Advance Care Planning (PZP)
1.0.0-rc1 - trial-use
Advance Care Planning (PZP)
1.0.0-rc1 - trial-use
Advance Care Planning (PZP), published by IKNL. This guide is not an authorized publication; it is the continuous build for version 1.0.0-rc1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IKNL/PZP-FHIR-R4/ and changes regularly. See the Directory of published versions
| Official URL: https://api.iknl.nl/docs/pzp/r4/Questionnaire/ACP-zib2020 | Version: 1.0.0-rc1 | |||
| Draft as of 2025-10-31 | Computable Name: ACPzib2020 | |||
Copyright/Legal: This form is subject to copyright, user rights and a disclaimer, as specified for all IKNL information standards. For details, see the paragraph on Gebruikersrechten en disclaimer at https://iknl.nl/onderzoek/eenheid-van-taal. |
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This form was developed to clearly document agreements resulting from the advance care planning (ACP) process. It is NOT a checklist. It can only be completed by a healthcare provider after a professional and nuanced conversation. For advice on conducting these conversations, please refer to the guideline for proactive care planning in the palliative phase and Palliaweb, see https://palliaweb.nl/zorgpraktijk/proactieve-zorgplanning. Enter 'unknown' if a topic is not discussed or if the patient does not (yet) have an opinion.When transferring to a long-term care setting, consider adding conversation records about advance care planning (ACP) to the transfer documents.
This form was developed to clearly document agreements resulting from the advance care planning (ACP) process.
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  ACPzib2020 | This form was developed to clearly document agreements resulting from the advance care planning (ACP) process. It is NOT a checklist. It can only be completed by a healthcare provider after a professional and nuanced conversation. For advice on conducting these conversations, please refer to the guideline for proactive care planning in the palliative phase and Palliaweb, see https://palliaweb.nl/zorgpraktijk/proactieve-zorgplanning. Enter 'unknown' if a topic is not discussed or if the patient does not (yet) have an opinion.When transferring to a long-term care setting, consider adding conversation records about advance care planning (ACP) to the transfer documents. | Questionnaire | https://api.iknl.nl/docs/pzp/r4/Questionnaire/ACP-zib2020#1.0.0-rc1 | ||
  963 | Datum van invullen | 0..1 | dateTime | ||
 7 | Naam patiënt | 0..1 | group | ||
  964 | Voornamen | 0..1 | string | ||
| 965 | Voorvoegsels | 0..1 | string | ||
 966 | Achternaam | 0..1 | string | ||
| 967 | Geboortedatum patiënt | 0..1 | dateTime | ||
| 8 | Gesprek gevoerd door: | 0..1 | group | ||
| 16 | Naam zorgverlener | 0..1 | group | ||
| 968 | Voornamen | 0..1 | string | ||
| 969 | Voorvoegsels | 0..1 | string | ||
| 970 | Achternaam | 0..1 | string | ||
 1405 | Functie (Specialisme) | 0..1 | choice | Options: 6 options | |
| 26 | 1.. Wilsbekwaamheid & Wettelijke vertegenwoordiging | 0..1 | group | ||
| 1406 | Is de patiënt op dit moment wilsbekwaam m.b.t. medische behandelbeslissingen? | 0..1 | choice | Options: 2 options | |
| 1407 | Toelichting | 0..1 | string | ||
| 29 | Bij wilsonbekwaamheid m.b.t. medische behandelbeslissingen is/wordt de wettelijke vertegenwoordiger: | 0..1 | group | ||
 30 | a). Naam wettelijk vertegenwoordiger | 0..1 | group | ||
| 973 | Voornamen | 0..1 | string | ||
| 974 | Voorvoegsels | 0..1 | string | ||
| 975 | Achternaam | 0..1 | string | ||
| 39 | b). Contactgegevens wettelijk vertegenwoordiger | 0..1 | group | ||
| 40 | Telefoonnummers | 0..* | group | ||
| 976 | Telefoonnummer | 0..1 | string | ||
| 977 | TelecomType | 0..1 | choice | Options: 4 options | |
| 978 | NummerSoort | 0..1 | choice | Options: 3 options | |
| 979 | Toelichting | 0..1 | string | ||
| 41 | EmailAdressen | 0..* | group | ||
| 980 | EmailAdres | 0..1 | string | ||
| 981 | EmailSoort | 0..1 | choice | Options: 2 options | |
