
Phone: (208) 381-9302| Fax: 208-381-7186 | E-mail: belnapc@slhs.org
"We cannot become what we need to be by remaining what we are" - Max DePree
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Friday, October 24, 2014 9:06 AM
To: Belnap, Cara
Subject: [BULK] [cdi_talk] infection prevention
I am wondering if you can share how your infection prevention team documents when they identify a hospital associated infection (CAUTI, VAP, C-diff, SSI, etc). Our IP team currently does not document in the medical record at all, only in their own tracking software and I am wondering if that is the norm or if other facilities handle this differently.
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
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CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
"This message is intended for the use of the person or entity to which it is addressed and may contain information that is confidential or privileged, the disclosure of which is governed by applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this information is strictly prohibited. If you have received this message by error, please notify us immediately and destroy the related message."
Our Infection Prevention team documents in their software. Anything documented in the medical record is discoverable in court.
Sincerely,
Cara Belnap MS, RN, CCDS
Lead Clinical Documentation Specialist | Health Information Management
St. Luke's Health System | 190 E Bannock St. | Boise, ID 83712
Phone: (208) 381-9302| Fax: 208-381-7186 | E-mail: belnapc@slhs.org
"We cannot become what we need to be by remaining what we are" - Max DePree
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Friday, October 24, 2014 9:06 AM
To: Belnap, Cara
Subject: [BULK] [cdi_talk] infection prevention
I am wondering if you can share how your infection prevention team documents when they identify a hospital associated infection (CAUTI, VAP, C-diff, SSI, etc). Our IP team currently does not document in the medical record at all, only in their own tracking software and I am wondering if that is the norm or if other facilities handle this differently.
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: belnapc@slhs.org
If you would like to be removed from CDI Talk, please send a blank email to
leave-cdi_talk-20296936.f7f1fdd5c00c3f8b2a25ac185bb94f13@hcprotalk.com
---
Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
"This message is intended for the use of the person or entity to which it is addressed and may contain information that is confidential or privileged, the disclosure of which is governed by applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this information is strictly prohibited. If you have received this message by error, please notify us immediately and destroy the related message."
Comments
That is the short version
Sincerely,
Cara Belnap MS, RN, CCDS
Lead Clinical Documentation Specialist | Health Information Management
St. Luke's Health System | 190 E Bannock St. | Boise, ID 83712
Phone: (208) 381-9302| Fax: 208-381-7186 | E-mail: belnapc@slhs.org
"We cannot become what we need to be by remaining what we are" - Max DePree
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Friday, October 24, 2014 9:19 AM
To: Belnap, Cara
Subject: [BULK] RE:[cdi_talk] infection prevention
This is what I was expecting. So is there a process in place to notify CDI when a dx has been made? We have NOT been encouraged to query for these conditions because IP feels like they are the appropriate people to be making this determination and there are concerns that the MD's would designate infections as HACs when they are not (like anytime a patient is identified as having a UTI after foley insertion). However, we are not privy to these dx when made by IP.
Our HAC data for infections as coded versus as perforated are completely different and the hospital would like to see this come into alignment as much as possible.
And for the record, I just HATE this legal business that discourages transparency in the medical record.....
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Friday, October 24, 2014 7:10 AM
To: Kathryn Good
Subject: RE:[cdi_talk] infection prevention
We have the same process as you do.
Thanks,
Kathy
[cid:image002.jpg@01CFD633.8BA7CD60]
[cid:image002.jpg@01CFAB4C.4AA03030]
Kathy Shumpert, MSN, RN, CCDS
Clinical Documentation Improvement Specialist
Community Howard Regional Health
3500 S Lafountain
PO Box 9011
Kokomo, IN 46902
O 765.864.8754 | C 765.431.0123 | F 765.453.8447 | E kshumper@communityhoward.org
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Friday, October 24, 2014 11:06 AM
To: Kathy Shumpert
Subject: [cdi_talk] infection prevention
I am wondering if you can share how your infection prevention team documents when they identify a hospital associated infection (CAUTI, VAP, C-diff, SSI, etc). Our IP team currently does not document in the medical record at all, only in their own tracking software and I am wondering if that is the norm or if other facilities handle this differently.
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
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CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: kshumper@communityhoward.org
If you would like to be removed from CDI Talk, please send a blank email to
leave-cdi_talk-11949319.2d7a8e305d1f6835e858a467b80844d3@hcprotalk.com
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
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The opinions expressed in this e-mail message are those of the author and may not be representative of Community Howard Regional Health or affiliates. This e-mail message and attachments, if any, may contain confidential or privileged information. If you are not the addressee or authorized to receive this message for the addressee, you must not use, copy, disclose, or take any action based on this message, any attachments to this message, or any information herein. If you have received this message in error, please advise the sender immediately by reply e-mail and delete this message in its entirety.
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CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: kathryn.good@nahealth.com
If you would like to be removed from CDI Talk, please send a blank email to
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
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CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: belnapc@slhs.org
If you would like to be removed from CDI Talk, please send a blank email to
leave-cdi_talk-20296936.f7f1fdd5c00c3f8b2a25ac185bb94f13@hcprotalk.com
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
"This message is intended for the use of the person or entity to which it is addressed and may contain information that is confidential or privileged, the disclosure of which is governed by applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this information is strictly prohibited. If you have received this message by error, please notify us immediately and destroy the related message."
Cara Belnap MS, RN, CCDS
Lead Clinical Documentation Specialist | Health Information Management
St. Luke's Health System | 190 E Bannock St. | Boise, ID 83712
Phone: (208) 381-9302| Fax: 208-381-7186 | E-mail: belnapc@slhs.org