Welcome to the National Healthcare Safety Network, or NHSN, Quick Learn series.
This presentation will provide information on the Hemovigilance Module’s Medical History
section of the Adverse Reaction Form.
We’ll review the Hemovigilance Module program goals and the purpose of the Adverse Reaction
form and its Medical History section.
We will also display data entry into the Medical History section and describe where to find
the Adverse Reaction Form online.
NHSN is an internet-based surveillance system operated by CDC for the purpose of tracking
healthcare-associated infections.
The mission of NHSN has expanded to include tracking of multidrug-resistant organisms,
healthcare personnel safety and vaccination compliance, and transfusion-related adverse
events.
The Biovigilance Component, which includes the Hemovigilance Module, is one of the five
components of the NHSN.
There are no fees for healthcare facilities to participate in NHSN or NHSN related activities,
including facility enrollment.
In addition, there is no cost to participating facilities for ongoing user support by CDC
staff, including assistance with facility enrollment, training, and analysis.
The goals of the NHSN Hemovigilance Module are to provide a systematic method for monitoring
transfusion-related adverse reactions and incidents, estimate the burden of transfusion
reactions, and identify emerging threats to blood safety, with the ultimate goal of improving
patient safety and minimizing morbidity and mortality among transfusion recipients.
The NHSN Hemovigilance Module collects data through five forms, including the Adverse
Reaction form.
The Medical History section is a new required addition to the Adverse Reaction form, and
must be entered to submit the Adverse Reaction form.
Data from the Adverse Reaction form is used by CDC for national analyses to calculate
rates of transfusion reactions.
The Adverse Reaction form captures patient information, medical and transfusion history,
adverse reaction details, investigation results, patient treatment and outcome, and component
details.
The Adverse Reaction Report form is entered within 30 days of the reaction and must be
completed for each adverse reaction that meets protocol criteria to be included in aggregated
national analysis.
An internal Adverse Reaction Investigation report is used to complete this form.
Medical history data will be used to identify any correlation between the patients’s pre-existing
diagnoses and relevant comorbid conditions and the associated transfusion.
The Medical History section has five parts and collects pertinent information about a
patient’s admitting diagnosis, underlying indication for transfusion, relevant comorbid
conditions at the time of the transfusion related to the adverse reaction, and relevant
past medical procedures.
The Adverse Reaction Form is pictured on the left.
The form’s corresponding Table of Instructions is shown on the right.
You can find a detailed explanation of the medical history section in the Table of Instructions.
You can access these forms with the URLS at the top of the slide.
Let’s walk through how to add data to this section.
The values for the first three questions are standardized by ICD-10 CM codes.
All diseases and conditions included in the ICD-10 CM codes are entered through a dropdown
menu.
ICD stands for International Classification of Disease and is the standardized classification
of diseases published by the World Health Organization or WHO.
ICD contains codes for diseases, signs and symptoms, abnormal findings, complaints, social
circumstances, and external causes of injury or diseases.
The ICD is the standard diagnostic tool for epidemiology, health management and clinical
purposes.
In order to enter information into each of the questions within the medical history section,
use the following steps: First search for the appropriate value to enter.
This can be done in three ways: 1) by typing the ICD-10 code, 2) by typing the name of
the disease or condition or 3) by scrolling through the list of ICD-10 codes using the
forward and back arrows and selecting the correct code.
For example, if the patient presented with leukemia then you can search using the ICD-10
CM code ‘C911’ or begin typing ‘chronic lymphocytic leukemia’ and selecting the
most appropriate option.
More than one diagnosis may be selected for any question by clicking the ‘Add Row’
button.
You can also select ‘unknown’ or ‘none’ if you do not have enough information to answer
the question.
If the wrong condition is selected then press the ‘X’ box on the left, next to the wrong
entry to remove it.
The remaining questions in this section can be answered using this format.
Details that are not captured in the previous parts of this section can be added in the
Additional Information box.
After all the data has been entered, click Save.
To access the Adverse Reaction form go to c-d-c dot-gov-slash-n-h-s-n and click on Reporting
and Surveillance for Enrolled Facilities near the bottom of the page.
Click on Acute Care Hospitals and Facilities, scroll down, and select Blood Safety Surveillance.
Then click the Data Collection Forms drop down menu and choose Adverse Reaction form.
Each form has a corresponding customizable version and table of instructions.
For more information, visit CDC-dot-gov-slash-NHSN.
For questions, e-mail NHSN at CDC-dot-gov and include Hemovigilance
in the subject line.