ID

6430

Description

Documentation form for quality assurance in German Health Care by the institute forapplied quality Improvement and Research in Health Care (Aqua), https://www.aqua-institut.de/en/home. Internal Aqua form version: 09-5 Specification 2015 V02

Link

https://www.aqua-institut.de/en/home

Keywords

Versions (2)
  1. 12/22/14 12/22/14 - Julian Varghese
  2. 1/7/15 1/7/15 - Julian Varghese
Uploaded on

December 22, 2014

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Quality assurance Implantable Defibrillator: Replacement (AQUA)

German English

Quality assurance Implantable Defibrillator: Replacement (AQUA)

1 forms  
Basic documentation
Description

Basic documentation

Healthcare Facility Identifier
Description

Institutionskennzeichen

Data type

integer

Alias
UMLS CUI-1
C2986045
Zip Code of Discharge
Description

Entlassender Standort

Data type

string

Alias
UMLS CUI-1
C1521842
Facility's Section Identifier
Description

Betriebsstätten-Nummer

Data type

string

Alias
UMLS CUI-1
C1547540
Medical specialty
Description

Fachabteilung

Data type

integer

Alias
UMLS CUI-1
C0037778
Patient identification number
Description

Identifikationsnummer des Patienten

Data type

string

Alias
UMLS CUI-1
C1549734
Date of Birth (DD.MM.YYYY)
Description

Geburtsdatum

Data type

date

Alias
UMLS CUI-1
C0421451
Gender
Description

Geschlecht

Data type

integer

Alias
UMLS CUI-1
C0079399
Hospital admission date (DD.MM.YYYY)
Description

Aufnahmedatum Krankenhaus

Data type

date

Alias
UMLS CUI-1
C1302393
Preoperative Clinical Examination
Description

Preoperative Clinical Examination

ASA classification
Description

Einstufung nach ASA-Klassifikation

Data type

integer

Alias
UMLS CUI-1
C1531480
Indication of aggregate replacement
Description

Indication of aggregate replacement

Alias
UMLS CUI-1-1
C0392360
UMLS CUI-1-2
C2048368
Indikation of aggregate replacement
Description

Indikation zum Aggregatwechsel

Data type

integer

Place of last ICD-(or pacemaker-)Operation before this procedure
Description

Ort der letzten ICD-(oder Schrittmacher-)OP vor diesem Eingriff

Data type

integer

Applied therapeutical shockings
Description

Therapien abgegeben

Data type

integer

Alias
UMLS CUI-1
C2022208
Operation
Description

Operation

Operation Date (DD.MM.YY)
Description

OP-Datum

Data type

date

Alias
UMLS CUI-1
C3258210
Procedure codes
Description

Operation

Data type

integer

Alias
UMLS CUI-1
C1550373
Procedure Duration (in minutes)
Description

Dauer des Eingriffs

Data type

integer

Measurement units
  • Minuten
Alias
UMLS CUI-1
C1442476
Minuten
intraoperative test of defibrillation
Description

intraoperativer Defibrillationstest durchgeführt

Data type

integer

Safety margin for Defibrillation Test >= 10 J under aggregate-specific maximum engery
Description

Sicherheitsabstand Test- (oder DFT-) zu aggregatspezifischer Maximalenergie > =10 J

