Logical model representing the nursing assessment questionnaire for home hospitalization patients receiving Trastuzumab. This questionnaire is filled in by the home nurse during each visit and exchanged as a FHIR QuestionnaireResponse with the hospital. Specific features: includes body weight, aftercare/reaction monitoring, and cardiac-focused contraindication checklist.

Nursing Assessment

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Storage

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Are there any remarks or concerns regarding the (proper) home storage of medication? (SNOMED 422413002) | Answers: 710977001 Medication stored correctly | 424363005 Concern about proper home storage

Specify remarks or concerns (conditional: if medicationStorageRemarks = concern)

Observation Parameters

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Body temperature (°C) (LOINC 8310-5)

Pulse (beats/min) (SNOMED 364075005)

Blood pressure systolic (mmHg) (LOINC 8480-6)

Blood pressure diastolic (mmHg) (LOINC 8462-4)

Body weight (kg) (LOINC 29463-7)

Contraindications

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Are there contraindications for administration? (SNOMED 395008009) | Answers: 373066001 Yes | 373067005 No

Fever, chills, feeling unwell (SNOMED 39104002) | Answers: 373066001 Yes | 373067005 No (conditional: if anyContraindication = Yes)

Repeated blood pressure lower than 100/60 mmHg (SNOMED 12763006) | Answers: 373066001 Yes | 373067005 No

Heart rate above 100 bpm at rest or irregular heart rhythm, unless chronically known (SNOMED 361137007) | Answers: 373066001 Yes | 373067005 No

Increase in body weight of 3 kg/3 weeks or 5 kg/6 weeks, especially with increased edema (SNOMED 262286000) | Answers: 373066001 Yes | 373067005 No

Increased edema in hands and/or feet (SNOMED 267038008) | Answers: 373066001 Yes | 373067005 No

Increased or severe shortness of breath (at rest or impacting daily activities) (SNOMED 297216006) | Answers: 373066001 Yes | 373067005 No

Decision after consultation with hospital (SNOMED 182836005) | Answers: Administration | No administration | Other

Specify if decision = Other (SNOMED 438833006)

Symptom Burden

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Nausea (SNOMED 422587007) | Answers: 444431007 Grade 0 (None) | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Vomiting (SNOMED 249497008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (<=2 times) | 444457005 Grade 2 (3-5 times) | 444447009 Grade 3 (6+ times)

Reduced appetite or taste changes (SNOMED 64379006) | Answers: 444431007 Grade 0 | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Diarrhea (SNOMED 62315008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (1-3x more) | 444457005 Grade 2 (4-6x more) | 444447009 Grade 3 (>6x or impacting daily life)

Constipation (SNOMED 14760008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Fatigue / lack of energy (SNOMED 224960004) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Pain (SNOMED 112104007) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Skin rash (SNOMED 271807003) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (limited redness) | 444457005 Grade 2 (moderate redness) | 444447009 Grade 3 (severe redness or peeling)

Psychosocial burden (SNOMED 384821006) | Answers: 444431007 Grade 0 (Feels well) | 444456001 Grade 1 (slight distress) | 444457005 Grade 2 (significant distress) | 444447009 Grade 3 (severe distress)

Shortness of breath (SNOMED 267036007) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (moderate exertion only) | 444457005 Grade 2 (light exertion) | 444447009 Grade 3 (at rest)

Edema (SNOMED 79654002) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Other Relevant Observations

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Other side effects or relevant clinical and psychosocial observations. Contact hospital in case of clinical concern. (SNOMED 365275006)

Task

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Could the medication be prepared according to the procedure? (SNOMED 385796006) | Answers: 373066001 Yes | 373067005 No

Could the medication be administered exactly according to the procedure (no deviations)? (SNOMED 373149000) | Answers: 373066001 Yes | 373067005 No

Aftercare

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Was there a reaction during the home observation period? (SNOMED 281647001) | Answers: 373066001 Yes | 373067005 No

Fever (SNOMED 386661006) | Answers: 373066001 Yes | 373067005 No (conditional: if reactionDuringObservation = Yes)

Nausea (SNOMED 422587007) | Answers: 373066001 Yes | 373067005 No

Shortness of breath (SNOMED 255365009) | Answers: 373066001 Yes | 373067005 No

Chills (SNOMED 43724002) | Answers: 373066001 Yes | 373067005 No

Flu-like symptoms (SNOMED 95891005) | Answers: 373066001 Yes | 373067005 No

Quality Follow-Up

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Remarks or concerns about patient registration, data sharing, hospital communication, material availability, or other transmural collaboration aspects (SNOMED 276238005)

Logical model representing the nursing assessment questionnaire for home hospitalization patients receiving Trastuzumab. This questionnaire is filled in by the home nurse during each visit and exchanged as a FHIR QuestionnaireResponse with the hospital. Specific features: includes body weight, aftercare/reaction monitoring, and cardiac-focused contraindication checklist.

