NHS Information Standards Board

Transcription

1 NHS Information Standards Board DSC Notice: 35/2003 Date of Issue: November 2003 Subject: Data Standards: National Joint Registry Data Set Implementation Date: 1 st April 2003 DATA SET CHANGE CONTROL PROCEDURE This paper gives notification of changes to be included in the NHS Data Dictionary and the NHS CDS Manual as appropriate. These will be consolidated into the publications in due course. Summary of Changes: Changes to data standards in the NHS Data Dictionary to support the introduction of the National Joint Registry Data Set. The NHS Information Standards Board (NHS ISB) is responsible for approving information standards. The NHS ISB is supported by the NHS Information Standards Advisory Board and on the NHSnet at:

2 DSC Notice: 35/2003 Change Request NHS Information Authority Data Standards and Information Programme Reference: Change Request 323 Version No: 1.73 Subject: National Joint Registry Data Set Type of Change: Incorporation of a Data Set into the NHS Data Dictionary Effective Date: 1 April 2003 Reason for Change: Incorporation of elements from the National Joint Registry Data Set was required in the NHS Data Dictionary. Background: Hip and knee joints comprise the largest number of joint replacements used in the UK and both are subject to a high proliferation of different implant types that commonly lack data on their long-term effectiveness. The National Joint Registry is a keystone to delivering the commitment of both the Department of Health and the Welsh Assembly Government to improve the health and wellbeing of the population and is a vital tool for improving clinical standards for hip and knee replacements. At the heart of the NJR is a database of information collected from all the hip and knee replacement procedures in England and Wales. The NJR data is being used to bring direct benefits to patients by: - Improving patient awareness of the outcomes of hip and knee joint replacement - Finding out how long the different joint replacements last - Helping to identify individual patients who have received an implant if there is a need for urgent clinical review. The National Joint Registry commenced collecting the Data Set on the 1st April 2003 and this DSCN has incorporated the National Joint Registry Data Set into the NHS Data Dictionary. The National Joint Registry website is accessible at: Summary of changes: Class Definitions CLINICAL CLASSIFICATION HEALTH CARE PROFESSIONAL HIP CEMENTING TECHNIQUE HIP REPLACEMENT SURGERY IMPLANT JOINT REPLACEMENT REVISION CLASSIFICATION JOINT REPLACEMENT REVISION INDICATION JOINT REPLACEMENT SURGERY KNEE REPLACEMENT SURGERY LANGUAGE OPERATING THEATRE PATIENT DIAGNOSIS PATIENT PROCEDURE Change to Attributes Change to Attributes New Class New Class New Class New Class New Class New Class New Class New Class Change to Attributes Change to Relationships Change to Attributes

3 PROSTHETIC DEVICE THROMBO PROPHYLAXIS REGIME New Class New Class Attribute Definitions CARE PROFESSIONAL INVOLVEMENT ROLE CEMENT GUN USED CEMENT MIXING SYSTEM CEMENT PRESSURISER USED GRADE OF RESPONSIBLE HCP HIP CEMENTING TECHNIQUE TYPE HIP REPLACEMENT BONEGRAFT HIP SURGERY INCISION TYPE HIP SURGERY PATIENT POSITION HIP SURGERY TROCHANTER INDICATOR IMAGE GUIDED SURGERY INDICATOR IMPLANT BATCH OR LOT NUMBER IMPLANT CATALOGUE NUMBER IMPLANT CLASSIFICATION CODE IMPLANT MANUFACTURER IMPLANT MODEL INTERPRETER REQUIRED INDICATOR JOINT IMPLANT REVISION INDICATOR JOINT IMPLANT REVISION REASON JOINT REPLACEMENT ANATOMICAL SIDE JOINT REPLACEMENT PRIMARY OR REVISION JOINT REPLACEMENT REVISION NUMBER KNEE REPLACEMENT CEMENT INDICATOR KNEE SURGERY FAT PAD REMOVED KNEE SURGERY SKIN INCISION METHOD KNEE SURGERY SURGICAL APPROACH KNEE SURGERY TOURNIQUET USED LAMINAR FLOW SYSTEM INDICATOR LANGUAGE USAGE LOCUM INDICATOR MINIMALLY INVASIVE SURGERY INDICATOR OVERSEAS SURGICAL TEAM MEMBER PATIENT DIAGNOSIS IMPLANT INDICATION PATIENT PHYSICAL STATUS PATIENT PROCEDURE IMPLANT INDICATION PROSTHESIS CEMENTED PROSTHETIC DEVICE CODE PROSTHETIC DEVICE TYPE PULSATILE LAVAGE SURGICAL DEFAULT TECHNIQUE INDICATOR THROMBO PROPHYLAXIS REGIME TYPE TYPE OF ANAESTHETIC Change to Description Data Elements CEMENT GUN USED CEMENT MIXING SYSTEM CEMENT PRESSURISER USED

4 HIP CEMENTING TECHNIQUE TYPE HIP REPLACEMENT BONEGRAFT HIP SURGERY INCISION TYPE HIP SURGERY PATIENT POSITION HIP SURGERY TROCHANTER INDICATOR IMAGE GUIDED SURGERY INDICATOR IMPLANT BATCH OR LOT NUMBER IMPLANT CATALOGUE NUMBER IMPLANT CLASSIFICATION CODE IMPLANT MANUFACTURER IMPLANT MODEL JOINT IMPLANT REVISION INDICATOR JOINT IMPLANT REVISION REASON JOINT REPLACEMENT ANATOMICAL SIDE JOINT REPLACEMENT PRIMARY OR REVISION JOINT REPLACEMENT REVISION NUMBER KNEE REPLACEMENT CEMENT INDICATOR KNEE SURGERY FAT PAD REMOVED KNEE SURGERY SKIN INCISION METHOD KNEE SURGERY SURGICAL APPROACH KNEE SURGERY TOURNIQUET USED LAMINAR FLOW SYSTEM INDICATOR LANGUAGE LANGUAGE USAGE LOCUM INDICATOR MINIMALLY INVASIVE SURGERY INDICATOR OVERSEAS SURGICAL TEAM MEMBER PATIENT CONSENT TO RECORDING DATA PATIENT DIAGNOSIS IMPLANT INDICATION PATIENT PHYSICAL STATUS PATIENT PROCEDURE IMPLANT INDICATION PROSTHESIS CEMENTED PULSATILE LAVAGE SURGICAL DEFAULT TECHNIQUE INDICATOR THROMBO PROPHYLAXIS REGIME TYPE TYPE OF ANAESTHETIC Data Sets (CDS, CMDS, HES) NATIONAL JOINT REGISTRY DATA SET New Data Set (CDS, CMDS, HES) Diagrams CL010 PERSON OBSERVATIONS AND CHARACTERISTICS NJR1 NATIONAL JOINT REGISTRY - DATA COLLECTION NJR1 NATIONAL JOINT REGISTRY DATA SET 1 Change to Diagram Contents New Diagram New Diagram Supporting Information DATA SETS DIAGRAM MIDDLE PANE NATIONAL JOINT REGISTRY DIAGRAM NATIONAL JOINT REGISTRY DIAGRAM CLASS DEFINITIONS NJR DATA SET OVERVIEW Change to Supporting Information New Supporting Information New Supporting Information New Supporting Information

