Wound Class
Patient underwent Myringotomy for otitis media. NIR indicates clean contaminated case. Is this correct?
What is NO. Considered Dirty/Infected
In the NSO Quarterly Report, a patient's death is reported under which surgery for the predicted and observed 30-day mortality graph?
1. Last CPT eligible case 2. First CPT eligible and assessed case 3. Last CPT eligible and assessed case 4. Last case irrespective of CPT
First CPT eligible and assessed surgery
Veteran underwent right carotid endarterectomy. New onset left arm weakness was noted in post anesthesia care unit. Per neurologist and radiologist, an ischemic stroke was likely caused by embolism. On postop day four, patient was able to move his left shoulder and squeeze hand, but remains unable to lift left thumb. What is the correct response for the postop stroke/CVA variable?
1. No CVA 2. CVA <24 hrs 3. CVA <72 hrs 4. CVA >72hrs
4. >72 hours
VASQIP Risk-adjustment models are generated annually for: 1. 30 day mortality and morbidity for NSO Quarterly Report 2. 180 day mortality NSO Risk Calculator 3. Postoperative ICU stay for NSO Risk Calculator 4. 1 & 2 5. All of the above
All of the above (Nursing documents (VASQIP Quality Chapter)
A hydrocele repair is considered a Clean Contaminated case? True or False
What is FALSE. Considered Clean
A gastrectomy surgery, mandatory case, is aborted due to anesthesia induced hypotensive event. The case is excluded under abortion option. Status report indicates case shows as EBNA. What should the SQN do? 1. Complete the assessment on case 2. Exclude the case again and update monthly transmission report 3. Do nothing because it will correct in next status report 4. Send field com for manual removal by NSO.
4. Send field com) for manual removal (FAQ)
Patient visited his primary care provider (PCP) 10 days prior to surgery. Nursing note states patient complained of chest discomfort while in the waiting room to see his PCP. There was no mention of an assessment of pain/discomfort or its treatment in his PCP’s note. Which is correct response for angina timeframe variable?
No angina
Patient is? undergoing colostomy reversal. He has an abdominal stoma. Wound you capture this as an open wound variable 1. Yes 2. No
2. No (Definition)
38 yo patient presented to ED with broken glass fragment to forearm sustained in GLF. In order to ensure removal of all fragments, patient taken to surgery for exploration with removal FB. Operative note states small shards of glass removed. Nurse report indicates Clean/Contaminated case. Is this correct? Yes or No
What is NO. Considered Dirty/Infected
If a VA surgeon performs surgeries in a "rented" OR room at an outside facility. These cases fall under the premise of VASQIP and must be reviewed to the extent possible? True or False
False. Only cases at VHA facility approved OR room (FAQ)
Anesthesia preop note and preop clinic RN note both state that the patient has quit smoking cigarettes three years ago. A behavioral health physician’s note, from two weeks prior to surgery, includes a comment that “patient reports his mood is better after smoking a cigar”. What is the correct response for the tobacco use variable?
Other (no cigarettes)
During patient's postoperative period, he develops diarrhea. EHR states: C.Diff: PCR (+), Toxins A&B Antigen (-). MD note states: Diarrhea, favor antibiotic associated rather than c.diff. Should the SQN capture postop C. Diff? [yes/no] 1. No 2. Yes
1. No. PCR is pos. but antibodies neg. Indicates C.Diff colonized. Does not meet definition "flourishes in the intestinal tract producing a toxin that causes watery diarrhea"
28 y o taken to surgery for acute appendicitis. The operative note indicates inflammation encountered surrounding appendix. Nurse report indicates Dirty/Infected case. Is this correct? Yes/No
What is NO. Considered Contaminated
VASQIP Risk-adjustment models are generated annually for: 1. 30 day mortality and morbidity for NSO Quarterly Report 2. 180 day mortality NSO Risk Calculator 3. Postoperative ICU stay for NSO Risk Calculator 4. 1 & 2 5. All of the above
All of the above (Nursing documents (VASQIP Quality Chapter)
Does a patient with thrombocytopenia meet the criteria for the bleeding (coagulation) disorder variable?
Yes
A non veteran employee suffers ruptured aneurysm and taken to OR emergently. Since surgery performed in equipped OR room, then the case should be assessed? True or False
False. Non veterans are excluded.
58 y o gentleman pending TURBT has emergent percutaneous nephrostomy tubes placed the day prior to surgery . What wound class would be assigned? 1) Clean 2) Clean/contaminated 3) Contaminated 4) Dirty/Infected
2) Clean/Contaminated
Quarterly report indicates facility with high outlier SSI rate. The facility creates a task force to examine and drill down on cases. From the VASQIP data tool, cases are extrapolated with identified SSI. This information is then used to create excel spreadsheet to drill down on cases. Is this data on spreadsheet 5705 protected? Yes/No
What is NO
A patient is diagnosed with a subdural hematoma after falling at home. His only complaint is a headache. He is taken emergently for cranial decompression and evacuation of the hematoma. Past medical history includes history of transient ischemic attacks (TIA). What is the correct response for the pre-op risk of stroke/CVA?
History of TIA
IPEC Rolling Inward transfer mortality 6 Month Results for VAMC is considered high if: 1. Greater than 10% 2. Greater than 20% 3. Greater than 8% 4. Greater than 5%
2. Greater than 20%