| 982 | c). Relatie tot patiënt (1) | 0..* | choice | Options: 6 options | |
| 411 | Anders, namelijk: | 0..1 | string | Enable When: 982 = | |
| 983 | c). Relatie tot patiënt (2) | 0..1 | choice | Options: 10 options | |
| 408 | Anders, namelijk: | 0..1 | string | Enable When: 983 = | |
| 984 | d). Is de wettelijk vertegenwoordiger ook de eerste contactpersoon? | 0..1 | choice | Options: 2 options | |
| 53 | e). Naam eerste contactpersoon | 0..1 | group | Enable When: 984 = | |
| 985 | Voornamen | 0..1 | string | ||
| 986 | Voorvoegsels | 0..1 | string | ||
| 987 | Achternaam | 0..1 | string | ||
| 61 | f). Contactgegevens eerste contactpersoon | 0..1 | group | Enable When: 984 = | |
| 62 | Telefoonnummers | 0..* | group | ||
| 988 | Telefoonnummer | 0..1 | string | ||
| 989 | TelecomType | 0..1 | choice | Options: 4 options | |
| 990 | NummerSoort | 0..1 | choice | Options: 3 options | |
| 991 | Toelichting | 0..1 | string | ||
| 66 | EmailAdressen | 0..* | group | ||
| 992 | EmailAdres | 0..1 | string | ||
| 993 | EmailSoort | 0..1 | choice | Options: 2 options | |
| 995 | g). Relatie tot patiënt | 0..1 | choice | Enable When: 984 = Options: 10 options | |
| 412 | Anders, namelijk: | 0..1 | string | Enable When: 995 = | |
| 78 | 2. Gesprek gevoerd in bijzijn van | 0..1 | group | ||
| 82 | Patiënt | 0..1 | choice | Options: 1 option | |
| 997 | Rol | 0..* | choice | Options: 4 options | |
| 414 | Anders, namelijk: | 0..1 | string | ||
| 998 | Relatie tot patiënt | 0..* | choice | Options: 10 options | |
| 413 | Anders, namelijk: | 0..1 | string | Enable When: 998 = | |
| 586 | 3.. Belangrijkste overeengekomen doel van medisch beleid | 0..1 | group | ||
| 1408 | Belangrijkste doel van behandeling ([MetingNaam]) | 0..1 | choice |  | Options: 1 option |
| 999 | Doel ([MetingWaarde]) | 0..1 | choice | Options: 4 options | |
| 83 | 4.. Behandelgrenzen | 0..1 | group | ||
| 1409 | a). Reanimatie | 0..1 | group | ||
| 1410 | Behandeling | 0..1 | choice | | Options: 1 option |
| 1386 | BehandelBesluit | 0..1 | choice | Options: 4 options | |
| 1001 | SpecificatieAnders | 0..1 | string | Enable When: 1386 = | |
| 1002 | Toelichting | 0..1 | string | ||
| 1411 | b). Kunstmatige invasieve beademing | 0..1 | group | ||
| 1412 | Behandeling | 0..1 | choice | | Options: 1 option |
| 1387 | BehandelBesluit | 0..1 | choice | Options: 4 options | |
| 1388 | SpecificatieAnders | 0..1 | string | Enable When: 1387 = | |
| 1389 | Toelichting | 0..1 | string | ||
| 1413 | c). Opname op intensive care | 0..1 | group | ||
| 1414 | Behandeling | 0..1 | choice | | Options: 1 option |
| 1390 | BehandelBesluit | 0..1 | choice | Options: 4 options | |
| 1391 | SpecificatieAnders | 0..1 | string | Enable When: 1390 = | |
| 1392 | Toelichting | 0..1 | string | ||
| 1415 | d). Opname in ziekenhuis | 0..1 | group | ||
| 1416 | Behandeling | 0..1 | choice | | Options: 1 option |
| 1393 | BehandelBesluit | 0..1 | choice | Options: 4 options | |
| 1394 | SpecificatieAnders | 0..1 | string | Enable When: 1393 = | |
| 1395 | Toelichting | 0..1 | string | ||
| 1417 | e). Behandeling met antibiotica | 0..1 | group | ||
| 1418 | Behandeling | 0..1 | choice | | Options: 1 option |
| 1396 | BehandelBesluit | 0..1 | choice | Options: 4 options | |
| 1397 | SpecificatieAnders | 0..1 | string | Enable When: 1396 = | |
| 1398 | Toelichting | 0..1 | string | ||
| 1419 | f). Toediening van een bloedproduct | 0..1 | group | ||
| 1420 | Behandeling | 0..1 | choice | | Options: 1 option |
| 1399 | BehandelBesluit | 0..1 | choice | Options: 4 options | |
| 1400 | SpecificatieAnders | 0..1 | string | Enable When: 1399 = | |
| 1401 | Toelichting | 0..1 | string | ||
| 1421 | g). Overige behandelgrenzen | 0..1 | group | ||
| 1422 | Behandeling | 0..1 | open-choice | | Options: 1 option |
| 1402 | BehandelBesluit | 0..1 | choice | Options: 3 options | |
| 1404 | Toelichting | 0..1 | string | ||
| 1006 | h). Heeft de patiënt een ICD? | 0..1 | choice | Options: 3 options | |