5 Packages NATIONAL JOINT REGISTRY DATA SET NATIONAL JOINT REGISTRY DATA COLLECTION NATIONAL JOINT REGISTRY DATA SET New Package New Package New Package Name: Michelle Cambridge Date: 12 November 2003 Sponsor: Data and Information Standards Programme Note: Additions shown in highlighted with a blue background. Deletions are shown using strikeout. Click here for a printer friendly view of this page. CLINICAL CLASSIFICATION Change to Class: Change to Attributes Attributes of this Class are: K CLINICAL CLASSIFICATION CODE O PATIENT DIAGNOSIS IMPLANT INDICATION HEALTH CARE PROFESSIONAL Change to Class: Change to Attributes Attributes of this Class are: O CARE PROFESSIONAL INVOLVEMENT ROLE O GRADE OF RESPONSIBLE HCP O GYNAECOLOGICAL ONCOLOGY ACCREDITATION O LOCUM INDICATOR O OVERSEAS SURGICAL TEAM MEMBER for lead operating surgeon or first assistant only O SPECIALIST HIV SKILLS AVAILABLE O SPECIALIST REGISTRAR FLAG for paediatric surgery only HIP CEMENTING TECHNIQUE Change to Class: New Class HIP CEMENTING TECHNIQUE

6 The HIP CEMENTING TECHNIQUE of a HIP REPLACEMENT SURGERY. Attributes of this Class are: CEMENT GUN USED CEMENT MIXING SYSTEM CEMENT PRESSURISER USED HIP CEMENTING TECHNIQUE TYPE PROSTHESIS CEMENTED PULSATILE LAVAGE Each HIP CEMENTING TECHNIQUE must be used during one and only one HIP REPLACEMENT SURGERY HIP REPLACEMENT SURGERY Change to Class: New Class HIP REPLACEMENT SURGERY A type of JOINT REPLACEMENT SURGERY to fit in place a joint IMPLANT. JOINT REPLACEMENT SURGERY where non-default surgical techniques are used. This class is also known by these names: HIP REPLACEMENT SURGERIES Attributes of this Class are: HIP REPLACEMENT BONEGRAFT HIP SURGERY INCISION TYPE HIP SURGERY PATIENT POSITION HIP SURGERY TROCHANTER INDICATOR Each HIP REPLACEMENT SURGERY may be made up of one or more HIP CEMENTING TECHNIQUE IMPLANT

7 Change to Class: New Class IMPLANT A type of PROSTHETIC DEVICE. An artificial component used to replace a part of the human body that is no longer functioning correctly as it is worn or damaged. An example being the use of an IMPLANT in JOINT REPLACEMENT SURGERY, where an IMPLANT is used to replace a worn or damaged joint (the commonest joint replacements being of the hip and knee). This class is also known by these names: IMPLANTS Attributes of this Class are: K IMPLANT CATALOGUE NUMBER K IMPLANT MANUFACTURER IMPLANT BATCH OR LOT NUMBER IMPLANT CLASSIFICATION CODE IMPLANT MODEL This class has no relationships. JOINT REPLACEMENT REVISION CLASSIFICATION Change to Class: New Class JOINT REPLACEMENT REVISION CLASSIFICATION A classification that identifies the reason why a revision of a joint IMPLANT is needed (indicating the requirement for further JOINT REPLACEMENT SURGERY on a hip or knee). The JOINT REPLACEMENT REVISION INDICATION identifies where the revision of a joint replacement is required on the basis of a JOINT REPLACEMENT REVISION CLASSIFICATION. This class is also known by these names:

8 JOINT REPLACEMENT REVISION CLASSIFICATION Attributes of this Class are: K JOINT IMPLANT REVISION REASON Each JOINT REPLACEMENT REVISION CLASSIFICATION may be the classification of one or more JOINT REPLACEMENT REVISION INDICATION JOINT REPLACEMENT REVISION INDICATION Change to Class: New Class JOINT REPLACEMENT REVISION INDICATION An indication that a joint replacement needs revising, perhaps because the IMPLANT used to replace a joint has become worn over time or the IMPLANT has been fitted recently and is not working correctly (perhaps as a result of the IMPLANT being faulty). The reasons behind the required revision of a joint replacement are identified through the JOINT REPLACEMENT REVISION CLASSIFICATION. This class is also known by these names: JOINT REPLACEMENT REVISION INDICATIONS Attributes of this Class are: K JOINT IMPLANT REVISION INDICATOR Each JOINT REPLACEMENT REVISION INDICATION K must be linked to one and only one JOINT REPLACEMENT REVISION CLASSIFICATION must be the indication for one and only one JOINT REPLACEMENT SURGERY JOINT REPLACEMENT SURGERY Change to Class: New Class JOINT REPLACEMENT SURGERY A type of PATIENT PROCEDURE.

