Policy Manual sample

MDT Home Health Care Agency, Inc. Comments Purulence alone at the burn wound site is not adequate for the diagnosis of burn infection; such purulence may reflect incomplete wound care. Fever alone in a burn patient is not adequate for the diagnosis of a burn infection because fever may be the result of tissue trauma or the patient may have an infection at another site. Surgeons in Regional Burn Centers who take care of burn patients exclusively may require Criterion 1 for diagnosis of burn infection. BRST-Breast abscess or mastitis A breast abscess or mastitis must meet at least 1 of the following criteria: 1Patient has a positive culture of affected breast tissue or fluid obtained by incision and drainage or needle aspiration. 2Patient has a breast abscess or other evidence of infection seen during a surgical operation or histopathologic examination. 3Patient has fever (>38 o C) and local inflammation of the breast and physician diagnosis of breast abscess. Comment Breast abscesses occur most frequently after childbirth. Those that occur within 7 days after childbirth should be considered health care associated. UMB-Oomphalitis Omphalitis in a newborn (>30 days old) must meet at least 1 of the following criteria: 1. Patient has erythema and/or serous drainage from umbilicus and at least 1 of the following: a. organisms cultured from drainage or needle aspirate b. organisms cultured from blood. 2. Patient has both erythema and purulence at the umbilicus. SYS-SYSTEMIC INFECTION DI-Disseminated infection Disseminated infection is infection involving multiple organs or systems, without an apparent single site of infection, usually of viral origin, and with signs or symptoms with no other recognized cause and compatible with infectious involvement of multiple organs or systems. PNEU-PNEUMONIA There are 3 specific types of pneumonia: clinically defined pneumonia (PNU1), pneumonia with specific laboratory findings (PNU2), and pneumonia in immunocompromised patients (PNU3). Listed below are general comments applicable to all specific types of pneumonia, along with abbreviations used in the algorithms (Tables 4-7) and reporting instructions. Table 8 shows threshold values for cultured specimens used in the surveillance diagnosis of pneumonia. Figures 1 and 2 are flowdiagrams for the pneumonia algorithms that may be used as data collection tools. General comments 1Physician diagnosis of pneumonia alone is not an acceptable criterion for health care–associated pneumonia. 2Although specific criteria are included for infants and children, pediatric patients may meet any of Home Health Agency Nursing Care & Procedures K-147