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Table 1 Definitions of paediatric nursing-sensitive outcomes

From: Evaluation of paediatric nursing-sensitive outcomes in an Australian population using linked administrative hospital data

Nursing-sensitive outcome Numeratora Denominator Key exclusions
Lower respiratory tract infection (LRTI) Lower respiratory tract infections, bronchiolitis (ICDb B97.0, B97.4, B97.89, > = J20.0 and < =J20.9, J21.0, J21.8, J21.9, J22., J85.1, J85.2, J86.0, J86.9) All medical and surgical inpatients MDC4-respiratory conditions
LOS > =3 days All pneumonias
Gastrointestinal (GI) infection Rota virus and other GI infections (ICD A02.2, > = A03.0 and < = A03.9, > = A04.0 and < = A04.9, A08.0, A08.1, A08.2, A08.3, A08.4, A09., A09.9) All medical and surgical inpatients Principal diagnoses of volume depletion, disorders of fluid and electrolytes or acid base
LOS > =5 days
(ICD E86., E87. > = E87.0 and < =E87.8)
MDC6-GI system
MDC18-infectious and parasitic
Pneumonia Aspiration, post-operative, hypostatic, bacterial, broncho and unspecified pneumonias: (ICD > =J14. and < =J15.9, J18.0, J18.1, J18.2, J18.8, J18.9, J69.0, J69.8, J95.8, J95.9) All medical and surgical inpatients MDC4-respiratory conditions
All diagnoses of probable community acquired pneumonia (ICD > =J10. and < =J10.8, > = J11. and < =J11.8, =J12. and < =J12.9, J13., J15.7, J16.8, > = J17. and < =J17.8)
Aspiration pneumonia and epilepsy (ICD J69.0, 69.8, > = G40. and < =G40.9, > = G41. and < =G41.9)
All diagnoses of epilepsy found in 'look back’ period
Surgical wound infection Surgical wounds, including surgery post traumatic injury plus those found in 30 day 'look forward period’ (ICD T79.3, T81.4, T81.41, T81.42) All surgical inpatients  
Total discharges only
Physiologic/metabolic derangement Diabetic hyperosmolarity/acidosis: (ICD > E10.1, E 10.11, E11.1, E11.11, E15.) All surgical inpatients If principal diagnoses diabetes: (ICD > =E10 and < =E14, E15.)
Principal diagnosis of trauma and burns: (ICD > =S00. and < =T32.9)
Disorders of fluid, electrolytes, acid–base: (ICD E86., > = E87. and < =E87.8)
MDC5 circulatory system, MDC7 hepatobiliary and pancreas, MDC10 endocrine and metabolic disorders, MDC11 kidney and urinary tract
Shock from a procedure: (ICD T81.1)
Anuria/oliguria: (ICD R34.)
No procedure code
If principal diagnosis cardiac arrhythmia/arrest (ICD > =I46. And < I50.) or GI haemorrhage (ICD K92., K92.1, K92.2)
Sepsis Septicaemia; bacteraemia (ICD > =A40. and < A42., A49.9, R78.81) All medical and surgical inpatients MDC17-cancer and all diagnosis of cancer in 2 year look back period
LOS > =3 days
Infection related admissions (DRG 2.0-4.2: B72Z, D63A, D63B, D64Z, D66A, D66B, E62A, E62B, E62C, F61Z, G07A, G07B, I64A, I64B, I67A, I67B, J11Z, J64B, L40Z, L41Z, L63C, M62A, M62B, N61Z, S63A, S63B, S64A, S64B, T01A, T01B, T01C, T60A, T60B, T61A, T61B, T64A, T64B)
Look back period for cancer
(DRG 5.0-6.0: B72A, B72B, D63A, D63B, D64Z, D66A, D66B, E62A, E62B, E62C, F61Z, G07A, G07B, I64A, I64B, I67A, I67B, J11Z, J64B, L40Z, L41Z, L63A, L63B, L63C, M62A, M62B, N61Z, S64B, S65A, S65B, S65C, T01A, T01B, T01C, T60A, T60B, T61A, T61B, T64A, T64B)
Postoperative cardiopulmonary complications (ICD > =I26. and < = I26.99, I44.2, I46.0, I46.1, I46.9, > = I50. and < =I50.9, > = I97. and < =I97.9, J80., J81., > = J95. and < =J95.4, J95.8, > = J96. and < =J96.9, > = J98.0 and < =J98.3, R09.2, > = T80.0 and < =T80.2, T81.7, T81.72, T82.8, T82.9) All surgical inpatients MDC3-Ear, nose, mouth and throat conditions
MDC4-respiratory conditions
MDC5-circulatory conditions
Arrest/shock/respiratory failure Arrest (respiratory, cardiac), respiratory failure, shock (ICD I46.0, I46.1, I46.9, J18.2, J80., J81., J95.1, J95.2, J96.0, J96.9, R09.2, > = R57.0 and < R58) All medical and surgical inpatients MDC4-respiratory conditions
MDC5-circulatory conditions
Procedures (ACHI 92042–00, 92052–00, 92053–00)
Central nervous system (CNS) complications Coma and stupor; acute delirium; reactive confusion; reactive depression (ICD F05.0, F05.8, F05.9, F43.2, F43.9, F44.88, F51., R40.0, R40.1, R40.2, R40.4, R41.0, R41.8, R45.1, R45.4,) All medical and surgical inpatients MDC1-neurological
MDC19-mental illness
Age >6 months
MDC20-substance abuse
MDC21-injuries, poisoning and toxic effects of drugs
Any procedure of sleep study (ACHI 12203.00)
Central venous line (CVL) infection Infection due to central venous catheter as per AHRQ (ICD > =T80.2 and < =T80.29, > = T82.7 and < = T82.79) All medical and surgical inpatients MDC17-cancer
Weight < 500gm
LOS > =2 days
Infectious disease Coxsacchie virus (ICD B34.1) and LOS > =3 All medical and surgical inpatients  
Pertussis (ICD A37.0, A37.1, A37.8 A37.9) and LOS > =7 LOS > =3, 7 or 14 days appropriate to incubation period
Other infections (ICD > =B01, B01.0 and < =B01.9, > = B05. and < =B05.9, B06.0, B06.8, B06.9, B08.4, B15.0 B15.9 > =B26.0 and < =B26.9) and LOS > =14
Pressure ulcer Pressure ulcer (ICD L89) All medical and surgical inpatients All diagnosis of hemiplegia, paraplegia, paralysis; cerebral palsy; spina bifida. (ICD > =G80 and < =G84; > = Q05. and < =Q05.9 or > =Q07. and < =Q07.03)
LOS > =3 days
All diagnoses of paralysis found in look back period
Failure to rescue Died in hospital All medical and surgical inpatients  
   Pneumonia, sepsis, arrest/shock/respiratory failure, LRTI as above and GI bleed and DVT/PE  
  1. Note. ICD = international classification of diseases; LOS = length of stay; MDC = major diagnostic category; ACHI = Australian classification of health interventions; AHRQ = agency for healthcare research and quality; DVT/PE = deep vein thrombosis/pulmonary embolus.
  2. Definitions amended from Needleman et al [8], and McCloskey [28].
  3. aAll numerators are based on secondary diagnosis only except surgical wound infection in look forward period.
  4. bICD codes are all ICD-10-AM (Australian Modified).