في نظام حصنVAEاجتماع تدشين

VAE Monitoring in HESN ProductionSURVEILLANCE GDIPC TEAM

5

Patient Safety

Component

Others

Procedure-

Associated

Module

Device-

Associated

Module

AUR MDROSSI

CLABSI VAP CAUTI DEVAE

Device-Associated

Module

Types of ICUs to be followed.Adult ICUs

1. A01-ICU-Burn2. A02-ICU-Medical3. A03-ICU-Medical Cardiac4. A04-ICU-Medical/Surgical5. A05-ICU-Neurologic6. A06-ICU-Neurosurgical7. A12-ICU-Prenatal8. A13-ICU-Respiratory9. A14-ICU-Surgical10. A15-ICU-Surgical Cardiothoracic11. A16-ICU-Trauma

Pediatric ICUs/ Neonatal ICUs

1. A07-ICU-Neonatal Intensive Care

2. A08-ICU-Pediatric Cardiothoracic

3. A09-ICU-Pediatric Medical

4. A10-ICU-Pediatric Medical Surgical

5. A11-ICU-Pediatric Surgical

Steps to follow in HESN Production Sitefor VAE Registration

Content

Activity 1: Login into HESN

Activity 2: Client Search/Set in context/Create Client

Activity 3: Infection Control Encounter Group

Activity 4: Create Encounter - Admission to Hospital

Encounter

Activity 5: Create Encounter - Admission/ Transfer to

Unit EncounterActivity 6: Ventilator Related EncounterActivity 7: Fill Adults Bundle UDFActivity 8: Fill VAE UDFActivity 9: Generate VAE Calculator ReportActivity 10: End of Surveillance “EOS”Activity 11: Re-start of Surveillance

Contacts

HESN Main Links

Activity 1: Login into HESN*Note that Firefox is the recommended web browser for HESN.

1. Use https://hesn.moh.gov.sa URL.

2. Enter your User Name and Password then click the Login button.

3. Select your desired language and click the Continuebutton.

Activity 2: Client Search/Set in context/Create Client1. Click on Investigation tab.2. Select Search Client under

Search section on the left navigation panel.

3. Search Client screen will display.

**It is recommended to use client personal identifier such as, Saudi ID, Iqama, Boarder Number, or HESN Client ID

Activity 2: Client Search/Set in context /Create Client 1. In Search Client Screen, Enter the search criteria and click on Search button.

2. If client found, select the client and then click Set in Context

3. If client Not found, click on Create Client. Fill required data and Save

** HESN Client ID will be generated and client is set in context

Activity 3: Infection Control Encounter Group

1. Once Client is in Context, under investigation in the left navigation panel click on Subject Summary.

2. Under Infection Control Encounter Group, click on Create Encounter.

Activity 4: Create Encounter - Admission to Hospital

Encounter

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*Fill out the required fields in the Encounter Details screen:

1. Encounter Date: Date of Hospital Admission2. Encounter Type: Admission to Hospital3. Encounter Reason: Click on the desired reason,

then click on Add to be moved to the next box “Selected Encounter Reasons”.

4. Responsible Organization. (Defaulted to User Organization)

5. Location (Defaulted to User “SDL” e.g. Hospital)6. Click Save

**Make sure that your organization and location are correct.

**To Create a new encounter, Click on Subject Summary from the left navigation panel. Then click on Create Encounter.

Activity 5: Create Encounter - Admission/ Transfer to Unit

Encounter

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*Fill out the required fields:1. Encounter Date: Date

of Unit Admission2. Encounter Type:

Admission/Transfer to Unit

3. Encounter Reason: Name of the Critical Care Unit from the list.Click on the desired reason,

then click on Add to be moved to the next box “Selected Encounter Reasons”.

4. Click Save

**This encounter should be created whenever a patient isadmitted/transferred to a new unit

Activity 6: Ventilator Related Encounter

*If patient is put on Ventilator, create new encounter.

1. For Patients in NICU or Pediatric ICU, Choose Encounter type Pediatric and Neonatal Ventilator.

2. For Patients in remaining ICU Units, Choose Encounter type Adult VAE Monitoring .

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Activity 6: Ventilator Related Encounter

*Fill out the required fields in the Encounter Details screen:1. Encounter Date: Date

of starting the bundle review.

2. Encounter Type: Adult VAE Monitoring

3. Click Save

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Activity 7 : Fill Adults Bundle UDF

2. The encounter UDF screen will display “ Available Forms”.3. Choose UDF “Ventilator Bundle Form For Adults”4. Click Fill out Form.

1. Click on Encounter UDF

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Activity 7 : Fill Adults Bundle UDF

In the insertion section information: Fill all mandatory fields.

