<status value="draft" /> <date value="2022-07-07T15:04:03.2592055+00:00" /> <publisher value="Healthdata.be (Sciensano)" /> <contact> <name value="Service portal – healthdata.be" /> <telecom> <system value="url" /> <value value="https://sciensano.service-now.com/sp" /> <use value="work" /> </telecom> </contact> <description value="A stoma is an unnatural, surgically created opening connecting a body cavity with the outside world. A stoma is created e.g. as an exit opening for feces or urine in the event that they cannot leave the body naturally. In the case of a tracheostomy, the stoma is intended to facilitate breathing if that is no longer possible via the oral, nasal and throat cavity. #### Purpose Information on present stomas is recorded to inform other health professionals. This information is of importance in determining the care required for the patient. In a transfer situation, the information offers the option to realize continuity of care by organizing specific expertise and materials in advance, for example."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Een stoma is een onnatuurlijke, chirurgisch aangelegde opening die een lichaamsholte verbindt met de buitenwereld. Een stoma wordt onder andere aangelegd als uitgang voor ontlasting of urine wanneer deze stoffen het lichaam niet op natuurlijke wijze kunnen verlaten. Bij een tracheostoma dient de stoma om ademhaling mogelijk te maken wanneer dat niet meer via de mond, neus- en keelholte kan. #### Purpose Het vastleggen van informatie over aanwezige stoma's heeft tot doel om andere zorgverleners hierover te informeren. Deze informatie is van belang bij het vaststellen van benodigde zorg voor de patiënt. In een overplaatsingssituatie biedt de informatie de mogelijkheid om de continuïteit van zorg te bewerkstelligen door bijvoorbeeld specifieke deskundigheid en materialen vooraf te regelen. **References** 1. V&VN afdeling Stomaverpleegkundigen. *Evidence-based Richtlijn Stomazorg Nederland.* (2012) [Online] Beschikbaar op: [http://www.mdl.nl/uploads/240/1143/Evidence-based_Richtlijn_Stomazorg_Nederland.pdf](http://www.mdl.nl/uploads/240/1143/Evidence-based_Richtlijn_Stomazorg_Nederland.pdf) [Geraadpleegd: 13 februari 2015]" /> </extension> </extension> </description> <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." /> <fhirVersion value="4.0.1" /> <kind value="logical" /> <abstract value="true" /> <type value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/Stoma" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element" /> <derivation value="specialization" /> <snapshot> <element id="Stoma"> <path value="Stoma" /> <short value="Stoma"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Stoma" /> </extension> </extension> </short> <definition value="Root concept of the Stoma information model. This root concept contains all data elements of the Stoma information model."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Rootconcept van de bouwsteen Stoma. Dit rootconcept bevat alle gegevenselementen van de bouwsteen Stoma." /> </extension> </extension> </definition> <min value="0" /> <max value="*" /> <base> <path value="Stoma" /> <min value="0" /> <max value="*" /> </base> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Stoma.id"> <path value="Stoma.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Stoma.extension"> <path value="Stoma.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Stoma.StomaType"> <path value="Stoma.StomaType" /> <short value="StomaType"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="StomaType" /> </extension> </extension> </short> <definition value="Stoma type indicates which body cavity the stoma is in and the kind of stoma used."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Het type stoma geeft aan vanuit welke lichaamsholte de stoma is aangelegd en wat voor een soort stoma hiervoor gebruikt is." /> </extension> </extension> </definition> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <min value="1" /> <max value="1" /> <base> <path value="Stoma.StomaType" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <binding> <strength value="extensible" /> <description value="StomaType codes" /> <valueSet value="https://fhir.healthdata.be/ValueSet/StomaType" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="Stoma.StomaMaterial"> <path value="Stoma.StomaMaterial" /> <short value="StomaMaterial"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="StomaMateriaal" /> </extension> </extension> </short> <definition value="Stoma material describes the medical aids used, such as a skin plate (the adhesive part around the stoma), the stoma pouch (to catch the stoma output) and other stoma aids for caring for the stoma. For tracheostomies, it also describes aids such as voice prostheses and stoma filters. Catheters inserted through the stoma such as tracheal cannulas are not described in this concept. These aids must be modeled in a higher information model describing the catheter and referring to the stoma."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Het stomamateriaal beschrijft de gebruikte hulpmiddelen, zoals huidplaat (het plakkende deel rondom stoma), stomazakje (voor het opvangen van output van stoma) en overige stomahulpmiddelen voor verzorgen van de stoma. Voor tracheostomata beschrijft het eveneens hulpmiddelen zoals spraakprothese en stomafilter. Katheters die door de stoma naar binnen gebracht worden zoals een tracheacanule worden niet in dit concept beschreven. Deze hulpmiddelen moeten in een bovenliggende bouwsteen die de katheter beschrijft en naar de stoma verwijst gemodelleerd worden." /> </extension> </extension> </definition> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <min value="0" /> <max value="*" /> <base> <path value="Stoma.StomaMaterial" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-MedicalDevice" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> </element> <element id="Stoma.AnatomicalLocation"> <path value="Stoma.AnatomicalLocation" /> <short value="AnatomicalLocation"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="AnatomischeLocatie" /> </extension> </extension> </short> <definition value="Anatomical location of the stoma on the patient."