Advance Care Planning (PZP)
1.0.0-rc2 - 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-rc2 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-rc2 | |||
| Draft as of 2026-06-02 | 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 advance 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![]() |
|---|---|---|---|---|---|
![]() | 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 advance 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-rc2 | ||
![]() ![]() | Datum van invullen | 0..1 | dateTime | Value Set: | |
![]() ![]() | Naam patiënt | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Voornamen | 0..1 | string | Value Set: | |
![]() ![]() ![]() | Voorvoegsels | 0..1 | string | Value Set: | |
![]() ![]() ![]() | Achternaam | 0..1 | string | Value Set: | |
![]() ![]() | Geboortedatum patiënt | 0..1 | date | Value Set: | |
![]() ![]() | Gesprek gevoerd door: | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Naam zorgverlener | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Voornamen | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() | Voorvoegsels | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() | Achternaam | 0..1 | string | Value Set: | |
![]() ![]() ![]() | Functie (Specialisme) | 0..1 | choice | Value Set: Options: 6 options | |
![]() ![]() | 1. Wilsbekwaamheid & Wettelijke vertegenwoordiging | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Is de patiënt op dit moment wilsbekwaam m.b.t. medische behandelbeslissingen? | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | Bij wilsonbekwaamheid m.b.t. medische behandelbeslissingen is/wordt de wettelijke vertegenwoordiger: | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | a). Naam wettelijk vertegenwoordiger | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() | Voornamen | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() | Voorvoegsels | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() | Achternaam | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() | b). Contactgegevens wettelijk vertegenwoordiger | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() | Telefoonnummers | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | Telefoonnummer | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | TelecomType | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() ![]() | NummerSoort | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() | EmailAdressen | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | EmailAdres | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | EmailSoort | 0..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() | c). Relatie tot patiënt (1) | 0..* | choice | Value Set: Options: 6 options | |
![]() ![]() ![]() ![]() ![]() | Anders, namelijk: | 0..1 | string | Enable When: 982 = Anders (COD472-VEKT Soort relatie cliënt#09) Value Set: | |
![]() ![]() ![]() ![]() | c). Relatie tot patiënt (2) | 0..1 | choice | Value Set: Options: 10 options | |
![]() ![]() ![]() ![]() ![]() | Anders, namelijk: | 0..1 | string | Enable When: 983 = Anders (v3 Code System NullFlavor#OTH) Value Set: | |
![]() ![]() ![]() ![]() | d). Is de wettelijk vertegenwoordiger ook de eerste contactpersoon? | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() | e). Naam eerste contactpersoon | 0..1 | group | Enable When: 984 = false Value Set: | |
![]() ![]() ![]() ![]() ![]() | Voornamen | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() | Voorvoegsels | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() | Achternaam | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() | f). Contactgegevens eerste contactpersoon | 0..1 | group | Enable When: 984 = false Value Set: | |
![]() ![]() ![]() ![]() ![]() | Telefoonnummers | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | Telefoonnummer | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | TelecomType | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() ![]() | NummerSoort | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() | EmailAdressen | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | EmailAdres | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() | EmailSoort | 0..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() | Rol | 0..1 | choice | Enable When: 984 = false Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | g). Relatie tot patiënt | 0..1 | choice | Enable When: 984 = false Value Set: Options: 10 options | |
![]() ![]() ![]() ![]() ![]() | Anders, namelijk: | 0..1 | string | Enable When: 995 = Anders (v3 Code System NullFlavor#OTH) Value Set: | |
![]() ![]() | 2. Gesprek gevoerd in bijzijn van | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Patiënt | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() | Rol | 0..* | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() | Anders, namelijk: | 0..1 | string | Value Set: | |
![]() ![]() ![]() | Relatie tot patiënt | 0..* | choice | Value Set: Options: 10 options | |
![]() ![]() ![]() ![]() | Anders, namelijk: | 0..1 | string | Enable When: 998 = Anders (v3 Code System NullFlavor#OTH) Value Set: | |
![]() ![]() | 3. Belangrijkste overeengekomen doel van medisch beleid | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Belangrijkste doel van behandeling ([MetingNaam]) | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() | Doel ([MetingWaarde]) | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() | 4. Behandelgrenzen | 0..1 | group | Value Set: | |
