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ResearchReportForm for the Perform web

Name: Type: Size: Values: Tooltip message: Attributes:
TopicType label 1   Classify a topic by function  
ImprovementFocus checkbox 3 ACEiOrARbPrescribedAtDischargeForLVSD, AntibioticTiming, AspirinAtArrival, AspirinPrescribedAtDischarge, BetaBlockerAtArrival, BetaBlockerPrescribedAtDischarge, BloodCulturesCollectedPriorToInitialAntiobiotic, BloodCulturesPerformedWithin24Hours, CardiacSurgeryPatientsWithControlledPostoperativeBloodGlucose, ColorectalSurgeryPatientsWithImmediatePostoperativeNormothermia, CompletePsychiatricAssessment, DischargeAssessmentSentToNextLevelOfCareProvider, DischargeInstructions, EngagingFamiliesInTreatment, EvaluationofLVSFunction, FailureModeAndEffectsAnalysisinBHC, FibrinolyticTherapyWithin30MinutesOfHospitalArrival, HomeManagementPlanOfCareGivenToPatientOrCaregiver, HoursOfRestraintUse, HoursOfSeclusionUse, InfluenzaVaccination, InitialAntibioticSelectionForCAPPatients, InpatientMortality, InpatientNeonatalMortality, LDLCholesterolAssessment, LipidLoweringTherapyAtDischarge, OutcomeInformedCareProcesses, OxygenationAssessment, PatientsDischargedOnMultipleAntipsychoticMedications, PneumococcalVaccination, PrimaryPCIReceivedWithin90MinutesOfHospitalArrival, ProphylacticAntibioticReceivedWithinOneHourPriorToSurgery, ProphylacticAntibioticSelectionForSurgicalPatients, ProphylacticAntibioticsDiscontinuedWithin24Hours, QualityOfLife? -Employment, QualityOfLife? -Housing, RapidTestingForInfluenza, RelieversForInpatientAsthma, ScreeningAndBriefIntervention, SmokeFreeHospitalCampus, SmokingCessationCounselingPrograms, SurgeryPatientsReceivedAppropriateVTEProphylaxisWithin24Hours, SurgeryPatientsWithAppropriateHairRemoval, SurgeryPatientsWithRecommendedVTEProphylaxisOrdered, SystemicCorticosteriodsForInpatientAsthma, ThirdOrFourthDegreeLaceration Specify area focus for this report. M
Title text 50   Title for report. M
Posted By text 30   Person who posted report M
Summary textarea 50x4   Brief (>100 words) summary or headline for report.  
Research Category select 1 Peer-reviewed Study, Literature Review, Resource Material, Original Research, Case Study    
Authors text 50   Author(s) of research. Enter as "Last Name, First Name Middle Initial"  
Journal Name text 30   If applicable  
Volume text 10   Enter number only.  
Issue text 10   Enter number only.  
Year text 10   Enter 4-digit year.  
Page Numbers text 10   If applicable  

Related Topic: TopicClassification, WebPreferences, TWikiForms

For more information about how you can use form to organize topics or create simple database applications, see TWikiForms.

r4 - 26 Apr 2007 - 11:19:55 - ScottWilliams
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