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Description

Determination of the nursing facility event type that is being reported.

On-Screen Instructions

Check all that apply. Please note: “Poisoning” should be submitted as “Other.” “Food allergy” and “medication allergy” should be submitted as “Medication or other substance.” The event type “Treatment related” has been split into “Contractures,” “Dehydration,” “Diabetic coma,” “Fecal impaction,” “Intravascular embolisms related to IV therapy,” and “Pressure ulcer.”

Field Type

Checkbox (multiselect)

Responses

OPTION ONE: Answer options with content (definition and/or inclusions, exclusions)

Add an anchor in front of the H1 “Responses” heading and name the anchor “Top.”

Include a table of contents, which should be limited to the answer option headers and displayed as a list.

Add a dividing line macro below the table of contents.


Answer option 1

Answer Option Anchors and Headings

Each answer option gets an anchor and an H2 heading in sentence case.

[If there is a very important piece of information about this answer option - like that it is always considered a serious event - display that between the answer option header and definition using a warning panel macro. It can also include an “include excerpt” macro, like this one with standard text for inherently serious events.]This event type is always considered a reportable event, regardless of level of patient harm.

[Definition goes here.]

Definition

Copy/paste the “description” text from the data dictionary.

Includes

Excludes

Inclusions and Exclusions

Add a page layout of two equal columns below the definition. Inclusions go in the left column, exclusions in the right.

Event-Type Specific Questions

If the answer option triggers additional question, add a content by label macro to display all pages that share the form_field label plus the relevant answer option label, possibly plus the relevant segment label, depending on the situation. The macro goes in a single cell table with a light gray fill. The title above the macro should just be table text, bold (no header level), that reads: Event-Type Specific Questions.

Additional Support

If the answer option is associated with an “faq” item, add a second row to the table and paste in a content by label macro to display all pages that share the faq label plus the relevant answer option label, possibly plus the relevant segment label, depending on the situation. Macro should have title “Additional Support” in the table cell, above it, as with the “Event specific questions” macro.

Return to top

Return to Top Links

Below the page layout or Content by Label macro(s) (if relevant), include a link to the “top” anchor to take the user back to the responses table of content.


Dividing Line

Add a dividing line after the “return to top” link and before the next answer option, or the next section (probably “Additional Guidance”).

Guide for Use

[If there is a adequate information about each answer option, this section may not be necessary. But if there is guidance that isn’t about the specific responses, then this is where you would put it, including instructions for how to use this field. If there is no guidance, you can use the “No additional guidance” excerpt: No additional information provided.]

In Option 2, this is where one would put an “Event specific questions” Content by Label macro in a single-cell table with light gray fill.

History

Start Date

Spring 2012

End Date

n/a

Change History

n/a [Month yyyy: brief description of change]

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