9 JOINT REPLACEMENT SURGERY is identified by the use of a metal/plastic IMPLANT to replace a diseased or worn joint or part of a joint. This class is also known by these names: JOINT REPLACEMENT SURGERIES Attributes of this Class are: IMAGE GUIDED SURGERY INDICATOR JOINT REPLACEMENT ANATOMICAL SIDE JOINT REPLACEMENT PRIMARY OR REVISION O JOINT REPLACEMENT REVISION NUMBER MINIMALLY INVASIVE SURGERY INDICATOR O PATIENT PROCEDURE IMPLANT INDICATION SURGICAL DEFAULT TECHNIQUE INDICATOR Each JOINT REPLACEMENT SURGERY may be indicated by one or more JOINT REPLACEMENT REVISION INDICATION may be indicated for revision by one or more PATIENT DIAGNOSIS may be indicated by one or more PATIENT DIAGNOSIS may be the fitting of one or more PROSTHETIC DEVICE may be related to one or more THROMBO PROPHYLAXIS REGIME KNEE REPLACEMENT SURGERY Change to Class: New Class KNEE REPLACEMENT SURGERY A type of JOINT REPLACEMENT SURGERY to fit in place a joint IMPLANT. JOINT REPLACEMENT SURGERY where non-default surgical techniques are used. This class is also known by these names: KNEE REPLACEMENT SURGERIES Attributes of this Class are:

10 KNEE REPLACEMENT CEMENT INDICATOR KNEE SURGERY FAT PAD REMOVED KNEE SURGERY SKIN INCISION METHOD KNEE SURGERY SURGICAL APPROACH KNEE SURGERY TOURNIQUET USED This class has no relationships. LANGUAGE Change to Class: New Class LANGUAGE A type of CHARACTERISTIC. A classification of a LANGUAGE used by a PERSON, recorded during or as a result of a course of treatment. Identifies the LANGUAGE that is used by a PERSON and the LANGUAGE USAGE, i.e. their preferred LANGUAGE. National codes: 001 Akan (Ashanti) 002 Albanian 003 Amharic 004 Arabic 005 Bengali & Sylheti 006 Brawa & Somali 007 British Signing Language 008 Cantonese 009 Cantonese and Vietnamese 010 Creole 011 Dutch 012 English 013 Ethiopian 014 Farsi (Persian) 015 Finnish 016 Flemish 017 French 018 French creole 019 Gaelic 020 German 021 Greek 022 Gujarati 023 Hakka 024 Hausa 025 Hebrew 026 Hindi 027 Igbo (Ibo)

11 028 Italian 029 Japanese 030 Korean 031 Kurdish 032 Lingala 033 Luganda 034 Maketon (sign language) 035 Malayalam 036 Mandarin 037 Norwegian 038 Pashto (Pushtoo) 039 Patois 040 Polish 041 Portuguese 042 Punjabi 043 Russian 044 Serbian/Croatian 045 Sinhala 046 Somali 048 Spanish 049 Swahili 050 Swedish 051 Sylhethi 052 Tagalog (Filipino) 053 Tamil 054 Thai 055 Tigrinya 056 Turkish 057 Urdu 058 Vietnamese 059 Welsh 060 Yoruba 200 Other This class is also known by these names: LANGUAGES Attributes of this Class are: INTERPRETER REQUIRED INDICATOR O LANGUAGE USAGE for JOINT REPLACEMENT SURGERY only This class has no relationships.

12 OPERATING THEATRE Change to Class: Change to Attributes Attributes of this Class are: K OPERATING THEATRE CODE ANAESTHETIC ROOM PRESENT O LAMINAR FLOW SYSTEM INDICATOR for JOINT REPLACEMENT SURGERY only OPERATING THEATRE NAME OPERATING THEATRE TYPE POST OPERATIVE ROOM PRESENT PATIENT DIAGNOSIS Change to Class: Change to Relationships Each PATIENT DIAGNOSIS may be recorded for one CONSULTANT EPISODE (ACUTE HOME-BASED) or may be related to one CONSULTANT EPISODE (HOSPITAL PROVIDER) or may be related to one OUT-PATIENT ATTENDANCE CONSULTANT may be the primary diagnosis of one or more CANCER CARE SPELL may be recorded for one CARE PROGRAMME APPROACH REVIEW may be the indication for revision of one JOINT REPLACEMENT SURGERY may be the indication for implantation of one JOINT REPLACEMENT SURGERY may be recorded for highest one NEONATAL LEVEL OF CARE PERIOD PATIENT PROCEDURE Change to Class: Change to Attributes Attributes of this Class are: O COLONOSCOPY INCOMPLETE REASON if procedure is colonoscopy O NEW LESIONS TREATED NUMBER if procedure is for treatment of Basal Cell or Squamous Cell Carcinoma only OPERATIVE PATIENT PROCEDURE INDICATOR O PATIENT INFORMED BIOPSY RESULT DATE colposcopy only O PATIENT PHYSICAL STATUS for OPERATIVE PROCEDURES only and where an anaesthetist is present to record the physical status O PATIENT PROCEDURE RESULT

13 O O O O if procedure is colonoscopy or other for cancer detection RECURRENT LESIONS TREATED NUMBER if procedure is for treatment of Basal Cell or Squamous Cell Carcinoma only SARCOMA SURGICAL MARGIN if procedure is for treatment of sarcoma SARCOMA SURGICAL PROCEDURE TYPE if procedure is for treatment of sarcoma SURGICAL URGENCY for operative procedures only TYPE OF ANAESTHETIC PROSTHETIC DEVICE Change to Class: New Class PROSTHETIC DEVICE An artificial IMPLANT or other device. An artificial organ, limb or joint, made of metal, plastic or ceramic. This class is also known by these names: PROSTHETIC DEVICES Attributes of this Class are: K PROSTHETIC DEVICE CODE PROSTHETIC DEVICE TYPE Each PROSTHETIC DEVICE must be fitted during one and only one JOINT REPLACEMENT SURGERY THROMBO PROPHYLAXIS REGIME Change to Class: New Class THROMBO PROPHYLAXIS REGIME A regime used in the reduction of platelet aggregation, which allows its prophylactic use at a low dose, as an antiplatelet treatment. An example of such a regime is the taking of aspirin tablets following surgery to prevent blood clots. Page 12 of 62

