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DELIVERY ROOM DEATH FORM FOR INFANTS BORN IN 20211DO NOT mail or fax this form to the CCC Data Center. This for is form internal use ONLY.NETWORK ID:HOSPITAL ID:Any eligible inborn infant who dies

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How to fill out cpqcc drd form v18

01

Here is how you can fill out the CPQCC DRD Form V18:

02

Begin by entering the details of the facility and the patient at the top of the form.

03

Fill in the medical record number and the date of birth of the patient.

04

Provide information about the primary care physician and the date of admission.

05

Record the gestational age in weeks and the birth weight in grams.

06

Answer the questions related to the pregnancy and delivery, such as prenatal care, maternal complications, and mode of delivery.

07

Fill in the information about the baby's condition at birth, Apgar scores, and resuscitation details if applicable.

08

Provide details of any confirmed or suspected diagnoses related to the baby's condition.

09

Record information about the baby's hospital course, including any procedures, medications, and transfers.

10

Answer the questions related to the baby's feeding, growth, and follow-up care.

11

Finally, review the completed form for accuracy and sign it as the healthcare provider.

12

Remember to consult the guidelines provided by the California Perinatal Quality Care Collaborative (CPQCC) for further instructions.

Who needs cpqcc drd form v18?

01

The CPQCC DRD Form V18 is needed by healthcare providers, primarily those involved in perinatal care.

02

This form is used to document the details of a baby's perinatal course, including prenatal care, delivery, and postnatal care.

03

It helps in collecting data for research, quality improvement, and benchmarking purposes.

04

Healthcare facilities, hospitals, and academic institutions involved in perinatal care may require the CPQCC DRD Form V18 to gather standardized data and improve patient outcomes.

05

Additionally, this form can be used by researchers, epidemiologists, and statisticians studying perinatal health trends and outcomes.

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What is cpqcc drd form v18?

cpqcc drd form v18 is a data reporting form used by the California Perinatal Quality Care Collaborative (CPQCC) to collect information on obstetric deliveries.

Who is required to file cpqcc drd form v18?

Hospitals and healthcare facilities in California that provide obstetric care are required to file cpqcc drd form v18.

How to fill out cpqcc drd form v18?

To fill out cpqcc drd form v18, healthcare providers need to provide detailed information about obstetric deliveries, including maternal and neonatal outcomes.

What is the purpose of cpqcc drd form v18?

The purpose of cpqcc drd form v18 is to collect data on obstetric deliveries in order to monitor and improve the quality of perinatal care in California.

What information must be reported on cpqcc drd form v18?

Information reported on cpqcc drd form v18 includes details about prenatal care, labor and delivery, maternal health, neonatal health, and outcomes.

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