Nursing Assessment

Storage

Are there any remarks or concerns regarding the (proper) home storage of medication? (SNOMED 422413002) | Answers: 710977001 Medication stored correctly | 424363005 Concern about proper home storage

Specify remarks or concerns (conditional: if medicationStorageRemarks = concern)

Observation Parameters

Body temperature (°C) (LOINC 8310-5)

Pulse (beats/min) (SNOMED 364075005)

Blood pressure systolic (mmHg) (LOINC 8480-6)

Blood pressure diastolic (mmHg) (LOINC 8462-4)

Body weight (kg) (LOINC 29463-7)

Contraindications

Are there contraindications for administration? (SNOMED 395008009) | Answers: 373066001 Yes | 373067005 No

Fever, chills, feeling unwell (SNOMED 39104002) | Answers: 373066001 Yes | 373067005 No (conditional: if anyContraindication = Yes)

Repeated blood pressure lower than 100/60 mmHg (SNOMED 12763006) | Answers: 373066001 Yes | 373067005 No

Heart rate above 100 bpm at rest or irregular heart rhythm, unless chronically known (SNOMED 361137007) | Answers: 373066001 Yes | 373067005 No

Increase in body weight of 3 kg/3 weeks or 5 kg/6 weeks, especially with increased edema (SNOMED 262286000) | Answers: 373066001 Yes | 373067005 No

Increased edema in hands and/or feet (SNOMED 267038008) | Answers: 373066001 Yes | 373067005 No

Increased or severe shortness of breath (at rest or impacting daily activities) (SNOMED 297216006) | Answers: 373066001 Yes | 373067005 No

Decision after consultation with hospital (SNOMED 182836005) | Answers: Administration | No administration | Other

Specify if decision = Other (SNOMED 438833006)

Symptom Burden

Nausea (SNOMED 422587007) | Answers: 444431007 Grade 0 (None) | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Vomiting (SNOMED 249497008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (<=2 times) | 444457005 Grade 2 (3-5 times) | 444447009 Grade 3 (6+ times)

Reduced appetite or taste changes (SNOMED 64379006) | Answers: 444431007 Grade 0 | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Diarrhea (SNOMED 62315008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (1-3x more) | 444457005 Grade 2 (4-6x more) | 444447009 Grade 3 (>6x or impacting daily life)

Constipation (SNOMED 14760008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Fatigue / lack of energy (SNOMED 224960004) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Pain (SNOMED 112104007) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Skin rash (SNOMED 271807003) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (limited redness) | 444457005 Grade 2 (moderate redness) | 444447009 Grade 3 (severe redness or peeling)

Psychosocial burden (SNOMED 384821006) | Answers: 444431007 Grade 0 (Feels well) | 444456001 Grade 1 (slight distress) | 444457005 Grade 2 (significant distress) | 444447009 Grade 3 (severe distress)

Shortness of breath (SNOMED 267036007) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (moderate exertion only) | 444457005 Grade 2 (light exertion) | 444447009 Grade 3 (at rest)

Edema (SNOMED 79654002) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Other Relevant Observations

Other side effects or relevant clinical and psychosocial observations. Contact hospital in case of clinical concern. (SNOMED 365275006)

Task

Could the medication be prepared according to the procedure? (SNOMED 385796006) | Answers: 373066001 Yes | 373067005 No

Could the medication be administered exactly according to the procedure (no deviations)? (SNOMED 373149000) | Answers: 373066001 Yes | 373067005 No

Aftercare

Was there a reaction during the home observation period? (SNOMED 281647001) | Answers: 373066001 Yes | 373067005 No

Fever (SNOMED 386661006) | Answers: 373066001 Yes | 373067005 No (conditional: if reactionDuringObservation = Yes)

Nausea (SNOMED 422587007) | Answers: 373066001 Yes | 373067005 No

Shortness of breath (SNOMED 255365009) | Answers: 373066001 Yes | 373067005 No

Chills (SNOMED 43724002) | Answers: 373066001 Yes | 373067005 No

Flu-like symptoms (SNOMED 95891005) | Answers: 373066001 Yes | 373067005 No

Quality Follow-Up

Remarks or concerns about patient registration, data sharing, hospital communication, material availability, or other transmural collaboration aspects (SNOMED 276238005)

Logical model representing the nursing assessment questionnaire for home hospitalization patients receiving Trastuzumab. This questionnaire is filled in by the home nurse during each visit and exchanged as a FHIR QuestionnaireResponse with the hospital. Specific features: includes body weight, aftercare/reaction monitoring, and cardiac-focused contraindication checklist.