14 This class is also known by these names: THROMBO PROPHYLAXIS REGIME Attributes of this Class are: K THROMBO PROPHYLAXIS REGIME TYPE Each THROMBO PROPHYLAXIS REGIME must be related to one and only one JOINT REPLACEMENT SURGERY CARE PROFESSIONAL INVOLVEMENT ROLE Change to Attribute: CARE PROFESSIONAL INVOLVEMENT ROLE Identifies the role undertaken by a HEALTH CARE PROFESSIONAL during a CLINICAL INTERVENTION. Classifications: a. Performs the procedure b. General Anaesthesia Administrator c. Local Anaesthesia Administrator d. Assists the procedure CARE PROFESSIONAL INVOLVEMENT ROLES CEMENT GUN USED Change to Attribute: CEMENT GUN USED Page 13 of 62

15 An indicator to show whether a cementing gun has been used for the fitting of a joint IMPLANT, during HIP REPLACEMENT SURGERY. 1 Yes 2 No CEMENT GUNS USED CEMENT MIXING SYSTEM Change to Attribute: CEMENT MIXING SYSTEM An indicator to identify the cement mixing system used for the fitting of a joint IMPLANT (to make the cement required to fit in place a prosthesis), during HIP REPLACEMENT SURGERY. 01 Open bowl and spatula 02 Vacuum Mixing CEMENT MIXING SYSTEMS CEMENT PRESSURISER USED Change to Attribute: CEMENT PRESSURISER USED Page 14 of 62

16 An indicator to show whether a cementing pressuriser has been used for the fitting of a joint IMPLANT, during HIP REPLACEMENT SURGERY. 1 Yes 2 No CEMENT PRESSURISERS USED GRADE OF RESPONSIBLE HCP Change to Attribute: Change to Description The grade of the operating surgeon. National codes: 1 Consultant 2 Associate Specialist 3 Staff grade/clinical assistant 4 Specialist Registrar (SPR) 5 Senior House Officer (SHO) 6 House Officer (HO) 7 Other 7 Other Medical 8 Non medically qualified practitioner National Cancer Data Set Version 1.3_ISB October 2002 GRADES_OF_RESPONSIBLE_HCP HIP CEMENTING TECHNIQUE TYPE Page 15 of 62

17 Change to Attribute: HIP CEMENTING TECHNIQUE TYPE An identifier for the cementing technique type used during HIP REPLACEMENT SURGERY. 01 Acetabular 02 Femoral HIP CEMENTING TECHNIQUE TYPES HIP REPLACEMENT BONEGRAFT Change to Attribute: HIP REPLACEMENT BONEGRAFT An indicator to show whether a bonegraft has been used during HIP REPLACEMENT SURGERY. 01 Acetabular only 02 Femoral only 03 Both 04 Neither HIP REPLACEMENT BONEGRAFTS HIP SURGERY INCISION TYPE

18 Change to Attribute: HIP SURGERY INCISION TYPE An identifier for an incision type used in a surgical approach, during HIP REPLACEMENT SURGERY. 01 Anterior/Antero-Lateral/Lateral 02 Posterior HIP SURGERY INCISION TYPES HIP SURGERY PATIENT POSITION Change to Attribute: HIP SURGERY PATIENT POSITION An identifier for a patient position used in a surgical approach, during HIP REPLACEMENT SURGERY. 01 Lateral 02 Supine HIP SURGERY PATIENT POSITIONS HIP SURGERY TROCHANTER INDICATOR Change to Attribute:

19 HIP SURGERY TROCHANTER INDICATOR An identifier as to whether a trochanteric osteotomy was used in a surgical approach, during HIP REPLACEMENT SURGERY. 1 Yes 2 No HIP SURGERY TROCHANTER INDICATORS IMAGE GUIDED SURGERY INDICATOR Change to Attribute: IMAGE GUIDED SURGERY INDICATOR An identifier for the presence of image guided surgery during JOINT REPLACEMENT SURGERY. 1 Yes 2 No IMAGE GUIDED SURGERY INDICATORS IMPLANT BATCH OR LOT NUMBER Change to Attribute: IMPLANT BATCH OR LOT NUMBER

20 Identifies the IMPLANT BATCH OR LOT NUMBER of an IMPLANT. IMPLANT BATCH OR LOT NUMBERS IMPLANT CATALOGUE NUMBER Change to Attribute: IMPLANT CATALOGUE NUMBER Identifies the IMPLANT CATALOGUE NUMBER of an IMPLANT. IMPLANT CATALOGUE NUMBERS IMPLANT CLASSIFICATION CODE Change to Attribute: IMPLANT CLASSIFICATION CODE Identifies the IMPLANT CLASSIFICATION CODE of an IMPLANT.

21 IMPLANT CLASSIFICATION CODES IMPLANT MANUFACTURER Change to Attribute: IMPLANT MANUFACTURER Identifies the IMPLANT MANUFACTURER of an IMPLANT. National codes: 01 ApaTech Products 02 Avatar 03 B Braun / Aesculap 04 Biomet 05 Centerpulse 06 Corin 07 DePuy 08 Endo Plus (UK) Limited 09 Finsbury 10 Intavent - Orthofix 11 Joint Replacement Instrumentation Ltd 12 Midland Medical Technologies Ltd 13 Orthodynamics 14 Plato Health Systems 15 Schering-Plough 16 Smith & Nephew 17 Sovereign Medical 18 Stryker Howmedica Osteonics 19 Summit Medical 20 Waldemar Link 21 Wright Cremascoli Ortho 22 Zimmer 23 Zynergy Orthopaedics 90 Other IMPLANT MANUFACTURERS

22 IMPLANT MODEL Change to Attribute: IMPLANT MODEL Identifies the IMPLANT MODEL of an IMPLANT. INTERPRETER REQUIRED INDICATOR Change to Attribute: INTERPRETER REQUIRED INDICATOR Identifies whether an interpreter is required for the purposes of communication between a HEALTH CARE PROFESSIONAL and a PATIENT, during a course of treatment. Classification: a. Yes b. No INTERPRETER REQUIRED INDICATOR JOINT IMPLANT REVISION INDICATOR Change to Attribute: JOINT IMPLANT REVISION INDICATOR Identifies whether the revision of a joint IMPLANT is required, on the basis of a JOINT IMPLANT REVISION REASON 1 Yes 2 No

