Appendix D: Table of Instructions (TOI) for Completion of the Respiratory Tract Infection (RTI) Denominator Form

Unique facility identification assigned by the EIP site, such as a 4-character code based on the EIP site State, followed by an assignment of two letters. For example, three nursing homes in Colorado may be coded as:

• CO-AA
• CO-BB
• CO-CC

Important Notes:

• The facility and Facility ID will be anonymous to the CDC team.
• For the form in REDCap, the Facility ID must be 4 alpha characters

Required. Record the count for Total Resident Days for the calendar month of surveillance. The count may represent data collected from an electronic data source or collected manually.

• Option 1: If the count is available from an electronic data source, this source may be used as long as the counts are not substantially different (+/- 5%) from manually collected counts. Place an “If an electronic data source was used to record
• Option 2: To calculate resident days manually, for each day of the month, at the same time each day, use the RTI denominator form to record the number of residents in the facility. At the end of the month, sum the daily counts and record the total for the month.

Required. Indicate if the monthly total was collected from an ELECTRONIC data source only by selecting YES or NO

Important Note:

• Do not include residents for whom a bed is being held but are not actually present in the facility.

Record the total number of new prescriptions or orders for an antibiotic given for residents suspected or diagnosed with having a respiratory tract infection (RTI) for the calendar month as Total Antibiotic Starts for RTI Indication for the calendar month of surveillance. The count may represent data collected from an electronic data source or collected manually.

• Option 1: If the count is available from an electronic data source, this source may be used as long as the counts are not substantially different (+/- 5%) from manually collected counts.
• Option 2: To manually calculate the number of new antibiotic starts for RTI indication for the calendar month, for each day of the month, at the same time each day, use the RTI denominator form to record the number of new prescriptions or orders for an antibiotic

given for residents in the facility suspected or diagnosed with having a respiratory tract infection. At the end of the month, sum the daily counts and record the total for the month.

Required. Indicate if the monthly total was collected from an ELECTRONIC data source only by selecting YES or NO

Important Notes:

• Capture all new antibiotic orders, regardless of number of doses or days of therapy, including antibiotics that are started, but not completed.
• Include only antibiotics that are started while the resident is receiving care by the reporting facility, either by clinical providers working in the facility or by outside physicians who see the resident in an outpatient clinic or emergency department.
• Do not include antibiotic courses started by another healthcare facility prior to the resident’s admission or readmission back to the reporting facility, even if the resident continues to take the antibiotic while in the facility.

Required. If the facility has ventilator beds or units, record the Total Ventilator Days for the calendar month of surveillance. If the count is zero, record zero. The count may represent data collected from an electronic data source or collected manually.

• Option 1: If the count is available from an electronic data source, this source may be used as long as the counts are not substantially different (+/- 5%) from manually collected counts.
• Option 2: To manually calculate the number of residents on a ventilator for the calendar month, for each day of the month, at the same time each day, use the RTI denominator form to record the number of residents on a ventilator at the time of the count. At the end of the month, sum the daily counts and record the total for the month as Total Ventilator Days.

Required. Indicate if the monthly total was collected from an ELECTRONIC data source only by selecting YES or NO