Data type

integer

ICD: Implantierted ICD-System
Description

ICD: Implantierted ICD-System

ICD-System
Description

System

Data type

integer

Alias
UMLS CUI-1
C2048304
Implantierted ICD-Aggregate
Description

Implantierted ICD-Aggregate

Manufacturer
Description

Hersteller

Data type

integer

Explantierted ICD-System
Description

Explantierted ICD-System

ICD-System
Description

System

Data type

integer

Alias
UMLS CUI-1
C2048304
Explantierted ICD-Aggregate
Description

Explantierted ICD-Aggregate

Year of implantation (YYYY)
Description

Jahr der Implantation

Data type

string

Alias
UMLS CUI-1
C2079500
unknown
Description

nicht bekannt

Data type

integer

Manufacturer
Description

Hersteller

Data type

integer

Left ICD electrodes - Atrium
Description

Left ICD electrodes - Atrium

Sensing threshold (in V)
Description

Reizschwelle

Data type

integer

Measurement units
  • V
Alias
UMLS CUI-1
C2048070
V
unknown
Description

nicht gemessen

Data type

integer

P wave height
Description

P-Wellen-Amplitude

Data type

integer

Measurement units
  • mV
Alias
UMLS CUI-1
C0429042
mV
not measured
Description

nicht gemessen

Data type

integer

Ventricle
Description

Ventricle

Number of existing ventricular electrodes
Description

Zahl der vorhandenen Ventrikelsonden

Data type

integer

First ventricular electrode /defibrillation electrode
Description

First ventricular electrode /defibrillation electrode

Position
Description

Position

Data type

integer

Sensing threshold(in V)
Description

Reizschwelle

Data type

integer

Measurement units
  • V
Alias
UMLS CUI-1
C2048285
V
not measured
Description

nicht gemessen

Data type

integer

R wave height
Description

R-Amplitude

Data type

integer

Measurement units
  • mV
Alias
UMLS CUI-1
C0429049
mV
not measured
Description

nicht gemessen

Data type

integer

Second ventricular electrode
Description

Second ventricular electrode

Position
Description

Position

Data type

integer

Sensing threshold(in V)
Description

Reizschwelle

Data type

integer

Measurement units
  • V
Alias
UMLS CUI-1
C2048378
V
not measured
Description

nicht gemessen

Data type

integer

R wave height
Description

R-Amplitude

Data type

integer

Measurement units
  • mV
Alias
UMLS CUI-1
C0429049
mV
not measured
Description

nicht gemessen

Data type

integer

Third ventricular electrode
Description

Third ventricular electrode

Position
Description

Position

Data type

integer

Sensing threshold (in V)
Description

Reizschwelle

Data type

integer

Measurement units
  • V
V
not measured
Description

nicht gemessen

Data type

integer

R wave height
Description

R-Amplitude

Data type

integer

Measurement units
  • mV
Alias
UMLS CUI-1
C0429049
mV
not measured
Description

nicht gemessen

Data type

integer

Perioperative Complications
Description

Perioperative Complications

perioperative complications
Description

perioperative Komplikation(en)

Data type

integer

Alias
UMLS CUI-2
C0946279
Cardiopulmonary Resuscitation
Description

kardiopulmonale Reanimation

Data type

integer

Alias
UMLS CUI-2
C0007203
Hematoma due to pacemaker, requiring action
Description

interventionspflichtiges Taschenhämatom

Data type

integer

Alias
UMLS CUI-1
C2586079
postoperative wound infection - according to definition of CDC classification
Description

postoperative Wundinfektion

Data type

integer

Alias
UMLS CUI-1
C1629491
CDC classification
Description

CDC-Klassifikation

Data type

integer

other complications complication, requiring action(if peri/operative complications existing)
Description

sonstige interventionspflichtige Komplikation

Data type

integer

Discharge
Description

Discharge

Hostpital discharge date (DD.MM.YYYY)
Description

Entlassungsdatum Krankenhaus

Data type

date

Alias
UMLS CUI-1
C2710998
Reason for Discharge
Description

Entlassungsgrund

Data type

integer

Alias
UMLS CUI-1
C3164834
Discharge diagnoses - ICD codes
Description

Entlassungsdiagnose(n)

Data type

integer

Alias
UMLS CUI-1
C0011900
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Similar models