23 JOINT IMPLANT REVISION INDICATORS JOINT IMPLANT REVISION REASON Change to Attribute: JOINT IMPLANT REVISION REASON Identifies the reason why a hip or knee joint IMPLANT needs revising. Hip and Knee 01 Aseptic loosening 02 Dislocation/subluxation 03 Incorrect sizing 04 Infection 05 Lysis 06 Malalignment 07 Pain 08 Periprosthetic fracture 09 Wear of polyethylene component 90 Other Hip only 10 Implant fracture - acetabulum 11 Implant fracture - femoral head 12 Implant fracture - stem Knee only 13 Implant fracture - femoral 14 Implant fracture - patella 15 Implant fracture - tibial 16 Instability 17 Patella maltracking 18 Wear of patella 19 Wear of tibia

24 JOINT IMPLANT REVISION REASONS JOINT REPLACEMENT ANATOMICAL SIDE Change to Attribute: JOINT REPLACEMENT ANATOMICAL SIDE An identifier for the side of the body where a JOINT REPLACEMENT SURGERY took place. 01 Left 02 Right JOINT REPLACEMENT ANATOMICAL SIDE JOINT REPLACEMENT PRIMARY OR REVISION Change to Attribute: JOINT REPLACEMENT PRIMARY OR REVISION An indicator that identifies whether a joint IMPLANT is a primary or revision joint replacement. 01 Primary Joint Replacement 02 Revision Joint Replacement JOINT REPLACEMENTS PRIMARY OR REVISION

25 JOINT REPLACEMENT REVISION NUMBER Change to Attribute: JOINT REPLACEMENT REVISION NUMBER This is the sequential number of a JOINT REPLACEMENT SURGERY; where the procedure is a revision, for example, one for first revision, two for second revision and so on and so forth. JOINT REPLACEMENT REVISION NUMBER KNEE REPLACEMENT CEMENT INDICATOR Change to Attribute: KNEE REPLACEMENT CEMENT INDICATOR An indicator that identifies whether cement was used to fit in place an IMPLANT during KNEE REPLACEMENT SURGERY. 1 Yes 2 No KNEE REPLACEMENT CEMENT INDICATOR KNEE SURGERY FAT PAD REMOVED

26 Change to Attribute: KNEE SURGERY FAT PAD REMOVED An indicator that identifies whether a fat pad has been removed or has been partially removed, during KNEE REPLACEMENT SURGERY. 01 Yes, fully 02 Yes, partially 03 No KNEE SURGERIES FAT PAD REMOVED KNEE SURGERY SKIN INCISION METHOD Change to Attribute: KNEE SURGERY SKIN INCISION METHOD An indicator that identifies the knee to skin incision method used during KNEE REPLACEMENT SURGERY. 01 Midline 02 Medial 03 Lateral KNEE SURGERIES SKIN INCISION METHOD KNEE SURGERY SURGICAL APPROACH

27 Change to Attribute: KNEE SURGERY SURGICAL APPROACH An indicator that identifies the surgical approach used during KNEE REPLACEMENT SURGERY. 01 Lateral Parapatellar 02 Medial Parapatellar 03 Sub-vastus 09 Other KNEE SURGERIES SURGICAL APPROACH KNEE SURGERY TOURNIQUET USED Change to Attribute: KNEE SURGERY TOURNIQUET USED Identifies whether a tourniquet was used during KNEE REPLACEMENT SURGERY. 1 Yes 2 No KNEE SURGERY TOURNIQUETS USED LAMINAR FLOW SYSTEM INDICATOR

28 Change to Attribute: LAMINAR FLOW SYSTEM INDICATOR Identifies the presence of a laminar flow system in an OPERATING THEATRE. 1 Yes 2 No LAMINAR FLOW SYSTEM INDICATOR LANGUAGE USAGE Change to Attribute: LANGUAGE USAGE Identifies whether the usage of a LANGUAGE is 'preferred for follow-up' and also, if a LANGUAGE is identified by the PATIENT as an 'other preferred' LANGUAGE for the purposes of follow-up. Note: The PATIENT could indicate a 'preferred' LANGUAGE for a follow-up, but could also indicate an 'other' preferred LANGUAGE for the purposes of a follow-up. 01 preferred for follow-up 02 'other' preferred for follow-up LANGUAGE USAGES

29 LOCUM INDICATOR Change to Attribute: LOCUM INDICATOR Identifies whether the lead HEALTH CARE PROFESSIONAL responsible for the determination of the treatment plan for the PATIENT is a locum. 1 Yes, a locum 2 No, not a locum LOCUM INDICATORS MINIMALLY INVASIVE SURGERY INDICATOR Change to Attribute: MINIMALLY INVASIVE SURGERY INDICATOR Identifies whether minimally invasive surgery was used during JOINT REPLACEMENT SURGERY. 1 Yes 2 No MINIMALLY INVASIVE SURGERY INDICATOR OVERSEAS SURGICAL TEAM MEMBER

30 Change to Attribute: OVERSEAS SURGICAL TEAM MEMBER This identifies whether a lead operating surgeon or first assistant is part of a non-uk visiting surgical team. 1 Yes 2 No OVERSEAS SURGICAL TEAM MEMBERS PATIENT DIAGNOSIS IMPLANT INDICATION Change to Attribute: PATIENT DIAGNOSIS IMPLANT INDICATION An indication that a PATIENT requires an IMPLANT as a result of a PATIENT DIAGNOSIS. Please note that other ICD-10 codes can be used only where applicable. Examples are: Hip and Knee M05 Seropositive rheumatoid arthritis M06.0 Seronegative rheumatoid arthritis M87 Osteonecrosis T84.1 Mechanical complication of internal fixation device of bones of limb Hip M16 Coxarthrosis [arthrosis of hip] M16.3 Other dysplastic coxarthrosis M16.5 Other post-traumatic coxarthrosis S72.0 Fracture of neck of femur S79 Other and unspecified injuries of hip and thigh Knee M17 Gonarthosis [arthrosis of knee] M17.3 Other post-traumatic gonarthrosis S83 Dislocation, sprain and strain of joints and ligaments of knee

