This page provides a list of all questions found on the PSRP reporting form for hospitals. They are grouped alphabetically by the section of the form in which they appear. This list does not indicate which questions are required for all hospital reports nor which questions only appear for certain event types. A list of required questions can be found here: Required Fields for Hospitals.
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| cql | label = "form_field" AND label not in ( "test" , "staffonly" ) and label = "hospital" and label = "general_information" and space = currentSpace ( ) |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "summary_information" and space = currentSpace ( ) |
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Harm Category
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "harm" and space = currentSpace ( ) |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "event_information" and space = currentSpace ( ) |
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HIT Questions
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| max | 100 |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "hit" and space = currentSpace ( ) |
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Event Type-Specific Questions
Anesthesia Event-Specific Questions
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| max | 100 |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "anesthesia" and space = currentSpace ( ) |
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Blood or Blood Product Event-Specific Questions
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| showLabels | false |
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| max | 100 |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "blood_event" and space = currentSpace ( ) |
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Contaminated Drug, Device or Biologic Event-Specific Questions
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "contaminated_event" and space = currentSpace ( ) |
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Device, Equipment or Supply Event-Specific Questions
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| max | 100 |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "device_event" and space = currentSpace ( ) |
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Fall Event-Specific Questions
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| showLabels | false |
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| max | 100 |
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| sort | title |
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| showSpace | false |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "fall" and space = currentSpace ( ) |
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HAI Event-Specific Questions
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| max | 100 |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "hai" and space = currentSpace ( ) |
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Maternal Event-Specific Questions
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| showLabels | false |
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| max | 100 |
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| sort | title |
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| showSpace | false |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "maternal_event" and space = currentSpace ( ) |
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Medication or Other Substance Event-Specific Questions
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| showLabels | false |
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| max | 100 |
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| sort | title |
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| showSpace | false |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "medication_event" and space = currentSpace ( ) |
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Perinatal Event-Specific Questions
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| showLabels | false |
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| max | 100 |
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| sort | title |
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| showSpace | false |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "perinatal_event" and space = currentSpace ( ) |
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Pressure Injury Event-Specific Questions
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| showLabels | false |
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| max | 100 |
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| showSpace | false |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "pressure_injury_event" and space = currentSpace ( ) |
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Surgical or Other Invasive Procedure Event-Specific Questions
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| showLabels | false |
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| max | 100 |
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| showSpace | false |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "surgical_event" and space = currentSpace ( ) |
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Unintended Retained Foreign Object Event-Specific Questions
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| max | 100 |
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| showSpace | false |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "retained_object_event" and space = currentSpace ( ) |
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Contributing Factors
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "contributing_factors" and space = currentSpace ( ) |
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| showLabels | false |
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| max | 100 |
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| cql | label = "form_field" AND label != "staffonly" and label = "hospital" and label = "review_information" and space = currentSpace ( ) |
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