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="De anatomische locatie van de stoma bij de patiënt." /> </extension> </extension> </definition> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <min value="0" /> <max value="1" /> <base> <path value="Stoma.AnatomicalLocation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-AnatomicalLocation" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> </element> <element id="Stoma.CreationDate"> <path value="Stoma.CreationDate" /> <short value="CreationDate"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="AanlegDatum" /> </extension> </extension> </short> <definition value="The date on which the stoma was created in the patient. A vague date, such as only the year, is permitted."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="De datum waarop de stoma bij de patiënt is aangelegd, een vage datum, bijv. alleen een jaartal, is toegestaan." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <base> <path value="Stoma.CreationDate" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Stoma.Comment"> <path value="Stoma.Comment" /> <short value="Comment"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Toelichting" /> </extension> </extension> </short> <definition value="A comment on the stoma."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Een toelichting op de stoma." /> </extension> </extension> </definition> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Stoma.Comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> </snapshot> <differential> <element id="Stoma"> <path value="Stoma" /> <short value="Stoma"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Stoma" /> </extension> </extension> </short> <definition value="Root concept of the Stoma information model. This root concept contains all data elements of the Stoma information model."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Rootconcept van de bouwsteen Stoma. Dit rootconcept bevat alle gegevenselementen van de bouwsteen Stoma." /> </extension> </extension> </definition> <min value="0" /> <max value="*" /> </element> <element id="Stoma.StomaType"> <path value="Stoma.StomaType" /> <short value="StomaType"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="StomaType" /> </extension> </extension> </short> <definition value="Stoma type indicates which body cavity the stoma is in and the kind of stoma used."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Het type stoma geeft aan vanuit welke lichaamsholte de stoma is aangelegd en wat voor een soort stoma hiervoor gebruikt is." /> </extension> </extension> </definition> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <binding> <strength value="extensible" /> <description value="StomaType codes" /> <valueSet value="https://fhir.healthdata.be/ValueSet/StomaType" /> </binding> </element> <element id="Stoma.StomaMaterial"> <path value="Stoma.StomaMaterial" /> <short value="StomaMaterial"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="StomaMateriaal" /> </extension> </extension> </short> <definition value="Stoma material describes the medical aids used, such as a skin plate (the adhesive part around the stoma), the stoma pouch (to catch the stoma output) and other stoma aids for caring for the stoma. For tracheostomies, it also describes aids such as voice prostheses and stoma filters. Catheters inserted through the stoma such as tracheal cannulas are not described in this concept. These aids must be modeled in a higher information model describing the catheter and referring to the stoma."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Het stomamateriaal beschrijft de gebruikte hulpmiddelen, zoals huidplaat (het plakkende deel rondom stoma), stomazakje (voor het opvangen van output van stoma) en overige stomahulpmiddelen voor verzorgen van de stoma. Voor tracheostomata beschrijft het eveneens hulpmiddelen zoals spraakprothese en stomafilter. Katheters die door de stoma naar binnen gebracht worden zoals een tracheacanule worden niet in dit concept beschreven. Deze hulpmiddelen moeten in een bovenliggende bouwsteen die de katheter beschrijft en naar de stoma verwijst gemodelleerd worden." /> </extension> </extension> </definition> <min value="0" /> <max value="*" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-MedicalDevice" /> </type> </element> <element id="Stoma.AnatomicalLocation"> <path value="Stoma.AnatomicalLocation" /> <short value="AnatomicalLocation"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="AnatomischeLocatie" /> </extension> </extension> </short> <definition value="Anatomical location of the stoma on the patient."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="De anatomische locatie van de stoma bij de patiënt." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-AnatomicalLocation" /> </type> </element> <element id="Stoma.CreationDate"> <path value="Stoma.CreationDate" /> <short value="CreationDate"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="AanlegDatum" /> </extension> </extension> </short> <definition value="The date on which the stoma was created in the patient. A vague date, such as only the year, is permitted."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="De datum waarop de stoma bij de patiënt is aangelegd, een vage datum, bijv. alleen een jaartal, is toegestaan." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="dateTime" /> </type> </element> <element id="Stoma.Comment"> <path value="Stoma.Comment" /> <short value="Comment"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Toelichting" /> </extension> </extension> </short> <definition value="A comment on the stoma."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Een toelichting op de stoma." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> </element> </differential> </StructureDefinition>