| 1008 | ProductType van ICD | 0..1 | choice | Enable When: 1006 = Options: 1 option | |
| 1009 | Toelichting | 0..1 | string | Enable When: 1006 = | |
| 1425 | i). Is er een afspraak over het moment van uitzetten ICD? | 0..1 | group | Enable When: 1006 = | |
| 1426 | Behandeling van uitzetten ICD (Behandeling) | 0..1 | choice | | Options: 1 option |
| 1005 | Afspraak uitzetten ICD (BehandelBesluit) | 0..1 | choice | Enable When: 1006 = Options: 3 options | |
| 1010 | Toelichting gemaakte afspraken | 0..1 | string | ||
| 107 | 5.. Behandelwensen | 0..1 | group | ||
| 1427 | a). Wat zouden zorgverleners, volgens de patiënt, moeten weten om goede zorg te kunnen verlenen? Heeft deze patiënt specifieke wensen met betrekking tot zijn zorg? (incl. culturele/religieuze/sociale/spirituele aspecten) | 0..1 | group | ||
| 1428 | Wens en verwachting patient ([MetingNaam]) | 0..1 | choice | | Options: 1 option |
| 1190 | Wens en verwachting patient ([MetingWaarde]) | 0..1 | string | ||
| 1429 | b). Gewenste plek van overlijden | 0..1 | group | ||
| 1430 | Gewenste plek van overlijden ([MetingNaam]) | 0..1 | choice | | Options: 1 option |
| 1191 | Voorkeursplek ([MetingWaarde]) | 0..1 | choice | Options: 6 options | |
| 1192 | Toelichting | 0..1 | string | ||
| 1431 | c). Euthanasie standpunt | 0..1 | group | ||
| 1432 | Euthanasie standpunt ([MetingNaam]) | 0..1 | choice | | Options: 1 option |
| 1193 | Euthanasie standpunt ([MetingWaarde]) | 0..1 | choice | Options: 4 options | |
| 1194 | Toelichting | 0..1 | string | ||
| 1433 | d). Keuze orgaandonatie vastgelegd in donorregister? | 0..1 | group | ||
| 1434 | Keuze orgaandonatie vastgelegd in donorregister? ([MetingNaam]) | 0..1 | choice | | Options: 1 option |
| 1435 | Keuze orgaandonatie in donorregister ([MetingWaarde]) | 0..1 | choice | Options: 3 options | |
| 598 | 6.. Wat verder nog belangrijk is | 0..1 | group | ||
| 1436 | Wat verder nog belangrijk is ([MetingNaam]) | 0..1 | choice | | Options: 1 option |
| 1196 | Wat verder nog belangrijk is ([MetingWaarde]) | 0..1 | string | ||
| 115 | 7.. Eerder vastgelegde behandelwensen | 0..1 | group | ||
| 1197 | a). Heeft de patiënt eerder behandelafspraken vastgelegd? | 0..1 | choice | Options: 3 options | |
| 1198 | Toelichting | 0..1 | string | ||
| 1199 | b). Staan in eerder vastgelegde behandelafspraken andere wensen dan nu in deze verklaring? | 0..1 | choice | Enable When: 1197 = Options: 3 options | |
| 119 | 8.. Informatie delen | 0..1 | group | ||
| 1200 | a). Heeft u patient geïnformeerd over eigen verantwoordelijkheid om deze behandelafspraken met naasten te bespreken? | 0..1 | choice | Options: 2 options | |
| 1201 | b). Patiënt gaat akkoord met het delen van deze behandelafspraken met andere betrokken hulpverleners | 0..1 | choice | Options: 2 options | |
| Documentation for this format | |||||
Options Sets
Answer options for 1405
Answer options for 1406
Answer options for 977
Answer options for 978
Answer options for 981
Answer options for 982
Answer options for 983
Answer options for 984
Answer options for 989
Answer options for 990
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Answer options for 995
Answer options for 82
Answer options for 997
Answer options for 998
Answer options for 1408
Answer options for 999
Answer options for 1410
Answer options for 1386
Answer options for 1412
Answer options for 1387
Answer options for 1414
Answer options for 1390
Answer options for 1416
Answer options for 1393
Answer options for 1418
Answer options for 1396
Answer options for 1420
Answer options for 1399
Answer options for 1422
Answer options for 1402
Answer options for 1006
Answer options for 1008
Answer options for 1426
Answer options for 1005
Answer options for 1428
Answer options for 1430
Answer options for 1191
Answer options for 1432
Answer options for 1193
Answer options for 1434
Answer options for 1435
Answer options for 1436
Answer options for 1197
Answer options for 1199
Answer options for 1200
Answer options for 1201