DHOPatientScreeningToolIPC
type: Questionnaire
node role: treeRoot
id:
  v: DHOPatientScreeningToolIPC
text:
  status:
    v: extensions
  div: Generated Narrative: Questionnaire DHOPatientScreeningToolIPC LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> DHOPatientScreeningToolIPC Patient infection prevention and control screening tool for district use. Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOPatientScreeningToolIPC#1.0 #xD; assessordetails_06 Assessor Details 0..1 string #xD; date_01 Date 0..1 date #xD; time_02 Time 0..1 time #xD; areacompleted_03 Area completed 0..1 string #xD; assessor_04 Assessor 0..1 string #xD; sign_05 sign 0..1 string #xD; patientdetails Patient Details 0..1 string #xD; surname Surname 0..1 string #xD; first-names First Names 0..1 string #xD; nhi NHI 0..1 string #xD; date-of-birth Date of Birth 0..1 date #xD; gender Gender 0..1 string #xD; question-a-group Question A – Required for all overnight admissions, plus dialysis outpatients, and Oncology outpatients 0..1 group #xD; question-a-info null. A: MDRO? Multi Drug Resistant Organism (e.g., MRSA, ESBL, VRE, CPO) 0..1 boolean #xD; a1 Has an MDRO alert (SPICS/HCS) or been previously MDRO positive? 0..1 boolean #xD; a2 Been admitted overnight in any North Island hospital in the last 12 months? 0..1 boolean #xD; a3 Been admitted overnight to an overseas hospital in the last 12 months? 0..1 boolean #xD; a4 Resided/travelled to the Indian subcontinent or South-East Asia in the last 12 months? Refer to MDRO-Admission-assessment-flowchart.dox (200982) for countries 0..1 boolean #xD; a5 In the last 6 months been a resident at Marne Street Hospital (Otago)? 0..1 boolean #xD; a6 In the last 6 months been a resident at Longwood Care Home (Southland)? 0..1 boolean #xD; a-action If answered yes, refer to MDRO-Admission-assessment-flowchart.dox (200982) for testing and placement. 0..1 display #xD; questions-b-f-group Questions B–F – Ask all patients in all clinical areas, including all inpatients and outpatients 0..1 group #xD; b B: Diar…
url:
  v: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOPatientScreeningToolIPC
version:
  v: 1.0
name:
  v: DHOPatientScreeningToolIPC
title:
  v: Patient Screening Tool IPC (District)
status:
  v: draft
subject type:
  v: Patient
date:
  v: 2026-04-16T21:32:31+00:00
publisher:
  v: Te Whatu Ora
contact:
  name:
    v: Te Whatu Ora
  telecom:
    system:
      v: url
    value:
      v: https://www.tewhatuora.govt.nz/
contact:
  name:
    v: Te Whatu Ora Integration Team
  telecom:
    system:
      v: email
    use:
      v: work
description:
  v: Patient infection prevention and control screening tool for district use.
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: NZ
    display:
      v: New Zealand
purpose:
  v: Patient infection prevention and control screening tool for district use.
item:
  link id:
    v: assessordetails_06
  text:
    v: Assessor Details
  type:
    v: string
  item:
    link id:
      v: date_01
    text:
      v: Date
    type:
      v: date
  item:
    link id:
      v: time_02
    text:
      v: Time
    type:
      v: time
  item:
    link id:
      v: areacompleted_03
    text:
      v: Area completed
    type:
      v: string
  item:
    link id:
      v: assessor_04
    text:
      v: Assessor
    type:
      v: string
  item:
    link id:
      v: sign_05
    text:
      v: sign
    type:
      v: string
item:
  link id:
    v: patientdetails
  text:
    v: Patient Details
  type:
    v: string
  item:
    link id:
      v: surname
    text:
      v: Surname
    type:
      v: string
  item:
    link id:
      v: first-names
    text:
      v: First Names
    type:
      v: string
  item:
    link id:
      v: nhi
    text:
      v: NHI
    type:
      v: string
  item:
    link id:
      v: date-of-birth
    text:
      v: Date of Birth
    type:
      v: date
  item:
    link id:
      v: gender
    text:
      v: Gender
    type:
      v: string
item:
  link id:
    v: question-a-group
  text:
    v: Question A – Required for all overnight admissions, plus dialysis outpatients, and Oncology outpatients
  type:
    v: group
  item:
    link id:
      v: question-a-info
    prefix:
      extension:
        value: string
    text:
      v: A: MDRO? Multi Drug Resistant Organism (e.g., MRSA, ESBL, VRE, CPO)
    type:
      v: boolean
    item:
      link id:
        v: a1
      text:
        v: Has an MDRO alert (SPICS/HCS) or been previously MDRO positive?
      type:
        v: boolean
    item:
      link id:
        v: a2
      text:
        v: Been admitted overnight in any North Island hospital in the last 12 months?
      type:
        v: boolean
    item:
      link id:
        v: a3
      text:
        v: Been admitted overnight to an overseas hospital in the last 12 months?
      type:
        v: boolean
    item:
      link id:
        v: a4
      text:
        v: Resided/travelled to the Indian subcontinent or South-East Asia in the last 12 months? Refer to MDRO-Admission-assessment-flowchart.dox (200982) for countries
      type:
        v: boolean
    item:
      link id:
        v: a5
      text:
        v: In the last 6 months been a resident at Marne Street Hospital (Otago)?
      type:
        v: boolean
    item:
      link id:
        v: a6
      text:
        v: In the last 6 months been a resident at Longwood Care Home (Southland)?
      type:
        v: boolean
item:
  link id:
    v: questions-b-f-group
  text:
    v: Questions B–F – Ask all patients in all clinical areas, including all inpatients and outpatients
  type:
    v: group

