PPS Line Listing.xlsx

	A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	Q	R	S	T	U	V	W	X	Y	Z	AA	AB	AC	AD	AE	AF	AG	AH	AI	AJ	AK	AL	AM	AN	AO	AP	AQ	AR	AS	AT	AU
1	Line Listing for PPS on Healthcare Associated Infection
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3	HOSPITAL			______________________________________					NO OF HOSPITAL BED								___________________________________							Number of airborne infection isolation rooms						___________________________________________________
4	DATE OF PPS			______________________________________					NO OF HOSPITAL BED								___________________________________							Number of patients with indwelling urinary catheters						___________________________________________________
5	HOSPITAL TYPE			______________________________________					Number of full time infection control nurses								___________________________________							Number of patients with central venous catheters						___________________________________________________
6	Total no of hospitalised patients during the survey period						_________________																	Number of patients with tracheostomy / mechanical ventilators						___________________________________________________
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9	CASE IDENTIFICATION DATA								CLINICAL DATA													HAI DATA																		MICROBIOLOGICAL DATA
10	CASE IDENTIFICATION DATA									General predisposing factors						Devices (related to current HAI)						HAI 1									HAI 2									HAI 1				HAI 2
11	No.	Name	Department	Ward	RN No.	Age	Gender	Date of admission	Clinical Diagnosis	Underlying disease	Immunosuppressive Rx	Prolonged hospitalisation	Prematurity/ LBW	Surgery within 30 days / 90 days	Others	Urinary catheter (For UTI)	Mechanical ventilator (For VAP)	Tracheostomy (For VAP)	CV catheter (For BSI)	Arterial Line (For BSI)	Other drainage catheters	Type of infection	Type of SSI	Type of SSI wound	Type UTI	Type of pneumonia	Type of BSI	BSI Category	Clinical Sepsis (Neonates)	Method of diagnosis	Type of infection	Type of SSI	Type of SSI wound	Type UTI	Type of pneumonia	Type of BSI	BSI Category	Clinical Sepsis	Method of diagnosis	Date of sample collection	Date of lab report	Type of specimen	Isolated Organism	Date of sample collection	Date of lab report	Type of specimen	Isolated Organism
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60			DEPARTMENT				GENDER																TYPE OF SSI	TYPE OF SSI WOUND	TYPE OF UTI	TYPE OF PNEUMONIA	TYPE OF BSI	BSI Category		DIAGNOSIS												SPECIMEN					ISOLATED ORGANISM
61			MED				MALE			YES												SSI	Superficial incisional	Clean	UTI-A	PNM-A	BSI-A1	CVC-BSI		CLINICAL												RECTAL SW	RECTAL SWAB				MRSA
62			ORTHO				FEMALE			NO												UTI	Deep incisional	Clean-contaminated	UTI-B	PNM-B	BSI-A2	Non CVC-BSI		LABORATORY/ RADIOLOGICAL												WOUND SW	WOUND SWAB				MSSA
63			SURG																			PNM	Organ or space	Contaminated	CAUTI	VAP	BSI-B	NA														THROAT SW	THROAT SWAB				VSE
64			PAED																			BSI	NA	Dirty or infected	NA	NA	NA															URINE	URINE				VRE
65			ANAEST																			CS		NA																		TR.ASP	TRACHEAL ASPIRATE				MDRO-Ac Sp
66			O&G																																							PD FLUID	PERITONEAL DIALYSIS FLUID				Non MDRO-Ac Sp
67			DERMATO																																							PUS	PUS				CRE
68			HAEMATO																																							BLOOD	BLOOD				CSE
69			URO																																							SPUTUM	SPUTUM				CRPA
70			CARDIO																																							STOOL	STOOL				CSPA
71			ONCO																																							BR.ASP	BRONCHIAL ASPIRATE				C3GS Kleb
72			NEPHRO																																							GASTRIC LAV	GASTRIC LAVAGE				C3GR ESBL kleb
73			OTHERS																																							CATH TIP	CATHETER TIP				C3GR Non ESBL Kleb
74																																										TISSUE	TISSUE				C3GS E.coli
75																																										OTHERS	OTHER SPECIMEN NOT LISTED ABOVE				C3GR ESBL E.coli
76																																															C3GR Non ESBL E.coli
77																																															C3GS Enterobacter
78																																															C3GR Enterobacter
79																																															C3GS Others
80																																															C3GR Others
81																																															Others
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