* Inserted in ICU: Fill out All the fields in the Insertion Section and Compliance Section

*Inserted in non-admitting unit (ER, OR): Fill out Only insertion section mandatory fields.

*Inserted in Other Units or Outside Hospital: Fill out Only insertion section mandatory fields.

Activity 7 : Fill Adults Bundle UDF

** To expand Bundle Daily Review Section, Click Add:

The bundle daily review section should be filled: 1. At Bundle Start Date2. At least once per week during ICU stay.3. At Device removal date 4. At End of Surveillance date (Discharge from ICU)5. At Development of symptoms date6. At Any significant change in the patient status.

** Date of first review:1. Either the first date of admission to ICU if pt was admitted with

this device 2. Or the date of insertion if the device was inserted in this ICU

Activity 8: Fill VAE UDF

*If patient has 2 days of stability followed by 2 days of worsening, fill out the VAE Form attached to the same encounter.

1. Place encounter in context and Click onEncounter UDF

2. The encounter UDF screen will display “Available Forms”.3. Choose “Ventilator Associated Event (VAE) Monitoring Form” UDF4. Click Fill out Form.

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Activity 8: Fill VAE UDF 1. Enter First Day of Mechanical Ventilation2. To expand VAE Monitorin section, Click Add3. Fill 2 entries for the 2 days of stability and 2 entries for the 2

days of worsening*No need to enter days starting from the First Day of Mechanical Ventilation*It is imperative to fill all days afterwards in order for the system to detect any change in type of VAE

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Activity 8: Fill VAE UDF

1. If any criterion is checked, 2. fill Organism and Sensitivity section

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Activity 9: Generate VAE Calculator Report

To confirm VAE occurrence and VAE type, generate VAE Calculator Report1. Go to Reports under Reporting and Analysis in the

Left Navigation Panel2. Expand Cases Folder

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Activity 9: Generate VAE Calculator Report

1. Choose KSA-Ventilator Associated Event (VAE) Calculator

2. Set Reports Filters screen displays. Click Generate Report Now

3. VAE Calculator report will display

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Activity 10: End of Surveillance “EOS”4

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*If patient transferred from Critical Care Unit

to Non- Critical Care Unit in the hospital, OR discharged/ transferred outside this hospital directly from ICU, OR patient died, create EOS Encounter

1. Encounter Date: Date of Discharge2. Encounter Type: EOS End of Surveillance 3. Encounter Reason: Select one of the

appropriate reason from the displayed list, then click on Add to be moved to the next box “Selected Encounter Reasons”.

4. Click Save

Activity 11: Re-Start of Surveillance

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*If patient transferred back to ICU / Surveillance Unit within the same admission occasion, then create two encounters

1. Encounter Type: Restarting Surveillance for patient within same admission

a. Encounter Reason: Patient Transferred back to Surveillance Unit. Click on the reason,

then click on Add to be moved to the next box “Selected Encounter Reasons”.

b. Encounter Date: Date of Admission to ICU Unit

2. Encounter Type: Admission/Transfer to Unita. Encounter Reason: Name of ICU Unit

(Surveillance Unit)b. Encounter Date: Date of Admission to ICU

Unit3. Click Save

ContactsPLEASE CONTACT US FOR ANY ISSUES OR MORE INFORMATION.

● HESN Support:○ EMAIL: HESNSupport@moh.gov.sa

○ TELEPHONE NUMBER: 00966112125555 Ext. 2759

● Infection Control Team:○ Surveillance GDPIC Team/ Email: surveillance.gdipc@gmail.com

HESN Main Links

● HESN Production Site○ https://hesn.moh.gov.sa

● HESN Web Portal○ https://hesn.moh.gov.sa/webportal

● HESN Training Site○ https://hesntraining.moh.gov.sa

Example 1, An Adult Patient

• EXAMPLE 1 Explanation:

• The data elements used to meet VAC, IVAC, and PVAP definition are organized in a fashion that facilitates identification of an event, highlighted in the shaded region.

• MV days 3 and 4 constitute the baseline period, with stable minimum PEEP of 5 cmH2O on each day. On MV days 5 and 6, the daily minimum PEEP is 8 cmH2O, which meets the VAC criterion for worsening oxygenation.

• IVAC temperature/white blood cell count criterion is not met (there are no temperatures < 36°C or > 38°C, and no white blood cell counts ≤ 4,000 cells/mm3 or ≥ 12,000 cells/mm3) – so even though the patient was started on a new antimicrobial agent and continued on that agent for 4 calendar days, IVAC is not met.

• Therefore, this event would be reported as a VAC, with the date of event being MV day 5.

Example 2, Pediatric/Neonatal Patient.

Thank you