string
v: font-weight: bold;

v: a-action

v: If answered yes, refer to MDRO-Admission-assessment-flowchart.dox (200982) for testing and placement.

v: display

link id:
  v: b
text:
  v: B: Diarrhoea / vomiting?
type:
  v: boolean
item:
  link id:
    v: b-more-than-3
  text:
    v: >3 watery bowel motions or any episodes in the past 24 hours
  type:
    v: boolean
  item:
    link id:
      v: b-action
    prefix:
      v: B – Contact
      extension:
        value: string
    text:
      v: precautions Single room, stool chart
    type:
      v: display
    enable when:
      question:
        v: b-more-than-3
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any

string
v: font-weight: bold;

link id:
  v: Infectious Disease
text:
  v: C: Other Infectious Disease
type:
  v: boolean
item:
  link id:
    v: DiseaseSpecificIsolation
  text:
    v: Refer to Disease Specific Isolation Guidelines (20435) for isolation period or discuss with IPC team.
  type:
    v: display
  enable when:
    question:
      v: Infectious Disease
    operator:
      v: =
    answer: boolean
      v: false
  enable behavior:
    v: any

link id:
  v: Acuterespiratoryillnesses
text:
  v: Acute respiratory illnesses
type:
  v: display

link id:
  v: acuterespiratoryillness
text:
  v: D: Positive test for acute respiratory illness? E.g., COVID / Influenza / RSV
type:
  v: string
item:
  link id:
    v: d-positive-test-detail
  text:
    v: Had a positive respiratory test in the past 10 days (or 14 days if immune compromised)
  type:
    v: boolean
  item:
    link id:
      v: d-respiratory-organism
    text:
      v: Respiratory organism
    type:
      v: string
    enable when:
      question:
        v: d-positive-test-detail
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
  item:
    link id:
      v: d-positive-test-date
    text:
      v: Date of positive test
    type:
      v: date
    enable when:
      question:
        v: d-positive-test-detail
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any
  item:
    link id:
      v: d-action
    text:
      v: Refer to Disease Specific Isolation Guidelines (20435) for isolation period or discuss with IPC team.
    type:
      v: display
    enable when:
      question:
        v: d-positive-test-detail
      operator:
        v: =
      answer: boolean
        v: true
    enable behavior:
      v: any

link id:
  v: e
text:
  v: E: Respiratory symptoms? Any new or worsening symptoms in the past 10 days (14 if immune compromised)
type:
  v: boolean
item:
  link id:
    v: e-runny-nose
  text:
    v: Runny nose/congestion
  type:
    v: boolean
item:
  link id:
    v: e-sore-throat
  text:
    v: Sore/scratchy throat
  type:
    v: boolean
item:
  link id:
    v: e-new-cough
  text:
    v: New cough
  type:
    v: boolean
item:
  link id:
    v: e-shortness-breath
  text:
    v: New shortness of breath
  type:
    v: boolean
item:
  link id:
    v: e-unexplained-fever
  text:
    v: Unexplained fever
  type:
    v: boolean
item:
  link id:
    v: covid-rat-instructions
  text:
    v: Yes to E -- COVID RAT Test
  type:
    v: group
  item:
    link id:
      v: covid-rat-display
    text:
      v: All RAT results (positive or negative) are to be uploaded to Eclair (20435). Note -- Influenza/RSV RATs are unreliable, PCR required for diagnosis. Inpatients – If RAT negative then complete a COVID PCR. If patient is COVID negative, place in droplet precautions and discuss with IPC.
    type:
      v: display

link id:
  v: f
text:
  v: F: Contact with COVID?
type:
  v: boolean
item:
  link id:
    v: f-household-contact
  text:
    v: A household contact or living in a communal situation with a person who has a confirmed COVID infection?
  type:
    v: boolean
  enable when:
    question:
      v: f
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: any
item:
  link id:
    v: f-action-display
  text:
    v: Yes to F -- Droplet isolation for 5 days, staff to wear N95 mask. Only test if symptoms develop.
  type:
    v: display

link id:
  v: all-no-action
text:
  v: If no to all questions, Standard Precautions
type:
  v: display