31 PATIENT DIAGNOSIS IMPLANT INDICATIONS PATIENT PHYSICAL STATUS Change to Attribute: PATIENT PHYSICAL STATUS Identifies the physical status of the PATIENT as recorded by an anaesthetist for an operative procedure. This is an abbreviated version of the American Society of Anaesthesiologists Physical Status grading. 01 Fit and healthy 02 Mild disease; not incapacitating 03 Incapacitating systemic disease 04 Life threatening disease 05 Expected to die within 24hrs with or without an operation 06 A declared brain dead patient whose organs are being removed for donor purposes PATIENT PHYSICAL STATUS PATIENT PROCEDURE IMPLANT INDICATION Change to Attribute: PATIENT PROCEDURE IMPLANT INDICATION An indication that a PATIENT requires an IMPLANT as a result of a PATIENT PROCEDURE. Please note that other OPCS-4 codes can be used only where applicable. Examples are:

32 Hip Primary W37.1 Primary total prosthetic replacement of hip joint using cement W38.1 Primary total prosthetic replacement of hip joint not using cement W39.1 Primary total prosthetic replacement hip joint not elsewhere classified (eg hybrid) W58.1 Primary resurfacing arthroplasty of joint Hip revision W37.3 Revision of total prosthetic replacement of hip joint using cement W38.3 Revision of total prosthetic replacement of hip joint not using cement W39.3 Revision of total prosthetic replacement of hip joint not elsewhere classified (eg hybrid) W58.2 Revision of resurfacing arthroplasty of joint Knee primary W40.1 Primary total prosthetic replacement of knee joint using cement W41.1 Primary total prosthetic replacement of knee joint not using cement W42.1 Primary total prosthetic replacement knee joint not elsewhere classified (eg hybrid) W52.1 Primary prosthetic replacement of articulation of bone using cement nec Z84.4 Patellofemoral joint Z84.6 Knee joint Knee revision W40.3 Revision of total prosthetic replacement of knee joint using cement W41.3 Revision of total prosthetic replacement of knee joint not using cement W42.3 Revision of total prosthetic replacement of knee joint not elsewhere classified (eg hybrid) PATIENT PROCEDURE IMPLANT INDICATIONS PROSTHESIS CEMENTED Change to Attribute: PROSTHESIS CEMENTED An indicator to show whether a joint IMPLANT has been cemented during HIP REPLACEMENT SURGERY. 1 Yes 2 No

33 PROSTHESES CEMENTED PROSTHETIC DEVICE CODE Change to Attribute: PROSTHETIC DEVICE CODE A PROSTHETIC DEVICE code used to identify a PROSTHETIC DEVICE. PROSTHETIC DEVICE CODES PROSTHETIC DEVICE TYPE Change to Attribute: PROSTHETIC DEVICE TYPE Identifies the type of PROSTHETIC DEVICE. Classifications: a. IMPLANT

34 PROSTHETIC DEVICE TYPES PULSATILE LAVAGE Change to Attribute: PULSATILE LAVAGE Identifies where pulsatile lavage has been used during the cementing of a joint IMPLANT, during HIP REPLACEMENT SURGERY. 1 Yes 2 No PULSATILE LAVAGES SURGICAL DEFAULT TECHNIQUE INDICATOR Change to Attribute: SURGICAL DEFAULT TECHNIQUE INDICATOR An indicator to identify whether a default surgical technique has been used during JOINT REPLACEMENT SURGERY. 1 Yes 2 No

35 SURGICAL DEFAULT TECHNIQUE INDICATORS THROMBO PROPHYLAXIS REGIME TYPE Change to Attribute: THROMBO PROPHYLAXIS REGIME TYPE Identifies the type of THROMBO PROPHYLAXIS REGIME used as part of a PATIENT PROCEDURE. Chemical 01 Chemical - Aspirin 02 Chemical - Chloroquine 03 Chemical - Low Dose Heparin (LDH) 04 Chemical - Low Molecular Weight Heparin (LMWH) 05 Chemical - Pentasaccharide 06 Chemical - Warfarin 07 Chemical - Other (please specify) Mechanical 08 Mechanical - Foot Pump 09 Mechanical - Intermittent calf compression 10 Mechanical - TED Stockings 11 Mechanical - Other THROMBO PROPHYLAXIS REGIME TYPES TYPE OF ANAESTHETIC Change to Attribute: TYPE OF ANAESTHETIC Identifies the type of anaesthetic used during a PATIENT PROCEDURE. 01 General

36 02 Regional - epidural 03 Regional nerve block 04 Regional - spinal intrathecal TYPE OF ANAESTHETIC CEMENT GUN USED Change to Data Element: CEMENT GUN USED n1 CEMENT GUNS USED CEMENT MIXING SYSTEM Change to Data Element: CEMENT MIXING SYSTEM n2

37 CEMENT MIXING SYSTEMS CEMENT PRESSURISER USED Change to Data Element: CEMENT PRESSURISER USED n1 CEMENT PRESSURISERS USED HIP CEMENTING TECHNIQUE TYPE Change to Data Element: HIP CEMENTING TECHNIQUE TYPE n2

38 HIP CEMENTING TECHNIQUE TYPES HIP REPLACEMENT BONEGRAFT Change to Data Element: HIP REPLACEMENT BONEGRAFT n2 HIP REPLACEMENT BONEGRAFTS HIP SURGERY INCISION TYPE Change to Data Element: HIP SURGERY INCISION TYPE n2

39 HIP SURGERY INCISION TYPES HIP SURGERY PATIENT POSITION Change to Data Element: HIP SURGERY PATIENT POSITION n2 HIP SURGERY PATIENT POSITIONS HIP SURGERY TROCHANTER INDICATOR Change to Data Element: HIP SURGERY TROCHANTER INDICATOR n1 HIP SURGERIES TROCHANTER INDICATOR

40 IMAGE GUIDED SURGERY INDICATOR Change to Data Element: IMAGE GUIDED SURGERY INDICATOR n1 IMAGE GUIDED SURGERY INDICATORS IMPLANT BATCH OR LOT NUMBER Change to Data Element: IMPLANT BATCH OR LOT NUMBER an50 The IMPLANT BATCH OR LOT NUMBER of an IMPLANT. IMPLANT BATCH OR LOT NUMBERS