Quality assurance Implantable Defibrillator: Replacement (AQUA)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Basic documentation
Institutionskennzeichen
Item
Healthcare Facility Identifier
integer
C2986045 (UMLS CUI-1)
Entlassender Standort
Item
Zip Code of Discharge
string
C1521842 (UMLS CUI-1)
Betriebsstätten-Nummer
Item
Facility's Section Identifier
string
C1547540 (UMLS CUI-1)
Item
Medical specialty
integer
C0037778 (UMLS CUI-1)
Fachabteilung
Code List
Medical specialty
CL Item
 (0100)
CL Item
 (0102)
CL Item
 (0103)
CL Item
 (0104)
CL Item
 (0105)
CL Item
 (0106)
CL Item
 (0107)
CL Item
 (0108)
CL Item
 (0109)
CL Item
 (0114)
CL Item
 (0150)
CL Item
 (0151)
CL Item
 (0152)
CL Item
 (0153)
CL Item
 (0154)
CL Item
 (0156)
CL Item
 (0190)
CL Item
 (0200)
CL Item
 (0224)
CL Item
 (0260)
CL Item
 (0261)
CL Item
 (0290)
CL Item
 (0300)
CL Item
 (0400)
CL Item
 (0410)
CL Item
 (0436)
CL Item
 (0490)
CL Item
 (0500)
CL Item
 (0510)
CL Item
 (0524)
CL Item
 (0533)
CL Item
 (0590)
CL Item
 (0600)
CL Item
 (0607)
CL Item
 (0610)
CL Item
 (0690)
CL Item
 (0700)
CL Item
 (0706)
CL Item
 (0710)
CL Item
 (0790)
CL Item
 (0800)
CL Item
 (0900)
CL Item
 (0910)
CL Item
 (0990)
CL Item
 (1000)
CL Item
 (1004)
CL Item
 (1005)
CL Item
 (1006)
CL Item
 (1007)
CL Item
 (1009)
CL Item
 (1011)
CL Item
 (1012)
CL Item
 (1014)
CL Item
 (1028)
CL Item
 (1050)
CL Item
 (1051)
CL Item
 (1090)
CL Item
 (1100)
CL Item
 (1136)
CL Item
 (1190)
CL Item
 (1200)
CL Item
 (1300)
CL Item
 (1400)
CL Item
 (1410)
CL Item
 (1490)
CL Item
 (1500)
CL Item
 (1513)
CL Item
 (1516)
CL Item
 (1518)
CL Item
 (1519)
CL Item
 (1520)
CL Item
 (1523)
CL Item
 (1536)
CL Item
 (1550)
CL Item
 (1551)
CL Item
 (1590)
CL Item
 (1600)
CL Item
 (1700)
CL Item
 (1800)
CL Item
 (1900)
CL Item
 (2000)
CL Item
 (2021)
CL Item
 (2036)
CL Item
 (2050)
CL Item
 (2090)
CL Item
 (2100)
CL Item
 (2118)
CL Item
 (2120)
CL Item
 (2136)
CL Item
 (2150)
CL Item
 (2190)
CL Item
 (2200)
CL Item
 (2300)
CL Item
 (2309)
CL Item
 (2315)
CL Item
 (2316)
CL Item
 (2390)
CL Item
 (2400)
CL Item
 (2402)
CL Item
 (2405)
CL Item
 (2406)
CL Item
 (2425)
CL Item
 (2490)
CL Item
 (2500)
CL Item
 (2600)
CL Item
 (2700)
CL Item
 (2800)
CL Item
 (2810)
CL Item
 (2856)
CL Item
 (2890)
CL Item
 (2900)
CL Item
 (2928)
CL Item
 (2930)
CL Item
 (2931)
CL Item
 (2950)
CL Item
 (2951)
CL Item
 (2952)
CL Item
 (2953)
CL Item
 (2954)
CL Item
 (2955)
CL Item
 (2956)
CL Item
 (2960)
CL Item
 (2961)
CL Item
 (2990)
CL Item
 (3000)
CL Item
 (3060)
CL Item
 (3061)
CL Item
 (3090)
CL Item
 (3100)
CL Item
 (3110)
CL Item
 (3160)
CL Item
 (3161)
CL Item
 (3190)
CL Item
 (3200)
CL Item
 (3233)
CL Item
 (3290)
CL Item
 (3300)
CL Item
 (3305)
CL Item
 (3350)
CL Item
 (3390)
CL Item
 (3400)
CL Item
 (3460)
CL Item
 (3490)
CL Item
 (3500)
CL Item
 (3600)
CL Item
 (3601)
CL Item
 (3603)
CL Item
 (3610)
CL Item
 (3617)
CL Item
 (3618)
CL Item
 (3621)
CL Item
 (3622)
CL Item
 (3624)
CL Item
 (3626)
CL Item
 (3628)
CL Item
 (3650)
CL Item
 (3651)
CL Item
 (3652)
CL Item
 (3690)
CL Item
 (3700)
CL Item
 (3750)
CL Item
 (3751)
CL Item
 (3752)
CL Item
 (3753)
CL Item
 (3754)
CL Item
 (3755)
CL Item
 (3756)
CL Item
 (3757)
CL Item
 (3790)
Identifikationsnummer des Patienten
Item
Patient identification number
string
C1549734 (UMLS CUI-1)