![]() ![]() ![]() | a). Reanimatie | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Behandeling | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | BehandelBesluit | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() | SpecificatieAnders | 0..1 | string | Enable When: 1386 = Anders (BehandelBesluiten#1) Value Set: | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | b). Kunstmatige invasieve beademing | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Behandeling | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | BehandelBesluit | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() | SpecificatieAnders | 0..1 | string | Enable When: 1387 = Anders (BehandelBesluiten#1) Value Set: | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | c). Opname op intensive care | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Behandeling | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | BehandelBesluit | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() | SpecificatieAnders | 0..1 | string | Enable When: 1390 = Anders (BehandelBesluiten#1) Value Set: | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | d). Opname in ziekenhuis | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Behandeling | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | BehandelBesluit | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() | SpecificatieAnders | 0..1 | string | Enable When: 1393 = Anders (BehandelBesluiten#1) Value Set: | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | e). Behandeling met antibiotica | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Behandeling | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | BehandelBesluit | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() | SpecificatieAnders | 0..1 | string | Enable When: 1396 = Anders (BehandelBesluiten#1) Value Set: | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | f). Toediening van een bloedproduct | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Behandeling | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | BehandelBesluit | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() | SpecificatieAnders | 0..1 | string | Enable When: 1399 = Anders (BehandelBesluiten#1) Value Set: | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | g). Overige behandelgrenzen | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Behandeling | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | BehandelBesluit | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | h). Heeft de patiënt een ICD? | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() | ProductType van ICD | 0..1 | choice | Enable When: 1006 = Ja (SNOMED CT#373066001) Value Set: Options: 6 options | |
![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Enable When: 1006 = Ja (SNOMED CT#373066001) Value Set: | |
![]() ![]() ![]() | i). Is er een afspraak over het moment van uitzetten ICD? | 0..1 | group | Enable When: 1006 = Ja (SNOMED CT#373066001) Value Set: | |
![]() ![]() ![]() ![]() | Behandeling van uitzetten ICD (Behandeling) | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | Afspraak uitzetten ICD (BehandelBesluit) | 0..1 | choice | Enable When: 1006 = Ja (SNOMED CT#373066001) Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() ![]() | Toelichting gemaakte afspraken | 0..1 | string | Value Set: | |
![]() ![]() | 5. Behandelwensen | 0..1 | group | Value Set: | |
![]() ![]() ![]() | 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 | Value Set: | |
![]() ![]() ![]() ![]() | Wens en verwachting patient ([MetingNaam]) | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | Wens en verwachting patient ([MetingWaarde]) | 0..1 | string | Value Set: | |
![]() ![]() ![]() | b). Gewenste plek van overlijden | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Gewenste plek van overlijden ([MetingNaam]) | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | Voorkeursplek ([MetingWaarde]) | 0..1 | choice | Value Set: Options: 6 options | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | c). Euthanasie standpunt | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Euthanasie standpunt ([MetingNaam]) | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | Euthanasie standpunt ([MetingWaarde]) | 0..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | d). Keuze orgaandonatie vastgelegd in donorregister? | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() | Keuze orgaandonatie vastgelegd in donorregister? ([MetingNaam]) | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() | Keuze orgaandonatie in donorregister ([MetingWaarde]) | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() | 6. Wat verder nog belangrijk is | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Wat verder nog belangrijk is ([MetingNaam]) | 0..1 | choice | Value Set: Options: 1 option | |
![]() ![]() ![]() | Wat verder nog belangrijk is ([MetingWaarde]) | 0..1 | string | Value Set: | |
![]() ![]() | 7. Eerder vastgelegde behandelwensen | 0..1 | group | Value Set: | |
![]() ![]() ![]() | a). Heeft de patiënt eerder behandelafspraken vastgelegd? | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() | Toelichting | 0..1 | string | Value Set: | |
![]() ![]() ![]() | b). Staan in eerder vastgelegde behandelafspraken andere wensen dan nu in deze verklaring? | 0..1 | choice | Enable When: 1197 = Ja (SNOMED CT#373066001) Value Set: Options: 3 options | |
![]() ![]() | 8. Informatie delen | 0..1 | group | Value Set: | |
![]() ![]() ![]() | a). Heeft u patient geïnformeerd over eigen verantwoordelijkheid om deze behandelafspraken met naasten te bespreken? | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() | b). Patiënt gaat akkoord met het delen van deze behandelafspraken met andere betrokken hulpverleners | 0..1 | choice | Value Set: Options: 2 options | |
Documentation for this format | |||||
Options Sets
Answer options for 1405
Answer options for 977
Answer options for 978
Answer options for 981
Answer options for 982
Answer options for 983
Answer options for 989
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Answer options for 1644
Answer options for 995
Answer options for 82
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Answer options for 1408
Answer options for 999
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Answer options for 1386
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Answer options for 1387
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Answer options for 1390
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Answer options for 1399
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Answer options for 1402
Answer options for 1006
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Answer options for 1426
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Answer options for 1428
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Answer options for 1191
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Answer options for 1193
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Answer options for 1197
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Answer options for 1201