41 IMPLANT CATALOGUE NUMBER Change to Data Element: IMPLANT CATALOGUE NUMBER an100 The IMPLANT CATALOGUE NUMBER of an IMPLANT. IMPLANT CATALOGUE NUMBERS IMPLANT CLASSIFICATION CODE Change to Data Element: IMPLANT CLASSIFICATION CODE n4 See reference below NJR Centre, B329, Harwell, Didcot, OX11 0QJ IMPLANT CLASSIFICATION CODES

42 IMPLANT MANUFACTURER Change to Data Element: IMPLANT MANUFACTURER n2 IMPLANT MANUFACTURERS IMPLANT MODEL Change to Data Element: IMPLANT MODEL an255 The IMPLANT MODEL of an IMPLANT. IMPLANT MODELS JOINT IMPLANT REVISION INDICATOR

43 Change to Data Element: JOINT IMPLANT REVISION INDICATOR n1 JOINT IMPLANT REVISION INDICATORS JOINT IMPLANT REVISION REASON Change to Data Element: JOINT IMPLANT REVISION REASON n2 JOINT IMPLANT REVISION REASONS JOINT REPLACEMENT ANATOMICAL SIDE Change to Data Element:

44 JOINT REPLACEMENT ANATOMICAL SIDE n2 JOINT REPLACEMENT ANATOMICAL SIDES JOINT REPLACEMENT PRIMARY OR REVISION Change to Data Element: JOINT REPLACEMENT PRIMARY OR REVISION n2 JOINT REPLACEMENTS PRIMARY OR REVISION JOINT REPLACEMENT REVISION NUMBER Change to Data Element: JOINT REPLACEMENT REVISION NUMBER n2

45 JOINT REPLACEMENT REVISION NUMBERS KNEE REPLACEMENT CEMENT INDICATOR Change to Data Element: KNEE REPLACEMENT CEMENT INDICATOR n1 KNEE REPLACEMENT CEMENT INDICATORS KNEE SURGERY FAT PAD REMOVED Change to Data Element: KNEE SURGERY FAT PAD REMOVED n2

46 KNEE SURGERIES FAT PAD REMOVED KNEE SURGERY SKIN INCISION METHOD Change to Data Element: KNEE SURGERY SKIN INCISION METHOD n2 KNEE SURGERIES SKIN INCISION METHOD KNEE SURGERY SURGICAL APPROACH Change to Data Element: KNEE SURGERY SURGICAL APPROACH n2

47 KNEE SURGERIES SURGICAL APPROACH KNEE SURGERY TOURNIQUET USED Change to Data Element: KNEE SURGERY TOURNIQUET USED n1 KNEE SURGERIES TOURNIQUET USED LAMINAR FLOW SYSTEM INDICATOR Change to Data Element: LAMINAR FLOW SYSTEM INDICATOR n1

48 LAMINAR FLOW SYSTEM INDICATORS LANGUAGE Change to Data Element: LANGUAGE n3 LANGUAGES LANGUAGE USAGE Change to Data Element: LANGUAGE USAGE n2 LANGUAGE USAGES

49 LOCUM INDICATOR Change to Data Element: LOCUM INDICATOR n1 LOCUM INDICATORS MINIMALLY INVASIVE SURGERY INDICATOR Change to Data Element: MINIMALLY INVASIVE SURGERY INDICATOR n1 MINIMALLY INVASIVE SURGERY INDICATORS

50 OVERSEAS SURGICAL TEAM MEMBER Change to Data Element: OVERSEAS SURGICAL TEAM MEMBER n1 OVERSEAS SURGICAL TEAM MEMBERS PATIENT CONSENT TO RECORDING DATA Change to Data Element: PATIENT CONSENT TO RECORDING DATA n1 This data element is to be collected for the recording of data for the National Joint Registry only; on JOINT REPLACEMENT SURGERIES. 1 Yes 2 No PATIENT CONSENT TO RECORDING DATA

51 PATIENT DIAGNOSIS IMPLANT INDICATION Change to Data Element: PATIENT DIAGNOSIS IMPLANT INDICATION an5 PATIENT DIAGNOSIS IMPLANT INDICATIONS PATIENT PHYSICAL STATUS Change to Data Element: PATIENT PHYSICAL STATUS n2 PATIENT PHYSICAL STATUSES

52 PATIENT PROCEDURE IMPLANT INDICATION Change to Data Element: PATIENT PROCEDURE IMPLANT INDICATION an5 PATIENT PROCEDURE IMPLANT INDICATIONS PROSTHESIS CEMENTED Change to Data Element: PROSTHESIS CEMENTED n1 PROSTHESES CEMENTED PULSATILE LAVAGE

53 Change to Data Element: PULSATILE LAVAGE n1 PULSATILE LAVAGES SURGICAL DEFAULT TECHNIQUE INDICATOR Change to Data Element: SURGICAL DEFAULT TECHNIQUE INDICATOR n1 SURGICAL DEFAULT TECHNIQUE INDICATORS THROMBO PROPHYLAXIS REGIME TYPE Change to Data Element: THROMBO PROPHYLAXIS REGIME TYPE

54 n2 THROMBO PROPHYLAXIS REGIME TYPES TYPE OF ANAESTHETIC Change to Data Element: TYPE OF ANAESTHETIC n2 TYPES OF ANAESTHETIC NATIONAL JOINT REGISTRY DATA SET Change to Data Set (CDS, CMDS, HES): New Data Set (CDS, CMDS, HES) NJR MDS NATIONAL JOINT REGISTRY DATA SET Operations to be included in the NJR database