Geburtsdatum
Item
Date of Birth (DD.MM.YYYY)
date
C0421451 (UMLS CUI-1)
Item
Gender
integer
C0079399 (UMLS CUI-1)
Geschlecht
Code List
Gender
CL Item
 (1)
CL Item
 (2)
Aufnahmedatum Krankenhaus
Item
Hospital admission date (DD.MM.YYYY)
date
C1302393 (UMLS CUI-1)
Item Group
Preoperative Clinical Examination
Item
ASA classification
integer
C1531480 (UMLS CUI-1)
Einstufung nach ASA-Klassifikation
Code List
ASA classification
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
Item Group
Indication of aggregate replacement
C0392360 (UMLS CUI-1-1)
C2048368 (UMLS CUI-1-2)
Item
Indikation of aggregate replacement
integer
Indikation zum Aggregatwechsel
Code List
Indikation of aggregate replacement
CL Item
 (1)
CL Item
 (2)
CL Item
 (9)
Item
Place of last ICD-(or pacemaker-)Operation before this procedure
integer
Ort der letzten ICD-(oder Schrittmacher-)OP vor diesem Eingriff
Code List
Place of last ICD-(or pacemaker-)Operation before this procedure
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
Item
Applied therapeutical shockings
integer
C2022208 (UMLS CUI-1)
Therapien abgegeben
Code List
Applied therapeutical shockings
CL Item
 (0)
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
Item Group
Operation
OP-Datum
Item
Operation Date (DD.MM.YY)
date
C3258210 (UMLS CUI-1)
Operation
Item
Procedure codes
integer
C1550373 (UMLS CUI-1)
Dauer des Eingriffs
Item
Procedure Duration (in minutes)
integer
C1442476 (UMLS CUI-1)
Item
intraoperative test of defibrillation
integer
intraoperativer Defibrillationstest durchgeführt
Code List
intraoperative test of defibrillation
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
Item
Safety margin for Defibrillation Test >= 10 J under aggregate-specific maximum engery
integer
Sicherheitsabstand Test- (oder DFT-) zu aggregatspezifischer Maximalenergie > =10 J
Code List
Safety margin for Defibrillation Test >= 10 J under aggregate-specific maximum engery
CL Item
 (0)
CL Item
 (1)
Item Group
ICD: Implantierted ICD-System
Item
ICD-System
integer
C2048304 (UMLS CUI-1)
System
Code List
ICD-System
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (9)
Item Group
Implantierted ICD-Aggregate
Item
Manufacturer
integer
Hersteller
Code List
Manufacturer
CL Item
 (1)
CL Item
 (18)
CL Item
 (19)
CL Item
 (3)
CL Item
 (7)
CL Item
 (89)
CL Item
 (9)
CL Item
 (99)
Item Group
Explantierted ICD-System
Item
ICD-System
integer
C2048304 (UMLS CUI-1)
System
Code List
ICD-System
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (9)
Item Group
Explantierted ICD-Aggregate
Jahr der Implantation
Item
Year of implantation (YYYY)
string
C2079500 (UMLS CUI-1)
Item
unknown
integer
nicht bekannt
Code List
unknown
CL Item
 (1)
Item
Manufacturer
integer
Hersteller
Code List
Manufacturer
CL Item
 (1)
CL Item
 (18)
CL Item
 (19)
CL Item
 (3)
CL Item
 (7)
CL Item
 (89)
CL Item
 (9)
CL Item
 (99)
CL Item
 (NULL)
Item Group
Left ICD electrodes - Atrium
Reizschwelle
Item
Sensing threshold (in V)
integer
C2048070 (UMLS CUI-1)
Item
unknown
integer
nicht gemessen
Code List
unknown
CL Item
 (1)
CL Item
 (9)
P-Wellen-Amplitude
Item
P wave height
integer
C0429042 (UMLS CUI-1)
Item
not measured
integer
nicht gemessen
Code List
not measured
CL Item
 (1)
CL Item
 (2)
CL Item
 (9)
Item Group
Ventricle
Item
