ROBYN KORN, MBA, RHIA, CPHQ Fundamentals of Health Information Week 8

Maternal/OB Terms Direct maternal death – death directly related to pregnancy Indirect maternal death – maternal death NOT directly related to obstetric causes but aggravated by pregnant condition

Maternal/OB Terms Delivered – act of giving birth Undelivered – admitted and discharged without giving birth

Maternal/OB Terms Partum  Antepartum – period before giving birth  Post partum – period after giving birth Puerperium – 42 day period following delivery

Neonatal Terms Neonates are newborns. A newborn is any live infant born in the hospital. A liveborn is considered and infant until one year of age.

Neonatal Terms Three neonatal periods have been established. They extend from birth up to the beginning of the 28 th day of life. Fetal deaths are classified as:  early (<20 weeks gestation)  intermediate (20 to <28 weeks gestation)  late (28 or more weeks gestation).

Rates Direct maternal death rate: Total direct maternal deaths for a period /Total maternal (obstetrical discharges for the period (including deaths) X 100

Rates Infant death rate: Total # of NB deaths for a period /Total # of NB discharges (including deaths) for the period X 100

Rates Fetal death rate: Total # of intermediate and late fetal deaths for a period /Total # of births for a period X 100

Rates C-section rate: Total #of C-sections performed in a period /Total #of deliveries in a period X 100

Problems to solve – Pg 154, # 8 NB:Births (live) 86 Discharges 75 Deaths 2 Fetal Deaths 10 (wks gestation 15, 18, 16, 28, 31, 25, 22, 14, 27, 20) Calculate:  A)Newborn Death Rate  B)Fetal Death Rate

# 8 - A New Born Death Rate Answer – 2.67% 2/75 X 100 = 2.67%  Numerator - 2  Total number of NB deaths for the period  100  Denominator - 75  Total number of NB discharges for the period (including deaths)

#8 - B Fetal Death Rate Answer – 6.52% 6/92 x 100 = 6.52%  Numerator - 6  Total number of intermediate and late fetal deaths for the period  100  Denominator - 92  Total number of births for the period Including live births intermediate and late fetal deaths

Problems to solve – Pg 191, # 8 Calculate:  A)Overall surgical consultation rate  B)Postoperative infection rate  C)Surgical service with this highest death rate

# 8 - A Surgical Consultation Rate Answer – 23.48% 54/230 x 100 = 23.48%  Numerator - 54  Total number of patients receiving a consultation  100  Denominator  Total number of patient discharges

#8 - B Post Operative Infection Rate Answer – 2.13% 5/235 x 100 = 2.13%  Numerator - 5 Total number of postoperative infections in a clean surgical case  Denominator Total number of surgical operations

#8 - C Surgical Service with highest Death Rate Answer – CV = 10% 2/20 x 100 = 10%  Numerator: 2  Total number of inpatient deaths, including NB, for the period  Denominator: 20  Total number of inpatient discharges, including deaths, (NB, adults, children) for the period

Rates Nosocomial infection rate: Total # of hospital-acquired infections (HAI) > 72 hours after admission /Total number of discharges (including deaths X 100)

Page 193 – 11b Nosocomial Infection Rate – 1.22% 25/2050 X100 = 1.22% Numerator: 25 Total # of hospital-acquired infections (HAI) > 72 hours after admission Denominator: 2050 Total number of discharges (including deaths X 100)

Rates Community-acquired infection rate: Total # of community-acquired infections (CAI) < 72 hours after admissions/ Total # of discharges (including deaths) X 100

Page 193 – 11d Community-acquired infection rate – 1.61 % 33/2050 x100 = 1.61% Numerator: 33 Total # of community-acquired infections (CAI) < 72 hours after admissions Denominator: 2050 Total # of discharges (including deaths) X 100

Rates Postoperative Infection Rate: Total # of postoperative infections in clean surgical cases/ Total # of surgical operations performed X 100

Page 193 – 11c Postoperative Infection Rate – 0.74% 9/1222 x100 = 0.74% Numerator: 9 Total # of postoperative infections in clean surgical cases Denominator: 1222 Total # of surgical operations performed X 100

Rates Hospital (Total) infection rate: Total # of infections / Total number of discharges (including deaths) X 100

Page 193 – 11e Hospital (Total) infection rate: 2.83% 58/2050 x100= 2.83% Numerator: Total # of infections Denominator: 2050 Total number of discharges (including deaths) X 100

Rates Consultation rates: For patients seen Total # of patients receiving consultations/ Total # of patients discharged X 100 For Consults Provided Total # of consultations provided / Total # of patients discharged X 100

Page 189 – 4d Consultation rates for patients seen : 27.91% 48/172 x 100 = 27.91% Numerator: 48 Total # of patients receiving consultations Denominator: 172 Total # of patients discharged X 100

Rates Complication rate: Total # of complications for a period / Total discharges for the period X 100

Page 193 – 11a Complication rate: 5.37% 110/2050 x100 = 5.37% Numerator: 110 Total # of complications for a period Denominator: 2050 Total discharges for the period X 100

Rates Direct turnover rate: Total # of discharges (including deaths) for a period/ Average bed count during the period

Page b Direct turnover rate for A&C: /188=4.23 Numerator: =795 Total # of discharges (including deaths) for a period Denominator: =188 Average bed count during the period

Rates Indirect turnover rate: Occupancy rate (in decimal form) X # of days in a period/ Average length of stay

Page g Indirect bassinet turnover rate : /2=8.55 Numerator: (171/300)x30 = 17.1 Occupancy rate (in decimal form) X # of days in a period Denominator: 2 Average length of stay