Nursing Assessment

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Storage

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Are there any remarks or concerns regarding the (proper) home storage of medication? (SNOMED 422413002) | Answers: 710977001 Medication stored correctly | 424363005 Concern about proper home storage

Specify remarks or concerns (conditional: if medicationStorageRemarks = concern)

Observation Parameters

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Body temperature (°C) (LOINC 8310-5)

Pulse (beats/min) (SNOMED 364075005)

Blood pressure systolic (mmHg) (LOINC 8480-6)

Blood pressure diastolic (mmHg) (LOINC 8462-4)

Body weight (kg) (LOINC 29463-7)

Contraindications

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Are there contraindications for administration? (SNOMED 395008009) | Answers: 373066001 Yes | 373067005 No

Fever, chills, feeling unwell (SNOMED 39104002) | Answers: 373066001 Yes | 373067005 No (conditional: if anyContraindication = Yes)

Repeated blood pressure lower than 100/60 mmHg (SNOMED 12763006) | Answers: 373066001 Yes | 373067005 No

Heart rate above 100 bpm at rest or irregular heart rhythm, unless chronically known (SNOMED 361137007) | Answers: 373066001 Yes | 373067005 No

Increase in body weight of 3 kg/3 weeks or 5 kg/6 weeks, especially with increased edema (SNOMED 262286000) | Answers: 373066001 Yes | 373067005 No

Increased edema in hands and/or feet (SNOMED 267038008) | Answers: 373066001 Yes | 373067005 No

Increased or severe shortness of breath (at rest or impacting daily activities) (SNOMED 297216006) | Answers: 373066001 Yes | 373067005 No

Decision after consultation with hospital (SNOMED 182836005) | Answers: Administration | No administration | Other

Specify if decision = Other (SNOMED 438833006)

Symptom Burden

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Nausea (SNOMED 422587007) | Answers: 444431007 Grade 0 (None) | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Vomiting (SNOMED 249497008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (<=2 times) | 444457005 Grade 2 (3-5 times) | 444447009 Grade 3 (6+ times)

Reduced appetite or taste changes (SNOMED 64379006) | Answers: 444431007 Grade 0 | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Diarrhea (SNOMED 62315008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (1-3x more) | 444457005 Grade 2 (4-6x more) | 444447009 Grade 3 (>6x or impacting daily life)

Constipation (SNOMED 14760008) | Answers: 444431007 Grade 0 | 444456001 Grade 1 | 444457005 Grade 2 | 444447009 Grade 3

Fatigue / lack of energy (SNOMED 224960004) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Pain (SNOMED 112104007) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Skin rash (SNOMED 271807003) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (limited redness) | 444457005 Grade 2 (moderate redness) | 444447009 Grade 3 (severe redness or peeling)

Psychosocial burden (SNOMED 384821006) | Answers: 444431007 Grade 0 (Feels well) | 444456001 Grade 1 (slight distress) | 444457005 Grade 2 (significant distress) | 444447009 Grade 3 (severe distress)

Shortness of breath (SNOMED 267036007) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (moderate exertion only) | 444457005 Grade 2 (light exertion) | 444447009 Grade 3 (at rest)

Edema (SNOMED 79654002) | Answers: 444431007 Grade 0 | 444456001 Grade 1 (mild) | 444457005 Grade 2 (moderate) | 444447009 Grade 3 (severe)

Other Relevant Observations

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Other side effects or relevant clinical and psychosocial observations. Contact hospital in case of clinical concern. (SNOMED 365275006)

Task

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Could the medication be prepared according to the procedure? (SNOMED 385796006) | Answers: 373066001 Yes | 373067005 No

Could the medication be administered exactly according to the procedure (no deviations)? (SNOMED 373149000) | Answers: 373066001 Yes | 373067005 No

Aftercare

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Was there a reaction during the home observation period? (SNOMED 281647001) | Answers: 373066001 Yes | 373067005 No

Fever (SNOMED 386661006) | Answers: 373066001 Yes | 373067005 No (conditional: if reactionDuringObservation = Yes)

Nausea (SNOMED 422587007) | Answers: 373066001 Yes | 373067005 No

Shortness of breath (SNOMED 255365009) | Answers: 373066001 Yes | 373067005 No

Chills (SNOMED 43724002) | Answers: 373066001 Yes | 373067005 No

Flu-like symptoms (SNOMED 95891005) | Answers: 373066001 Yes | 373067005 No

Quality Follow-Up

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Remarks or concerns about patient registration, data sharing, hospital communication, material availability, or other transmural collaboration aspects (SNOMED 276238005)