Patient Monitoring Outcome FHIR Implementation Guide
0.1.0 - STU1 Belgium flag

Patient Monitoring Outcome FHIR Implementation Guide, published by HL7 Belgium. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/patient-monitoring/ and changes regularly. See the Directory of published versions

Questionnaire: HomehospAzacitidineQuestionnaireDefinition

Branch:

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
HomehospAzacitidineQuestionnaireDefinitionQuestionnaire containing the necessary information for the home hospitalization of a patient treated with Azacitidine.Questionnairehttp://hl7belgium.org/fhir/patient-monitoring/Questionnaire/homehosp-azacitidine#0.1.0
HomehospAzacitidineQuestionnaireDefinition / NursingAssessmentVerpleegkundig assessment0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / MedicationStorageMedicationStorage0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / MedicationStorage / A1_MedicationStorageZijn er opmerkingen of bezorgdheden omtrent de (correcte) thuisbewaring van de medicatie?1..1choiceValue Set:
Options: 2 options
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / MedicationStorage / A2_MedicationStorageSpecify> Indien opmerkingen of bezorgdheid: specifieer0..1stringEnable When: A1_MedicationStorage = Improper storage of medication (SNOMED CT#424363005)
Value Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / ObservationParametersObservatie parameters0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / ObservationParameters / B1_BodyTemperatureLichaamstemperatuur:1..1decimalValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / ObservationParameters / B2_HeartRatePols:1..1decimalValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / ObservationParameters / B3_SystolicBloodPressureBloeddruk systolisch:1..1decimalValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / ObservationParameters / B4_DiastolicBloodPressureBloeddruk diastolisch:1..1decimalValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / ObservationParameters / B5_OxygenSaturationZuurstofsaturatie (enkel uitvoeren bij hoest en kortademigheid)0..1decimalValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / ContraindicationsContraindications0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C1_ContraindicationPresentZijn er tegenindicaties voor toediening?1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C2_ContraindicationSpecify> Indien 'ja': specifieer0..1displayEnable When: C1_ContraindicationPresent = Yes (SNOMED CT#373066001)
Value Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C3_FeverChillsKoorts , koude rillingen, zich ziek voelen1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C4_OralIntakeGeen orale intake (tgv verminderde eetlust of smaakverandering)1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C5_SevereNauseaErnstige misselijkheid (dwz misselijkheid met onvoldoende orale intake)1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C6_SevereDyspneaToegenomen kortademigheid en/of ernstige kortademigheid (dwz kortademigheid in rust/zonder inspanning en/of kortademigheid die hindert bij de dagelijkse activiteiten) (Trastuzumab, Azacitidine)1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C7_NewCoughDyspneaNieuwe of toegenomen productieve of droge hoest, met of zonder dyspnoe1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C8_GeneralDeclineAlgemene achteruitgang1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C9_OtherAndere: (indien van toepassing)0..1stringValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C10_ContactCareTeam> Indien tegenindicatie(s): gelieve contact op te nemen met het zorgteam in het ziekenhuis0..1displayEnable When: C1_ContraindicationPresent = Yes (SNOMED CT#373066001)
Value Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C11_DecisionBeslissing na overleg ziekenhuis0..1choiceValue Set:
Options: 3 options
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / Contraindications / C12_DecisionSpecify> Indien andere: specifieer0..1stringEnable When: C11_Decision = andere
Value Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurdenSymptomBurden0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D1_NauseaMisselijkheid0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D2_VomitingBraken0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D3_DecreasedAppetiteVerminderde eetlust of smaakverandering0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D4_DiarrheaBuikloop0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D5_ConstipationVerstopping0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D6_FatigueVermoeidheid/futloosheid0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D7_PainPijn0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D8_SkinRashHuiduitslag0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D9_PsychosocialBurdenPsychosociale belasting0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D10_DyspneaKortademigheid0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D11_CoughHoest0..1choiceValue Set: ONCO Symptom Grade Scale (CTCAE 0–3)
HomehospAzacitidineQuestionnaireDefinition / NursingAssessment / SymptomBurden / D12_OtherObservationsAndere nevenwerkingen of relevante klinische en psychosociale observaties (gelieve bij klinische bezorgdheid contact te nemen met het ziekenhuis voor bespreking)0..1stringValue Set:
HomehospAzacitidineQuestionnaireDefinition / AssignmentAssignment0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / Assignment / MedicationPreparationVoorbereiding medicatietoediening0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / Assignment / MedicationPreparation / E1_PreparationCorrectKon de medicatie worden bereid volgens de procedure?1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / Assignment / MedicationPreparation / E2_ContactCareTeam> Indien 'nee': gelieve contact op te nemen met het zorgteam in het ziekenhuis0..1displayEnable When: E1_PreparationCorrect = No (SNOMED CT#373067005)
Value Set:
HomehospAzacitidineQuestionnaireDefinition / Assignment / MedicationAdministrationMedicationAdministration0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / Assignment / MedicationAdministration / E3_AdministrationCorrectKon de medicatie exact volgens de procedure worden toegediend (er waren geen afwijkingen)?1..1choiceValue Set: Yes / No Value Set
HomehospAzacitidineQuestionnaireDefinition / Assignment / MedicationAdministration / E4_SpecifyNo> Indien 'nee': specifieer0..1stringEnable When: E3_AdministrationCorrect = No (SNOMED CT#373067005)
Value Set:
HomehospAzacitidineQuestionnaireDefinition / QualityMonitoring(Kwaliteits)opvolging0..1groupValue Set:
HomehospAzacitidineQuestionnaireDefinition / QualityMonitoring / F1_CommentsRegistrationZijn er opmerkingen of bezorgdheden omtrent de aanmelding van deze patient, de gegevensdeling vanuit het ziekenhuis, de communicatie door en het contact met het ziekenhuis, de beschikbaarheid van de materialen, of andere aspecten van de transmurale samenwerking rond thuishospitalisatie oncologie, dan kan je deze hier noteren. Alvast dank.0..1stringValue Set:

doco Documentation for this format

Options Sets

Answer options for A1_MedicationStorage

  • http://snomed.info/sct#710977001 ("Safe storage and management of medication")
  • http://snomed.info/sct#424363005 ("Improper storage of medication")

Answer options for C11_Decision

  • toediening
  • geen toediening
  • andere