ACP-zib2020
type: Questionnaire
node role: treeRoot
id:
  v: ACP-zib2020
text:
  status:
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  div:
    v: Generated Narrative: Questionnaire ACP-zib2020 Structure LinkID Text Cardinality Type Flags Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> 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 #xD; 963 Datum van invullen 0..1 dateTime #xD; 7 Naam patiënt 0..1 group #xD; 964 Voornamen 0..1 string #xD; 965 Voorvoegsels 0..1 string #xD; 966 Achternaam 0..1 string #xD; 967 Geboortedatum patiënt 0..1 dateTime #xD; 8 Gesprek gevoerd door: 0..1 group #xD; 16 Naam zorgverlener 0..1 group #xD; 968 Voornamen 0..1 string #xD; 969 Voorvoegsels 0..1 string #xD; 970 Achternaam 0..1 string #xD; 1405 Functie (Specialisme) 0..1 choice Options: 6 options #xD; 26 1.. Wilsbekwaamheid & Wettelijke vertegenwoordiging 0..1 group #xD; 1406 Is de patiënt op dit moment wilsbekwaam m.b.t. medische behandelbeslissingen? 0..1 choice Options: 2 options #xD; 1407 Toelichting 0..1 string #xD; 29 Bij wilsonbekwaamheid m.b.t. medische behandelbeslissingen is/wordt de wettelijke vertegenwoordiger: 0..1 group #xD; 30 a). Naam wettelijk vertegenwoordiger 0..1 group #xD; 973 Voornamen 0..1 string #xD; 974 Voorvoegsels 0..1 string #xD; 975 Achternaam 0..1 string #xD; 39 b). Contactgegevens wettelijk vertegenwoordiger 0..1 group #xD; 40 Telefoonnummers 0..* gro…
url:
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  l: ACP-zib2020
version:
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name:
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title:
  v: Uniform vastleggen proactieve zorgpanning advance care planning (ACP) o.b.v. zibs2020 - Beta3 28-08-2025
status:
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experimental:
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date:
  v: 2025-10-31T09:52:04+00:00
publisher:
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  v: 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.
purpose:
  v: This form was developed to clearly document agreements resulting from the advance care planning (ACP) process.
copyright:
  v: 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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    answer option:
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l: 2.16.840.1.113883.2.4.3.11.60.40.4.22.1

v: LL

v: Land Line

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v: Fax

v: MC

v: Mobiel telefoonnummer

v: PG

v: Pieper

v: HP

v: Telefoonnummer thuis

v: TMP

v: Tijdelijk telefoonnummer

v: WP

v: Zakelijk telefoonnummer

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v: Privé e-mailadres

v: WP

v: Zakelijk e-mailadres

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code:
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code:
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answer option:
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answer option:
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item:
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item:
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value: Coding
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value: Coding
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value: Coding
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value: Coding
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value: Coding
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value: Coding
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value: Coding
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link id:
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text:
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type:
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enable when:
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enable behavior:
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link id:
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link id:
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Coding
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v: Anders

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Coding
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code:
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v: 48767-8

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item:
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  code:
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    answer option:
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v: Gewenste plek van overlijden

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v: Thuis

v: 22232009

v: Ziekenhuis

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v: Verpleeghuis

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v: Hospice

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v: Standpunt ten opzichte van euthanasie (waarneembare entiteit)

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v: Geen euthanasieverklaring, zou wel verzoek kunnen doen in bepaalde situaties

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v: Nog onbekend

v: 48767-8

v: Keuze orgaandonatie vastgelegd in donorregister?

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v: false

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answer option:
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    code:
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    display:
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text:
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  type:
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  required:
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  repeats:
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v: drop-down

v: Drop down

link id:
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prefix:
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type:
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repeats:
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    v: a)
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      system:
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      code:
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      display:
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      system:
        v: http://snomed.info/sct
        l: sct
      code:
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      display:
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  answer option:
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      system:
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      system:
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text:
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    v: false
  repeats:
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  answer option:
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      code:
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item:
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  repeats:
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      code:
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        v: Nog onbekend