55 HIPS Primary Operations to include in the NJR Total joint replacement - i.e. replacement of the femoral head with a stemmed femoral prosthesis and the insertion of an acetabular cup Primary Revision With cement / Without cement Hip resurfacing - Resurfacing of the femoral head with surface replacement femoral prosthesis and insertion of an acetabular cup Revision of total joint replacement Revision HIPS KNEES Primary With cement / Without cement Revision of hip resurfacing Operations to exclude from the NJR Hemiarthroplasty - i.e. replacement of only the femoral head following fracture of the femoral neck) Operations to include in the NJR Total knee arthroplasty - i.e. replacement of both tibial and both femoral condyles with or without resurfacing of the patella Primary Primary Revision With cement / Without cement Unicondylar arthroplasty - i.e. replacement of one tibial condyl and one femoral condyl with or without resurfacing of the patella Patello-femoral replacement - i.e. where the femoral condyles are replaced and the patella is resurfaced Revision of total knee arthroplasty Revision Revision With cement / Without cement Revision of unicondylar arthroplasty Revision of patello-femoral replacement Note: "Re-operations excluding Revisions" - e.g. for dislocation, infection - are not specifically captured in Version Live MDS_v1 of the Dataset. Relevant procedures will be included in Live MDS_v2 following consultation with the NJR Steering Committee and the Regional Clinical Co-ordinators' Network. National Joint Registry Data Set - Data Element List Data Set data element Patient Details BIRTH DATE LANGUAGE LANGUAGE USAGE LOCAL PATIENT IDENTIFIER NHS NUMBER PATIENT CONSENT TO RECORDING DATA PATIENT FAMILY OR SURNAME PATIENT FORENAME OR PERSONAL NAME POSTCODE OF USUAL ADDRESS SEX Common Operation Details ADMINISTRATIVE CATEGORY LAMINAR FLOW SYSTEM INDICATOR

56 ORGANISATION CODE (LOCAL PATIENT IDENTIFIER) PATIENT PHYSICAL STATUS PROCEDURE DATE TYPE OF ANAESTHETIC Surgeon Details CONSULTANT CODE GRADE OF RESPONSIBLE HCP LOCUM INDICATOR OVERSEAS SURGICAL TEAM MEMBER Joint Specific Details IMPLANT BATCH OR LOT NUMBER IMPLANT CATALOGUE NUMBER IMPLANT CLASSIFICATION CODE IMPLANT MANUFACTURER IMPLANT MODEL JOINT IMPLANT REVISION INDICATOR JOINT IMPLANT REVISION REASON JOINT REPLACEMENT ANATOMICAL SIDE JOINT REPLACEMENT PRIMARY OR REVISION JOINT REPLACEMENT REVISION NUMBER ORGANISATION CODE (LOCAL PATIENT IDENTIFIER) PATIENT DIAGNOSIS IMPLANT INDICATION PATIENT PROCEDURE IMPLANT INDICATION PROCEDURE DATE SURGICAL DEFAULT TECHNIQUE INDICATOR Default Technique - Hips CEMENT GUN USED CEMENT MIXING SYSTEM CEMENT PRESSURISER USED HIP CEMENTING TECHNIQUE TYPE HIP SURGERY INCISION TYPE HIP SURGERY PATIENT POSITION HIP SURGERY TROCHANTER INDICATOR IMAGE GUIDED SURGERY INDICATOR MINIMALLY INVASIVE SURGERY INDICATOR PROSTHESIS CEMENTED PULSATILE LAVAGE THROMBO PROPHYLAXIS REGIME TYPE Default Technique - Knees IMAGE GUIDED SURGERY INDICATOR KNEE REPLACEMENT CEMENT INDICATOR KNEE SURGERY FAT PAD REMOVED KNEE SURGERY SKIN INCISION METHOD KNEE SURGERY SURGICAL APPROACH

57 KNEE SURGERY TOURNIQUET USED THROMBO PROPHYLAXIS REGIME TYPE CL010 PERSON OBSERVATIONS AND CHARACTERISTICS Change to Diagram: Change to Diagram Contents CL010 Person Observations and Characteristics

58 NJR1 NATIONAL JOINT REGISTRY - DATA COLLECTION Change to Diagram: New Diagram

59 NJR1 National Joint Registry - Data Collection

60

61 NJR1 NATIONAL JOINT REGISTRY DATA SET 1 Change to Diagram: New Diagram NJR1 National Joint Registry Data Set 1 DATA SETS DIAGRAM MIDDLE PANE Change to Supporting Information: Change to Supporting Information Data Set Diagrams Cancer Data Set Diagrams Mental Health Data Set Diagram

62 No reference found for this link NATIONAL JOINT REGISTRY DIAGRAM Change to Supporting Information: New Supporting Information National Joint Registry Diagram National Joint Registry Data Set Diagram NATIONAL JOINT REGISTRY DIAGRAM CLASS DEFINITIONS Change to Supporting Information: New Supporting Information National Joint Registry Diagram Class Definitions The National Joint Registry Data Set is represented by diagrams which contain the class types and their relationships that are required to support the National Joint Registry Data Set. By clicking on a class box on the diagram opposite, the selected class definition will display. Any text within the displayed definition which is in blue, uppercase and underlined is the name of an class or an attribute and if clicked on will display the definition for the class or attribute. NJR DATA SET OVERVIEW Change to Supporting Information: New Supporting Information National Joint Registry Data Set Overview National Joint Registry Data Set - Overview About the National Joint Registry: Hip and knee joints comprise the largest number of joint replacements used in the UK and both are subject to a high proliferation of different implant types that commonly lack data on their long-term effectiveness. The NJR is a keystone to delivering the commitment of both the Department of Health and the Welsh Assembly Government to improve the health and wellbeing of the population and is a vital tool for improving clinical standards for hip and knee replacements. It will benefit patients, clinicians and the orthopaedic industry. At the heart of the NJR is a database of information collected from all the hip and knee replacement procedures in England and Wales.

63 Is the NJR Compulsory? If a hospital is in an NHS Trust, then they are expected by ministers to comply. If the hospital is Independent, then the NJR is compulsory and enforced by the National Care Standards Commission. Further Information: Further information on the background to the National Joint Registry can be found in the summary of a consultation exercise, which can be accessed on the Department of Health website. National Joint Registry website: The National Joint Registry website is available at: There is also a frequently asked questions page within the NJR website, at: NATIONAL JOINT REGISTRY DATA SET Change to Package: New Package NATIONAL JOINT REGISTRY DATA COLLECTION Change to Package: New Package Note, this package has a fully qualified name of: Change_Packages.CP323.Data_Dictionary.Diagrams.Model_View.National_Joint_Registry_Data_Collec NATIONAL JOINT REGISTRY DATA SET Change to Package: New Package Note, this package has a fully qualified name of: Change_Packages.CP323.Data_Dictionary.Messages.National_Joint_Registry Data_Set.National_Join Please send enquiries about this DSCN to the mailbox of the Data and Information Standards Programme:- disp@nhsia.nhs.uk or contact Alison Parsons of the Data and Information Standards Programme on: tel: