Prenatal Care: Anti-D Immune Globulin (NQF 0014)

eMeasure Name Prenatal Care: Anti-D Immune Globulin eMeasure Id 4E7D9934-2734-4CDD-8AF6-4D78632382B5
Version number 1 eMeasure Set Id 6C265136-1C62-40C8-B583-EE25C5A65A95
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward American Medical Association - Physician Consortium for Performance Improvement
Endorsed by National Quality Forum
Description Percentage of D(Rh) negative, unsensitized patients, regardless of age, who gave birth during a 12-month period who received anti-D immune globulin at 26-30 weeks gestation
Copyright
© 2010 American Medical Association.  All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
Rh sensitization is a serious complication of pregnancy that places the lives of both mother and child at risk. This complication can be avoided through the prophylactic administration of anti-D immune globulin.
Clinical Recommendation Statement
Antibody tests can be repeated in an unsensitized, D-negative patient at 26-28 weeks gestation. She should also receive anti-D immune globulin prophylactically at that time. In addition, any unsensitzed, D-negative patient should receive anti-D immune globulin if she has one of the following conditions or procedures:
• Ectopic gestation
• Abortion (either threatened, spontaneous, or induced)
• Procedure associated with possible fetal-to-maternal bleeding, such as chorionic villus sampling (CVS) or amniocentesis
• Condition associated with fetal-maternal hemorrhage (eg, abdominal trauma, abruptio placentae)
• Delivery of a D-positive newborn(AAP/ACOG)(LevelA)                                                                                                                                                                                              

The USPSTF recommends the repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24-28 weeks gestation, unless the biological father is known to be Rh (D)-negative (USPSTF) (B Recommendation).
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
American Academy of Pediatrics and American College of Obstetricians and Gynecologists. Guidelines for Prenatal Care, 5th Edition. Elk Grove Village, IL, AAP/ACOG, 2002.
Reference
A Brief Evidence Update for the U.S. Preventive Services Task Force. Available at: www.preventiveservices.ahrq.gov. Accessed November 2005.
Reference
US Preventive Services Task Force. Guide to Clinical Preventive Services. 3rd ed. Baltimore, Md: Williams amp; Wilkins; 2000-2002.
Reference
Prevention of Rh D Alloimmunization. ACOG Practice Bulletin. American College of Obstetricians and Gynecologists. Number 4, May 1999.
Definition
Initial Patient Population(s): 
Diagnosis Active: Documented diagnosis of pregnancy, delivered during the measurement period.   Procedure: Delivery during the measurement period.
Definition
Denominator(s): 
All patients, regardless of age, who are D (Rh) negative and unsensitized who gave birth during a 12-month period, seen for continuing prenatal care.
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): 
Patients who received anti-D immune globulin at 26-30 weeks gestation.
Definition
Denominator Exception(s): 
Documentation of medical reason(s) for patient not receiving anti-D immune globulin at 26-30 weeks gestation.  Documentation of patient reason(s) for patient not receiving anti-D immune globulin at 26-30 weeks gestation.  Documentation of system reason(s) for patient not receiving anti-D immune at 26-30 weeks gestation.
Guidance
The purpose of the data element "Estimated date of conception" <= 44 weeks starts before or during "Procedure, Performed: Delivery of Live Birth" is to establish the date when the pregnancy began.  We have included the timeframe of 44 weeks prior to the delivery date to link the estimated date of conception to the delivery that occurred during the measurement period (to ensure it isn't the estimated date of conception for a previous pregnancy).
Supplemental Data Elements
Report "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"; Report "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"; Report "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"; Report "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)".

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Supplemental Data Elements




Measure set CLINICAL QUALITY MEASURE SET 2011-2012