0.2.2 - ci-build

FastAccessControl, published by MITRE. This guide is not an authorized publication; it is the continuous build for version 0.2.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/awatson1978/fhir-access-control-ig/ and changes regularly. See the Directory of published versions

Questionnaire: leap-polst (Experimental)

Official URL: http://34.94.253.50:8080/hapi-fhir-jpaserver/fhir/Questionnaire/leap-polst Version: 0.2.2
Active as of 1970-01-01 Computable Name:

Generated Narrative: Questionnaire leap-polst

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. Questionnairehttp://34.94.253.50:8080/hapi-fhir-jpaserver/fhir/Questionnaire/leap-polst#0.2.2
... 1A. Cardiopulmonary Resuscitation Orders - Follow these orders if patient has no pulse and is not breathing.0..1group
... 1.1YES CPR: Attempt Resuscitation, including mechanical ventilation, defibrillation and cardioversion. (Requires choosing Full Treatments in Section B)0..1boolean
... 1.2NO CPR: Do Not Attempt Resuscitation.</b> (May choose any option in Section B)0..1boolean
... 2B. Initial Treatment Orders - Follow these orders if patient has a pulse and/or is breathing.0..1group
... 2.1Full Treatments (required if choose CPR in Section A). Goal: Attempt to sustain life by all medically effective means. Provide appropriate medical and surgical treatments as indicated to attempt to prolong life, including intensive care.0..1boolean
... 2.2Selective Treatments. Goal: Attempt to restore function while avoiding intensive care and resuscitation efforts (ventilator, defibrillation and cardioversion). May use non-invasive positive airway pressure, antibiotics and IV fluids as indicated. Avoid intensive care. Transfer to hospital if treatment needs cannot be met in current location.0..1boolean
... 2.3Comfort-focused Treatments. Goal: Maximize comfort through symptom management; allow natural death. Use oxygen, suction and manual treatment of airway obstruction as needed for comfort. Avoid treatments listed in full or select treatments unless consistent with comfort goal. Transfer to hospital <b>only</b> if comfort cannot be achieved in current setting.0..1boolean
... 3C. Additional Orders or Instructions - These orders are in addition to those in section B (e.g., blood products, dialysis). [EMS protocols may limit emergency responder ability to act on orders in this section.]0..1string
... 4D. Medically Assisted Nutrition - (Offer food by mouth if desired by patient, safe and tolerated) 0..1group
... 4.1Provide feeding through new or existing surgically-placed tubes0..1boolean
... 4.2Trial period for artificial nutrition but no surgically-placed tubes0..1boolean
... 4.3No artificial means of nutrition desired0..1boolean
... 4.4Discussed but no decision made (standard of care provided)0..1boolean
... 5E. Signature: Patient or Patient Representative - I understand this form is voluntary. I have discussed my treatment options and goals of care with my provider. If signing as the patient’s representative, the treatments are consistent with the patient’s known wishes and in their best interest. The most recently completed valid POLST form supersedes allpreviously completed POLST forms.0..1group
... 5.1Patient signature acquired0..1boolean
... 5.2If other than patient, enter full name, and provide authority if any.0..1boolean
... 5.2.1Full Name0..1stringEnable When: 5.2 =
... 5.2.2Authority0..1stringEnable When: 5.2 =
... 6F. Signature: Health Care Provider - Verbal orders are acceptable with follow up signature. I have discussed this order with the patient or his/her representative. The orders reflect the patient’s known wishes, to the best of my knowledge. [Note: Only licensed health care providers authorized by law to sign POLST form in state where completed may sign this order] 0..1group
... 6.1Health care provider signature acquired0..1boolean
... 6.2Health care provider full name0..1string
... 6.3License/Certification #0..1string
... 6.4Supervising Physician Signature0..1group
... 6.4.1Not applicable0..1boolean
... 6.4.2Supervising signature acquired0..1booleanEnable When: 6.4.1 =
... 6.4.3License #0..1stringEnable When: 6.4.1 =
... 7Contact Information - Emergency Contact (Optional): Patient’s Emergency Contact. (Note: Listing a person here does NOT grant them authority to be a legal representative. Only an advance directive or state law can grant that authority.)0..1group
... 7.1Full Name0..1string
... 7.2Address0..1string
... 7.3Contact Type0..1group
... 7.3.1Legal representative0..1boolean
... 7.3.2Other contact type0..1boolean
... 7.4Day Phone Number0..1string
... 7.5Night Phone Number0..1string
... 8Contact Information - Primary Provider (Optional): Patient’s Emergency Contact.0..1group
... 8.1Primary Provider Name0..1string
... 8.2Phone Number0..1string
... 9Contact Information - Hospice Care (Optional)0..1group
... 9.1Patient is enrolled in Hospice0..1boolean
... 9.2Name of Agency0..1stringEnable When: 9.1 =
... 9.3Agency Phone Number0..1stringEnable When: 9.1 =
... 10Form Completion Info - Review(Optional): Reviewed patient’s advance directive to confirm no conflict with POLST orders: (A POLST form does not replace an advance directive or living will)0..1group
... 10.1Yes0..1boolean
... 10.2Date Reviewed0..1dateEnable When: 10.1 =
... 10.3Conflict exists, patient notified(if patient lacks capacity, noted in chart)0..1boolean
... 10.4Advance directive not available0..1boolean
... 10.5No Advance directive exists0..1boolean
... 11Form Completion Info - Participant Types(Optional)0..1group
... 11.1Patient with decision making capacity0..1boolean
... 11.2Legal surrogate/Health care agent0..1boolean
... 11.3Court appointed guardian0..1boolean
... 11.4Parent of minor0..1boolean
... 11.5Other0..1boolean
... 11.6List of others who participated0..1stringEnable When: 10.5 =
... 12Professional Assisting Health Care Provider w/ Form Completion (if applicable):0..1group
... 12.1Full Name0..1string
... 12.2Date Assisted0..1date
... 12.3Phone Number0..1string
... 12.4This individual is the patient’s:0..1group
... 12.4.1Social Worker0..1boolean
... 12.4.2Nurse0..1boolean
... 12.4.3Clergy0..1boolean
... 12.4.4Other0..1boolean
... 12.4.5Enter Type0..1stringEnable When: 12.4.4 =

doco Documentation for this format