Number of existing ventricular electrodes
integer
Zahl der vorhandenen Ventrikelsonden
Code List
Number of existing ventricular electrodes
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
Item Group
First ventricular electrode /defibrillation electrode
Item
Position
integer
Position
Code List
Position
CL Item
 (1)
CL Item
 (2)
CL Item
 (9)
Reizschwelle
Item
Sensing threshold(in V)
integer
C2048285 (UMLS CUI-1)
Item
not measured
integer
nicht gemessen
Code List
not measured
CL Item
 (1)
CL Item
 (9)
R-Amplitude
Item
R wave height
integer
C0429049 (UMLS CUI-1)
Item
not measured
integer
nicht gemessen
Code List
not measured
CL Item
 (1)
CL Item
 (2)
CL Item
 (9)
Item Group
Second ventricular electrode
Item
Position
integer
Position
Code List
Position
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (9)
Reizschwelle
Item
Sensing threshold(in V)
integer
C2048378 (UMLS CUI-1)
Item
not measured
integer
nicht gemessen
Code List
not measured
CL Item
 (1)
R-Amplitude
Item
R wave height
integer
C0429049 (UMLS CUI-1)
Item
not measured
integer
nicht gemessen
Code List
not measured
CL Item
 (1)
CL Item
 (9)
Item Group
Third ventricular electrode
Item
Position
integer
Position
Code List
Position
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (9)
Reizschwelle
Item
Sensing threshold (in V)
integer
Item
not measured
integer
nicht gemessen
Code List
not measured
CL Item
 (1)
R-Amplitude
Item
R wave height
integer
C0429049 (UMLS CUI-1)
Item
not measured
integer
nicht gemessen
Code List
not measured
CL Item
 (1)
CL Item
 (9)
Item Group
Perioperative Complications
Item
perioperative complications
integer
C0946279 (UMLS CUI-2)
perioperative Komplikation(en)
Code List
perioperative complications
CL Item
 (0)
CL Item
 (1)
Item
Cardiopulmonary Resuscitation
integer
C0007203 (UMLS CUI-2)
kardiopulmonale Reanimation
Code List
Cardiopulmonary Resuscitation
CL Item
 (1)
Item
Hematoma due to pacemaker, requiring action
integer
C2586079 (UMLS CUI-1)
interventionspflichtiges Taschenhämatom
Code List
Hematoma due to pacemaker, requiring action
CL Item
 (1)
Item
postoperative wound infection - according to definition of CDC classification
integer
C1629491 (UMLS CUI-1)
postoperative Wundinfektion
Code List
postoperative wound infection - according to definition of CDC classification
CL Item
 (1)
Item
CDC classification
integer
CDC-Klassifikation
Code List
CDC classification
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
Item
other complications complication, requiring action(if peri/operative complications existing)
integer
sonstige interventionspflichtige Komplikation
Code List
other complications complication, requiring action(if peri/operative complications existing)
CL Item
 (1)
Item Group
Discharge
Entlassungsdatum Krankenhaus
Item
Hostpital discharge date (DD.MM.YYYY)
date
C2710998 (UMLS CUI-1)
Item
Reason for Discharge
integer
C3164834 (UMLS CUI-1)
Entlassungsgrund
Code List
Reason for Discharge
CL Item
 (1)
CL Item
 (10)
CL Item
 (11)
CL Item
 (13)
CL Item
 (14)
CL Item
 (15)
CL Item
 (17)
CL Item
 (2)
CL Item
 (22)
CL Item
 (25)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (7)
CL Item
 (8)
CL Item
 (9)
Entlassungsdiagnose(n)
Item
Discharge diagnoses - ICD codes
integer
C0011900 (UMLS CUI-1)
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