<status value="active" /> <publisher value="Nictiz" /> <contact> <name value="Nictiz" /> <telecom> <system value="email" /> <value value="info@nictiz.nl" /> <use value="work" /> </telecom> </contact> <description value="Freedom restricting measures are (physical or verbal) measures used to deliberately restrict the freedom of the patient in question. Many forms of freedom restricting measures fall under this definition, including but not limited to: involuntary treatment (e.g. forced medication) physical restraints (side rails fully up) physical fixation (arm restraints in order to prevent removal of drip) electronic surveillance to monitor the whereabouts of the patient. In hospitals, these often include the use of side rails, a cushion belt (around the waist) or a Posey bed. Often sedatives are administered in combination with the freedom restricting measures. For small children it often involves fixation of e.g. hands to prevent the extraction of a nasogastric tube. The Vereniging Verpleegkundigen & Verzorgenden Nederland (V&VN) [Dutch Nurses and Carers Association] published a set of guidelines for nurses to implement these restraints in hospitals. The ‘Wet BOPZ’ [Dutch Psychiatric Hospitals (Compulsory Admissions) Act] protects the rights of clients who are involuntarily admitted into mental healthcare, services for the disabled and in geriatric psychiatry. The act only applies to ‘BOPZ’-marked facilities and also applies to some (closed) wards in nursing homes. Mental healthcare facilities use a national registration system to register the restraints called Argus registration. Permission of the patient or his/hers legal representative is required before starting freedom restricting measures. The patient’s high-risk behavior providing cause for the restraints is not described in this concept." /> <purpose value="Implementing medical restraints is risky and can result in damage to the patient if they are not carefully implemented. Nurses fulfil an important role in identifying risks, observing the effect of the restraints and any changes to the policy in terms of medical restraints. Recording all information on the measures is of major importance for insight into decision-making, implementing, monitoring and evaluating the measures. In the event of a transfer to the next facility, the proper preparations can be taken to safely continue the care and to limit the risks to the patient and their environment." /> <copyright value="CC0" /> <fhirVersion value="3.0.2" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <uri value="https://zibs.nl/wiki/FreedomRestrictingMeasures-v3.1(2017EN)" /> <name value="HCIM FreedomRestrictingMeasures-v3.1(2017EN)" /> </mapping> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <uri value="https://zibs.nl/wiki/BasicElements-v1.0(2017EN)" /> <name value="HCIM BasicElements-v1.0(2017EN)" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Procedure" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Procedure" /> <derivation value="constraint" /> <differential> <element id="Procedure"> <path value="Procedure" /> <short value="Procedure" /> <definition value="Root concept of the FreedomRestrictingMeasures information model. This root concept contains all data elements of the FreedomRestrictingMeasures information model." /> <alias value="VrijheidsbeperkendeMaatregelen" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.1" /> <comment value="FreedomRestrictingMeasures" /> </mapping> </element> <element id="Procedure.extension"> <path value="Procedure.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Procedure.extension:legalStatus"> <path value="Procedure.extension" /> <sliceName value="legalStatus" /> <short value="LegalStatus" /> <definition value="The legal situation that applies to the patient during the intervention." /> <alias value="JuridischeStatus" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus" /> </type> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.2" /> <comment value="LegalStatus" /> </mapping> </element> <element id="Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept"> <path value="Procedure.extension.valueCodeableConcept" /> <sliceName value="valueCodeableConcept" /> <min value="1" /> <binding> <strength value="extensible" /> </binding> </element> <element id="Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding"> <path value="Procedure.extension.valueCodeableConcept.coding" /> <min value="1" /> </element> <element id="Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.system"> <path value="Procedure.extension.valueCodeableConcept.coding.system" /> <min value="1" /> </element> <element id="Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.code"> <path value="Procedure.extension.valueCodeableConcept.coding.code" /> <min value="1" /> </element> <element id="Procedure.extension:legallyCapable"> <path value="Procedure.extension" /> <sliceName value="legallyCapable" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures-LegallyCapable" /> </type> </element> <element id="Procedure.extension:legallyCapable.extension:LegallyCapableIndicator"> <path value="Procedure.extension.extension" /> <sliceName value="LegallyCapableIndicator" /> <short value="LegallyCapableIndicator" /> <definition value="Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision." /> <alias value="Wilsbekwaam" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.3" /> <comment value="LegallyCapable" /> </mapping> </element> <element id="Procedure.extension:legallyCapable.extension:LegallyCapableComment"> <path value="Procedure.extension.extension" /> <sliceName value="LegallyCapableComment" /> <alias value="WilsbekwaamToelichting" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.4" /> <comment value="LegallyCapableComment" /> </mapping> </element> <element id="Procedure.extension:permission"> <path value="Procedure.extension" /> <sliceName value="permission" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures-Permission" /> </type> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.7" /> <comment value="Permission" /> </mapping> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept"> <path value="Procedure.extension.valueCodeableConcept" /> <sliceName value="valueCodeableConcept" /> <min value="1" /> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding"> <path value="Procedure.extension.valueCodeableConcept.coding" /> <slicing> <discriminator> <type value="value" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:ArgusPermissionCode"> <path value="Procedure.extension.valueCodeableConcept.coding" /> <sliceName value="ArgusPermissionCode" /> <max value="1" /> <binding> <strength value="required" /> <description value="ArgusInstemmingCodelijst" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.5--20171231000000" /> <display value="ArgusInstemmingCodelijst" /> </valueSetReference> </binding> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:ArgusPermissionCode.system"> <path value="Procedure.extension.valueCodeableConcept.coding.system" /> <min value="1" /> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:ArgusPermissionCode.code"> <path value="Procedure.extension.valueCodeableConcept.coding.code" /> <min value="1" /> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:permissionCode"> <path value="Procedure.extension.valueCodeableConcept.coding" /> <sliceName value="permissionCode" /> <max value="1" /> <binding> <strength value="required" /> <description value="ToestemmingCodelijst" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.1--20171231000000" /> <display value="ToestemmingCodelijst" /> </valueSetReference> </binding> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:permissionCode.system"> <path value="Procedure.extension.valueCodeableConcept.coding.system" /> <min value="1" /> </element> <element id="Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:permissionCode.code"> <path value="Procedure.extension.valueCodeableConcept.coding.code" /> <min value="1" /> </element> <element id="Procedure.identifier"> <path value="Procedure.identifier" /> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.6" /> <comment value="IdentificationNumber" /> </mapping> </element> <element id="Procedure.category"> <path value="Procedure.category" /> <min value="1" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.6" /> <comment value="TypeOfIntervention" /> </mapping> </element> <element id="Procedure.category.coding"> <path value="Procedure.category.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <rules value="open" /> </slicing> <min value="1" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.6" /> <comment value="TypeOfIntervention" /> </mapping> </element> <element id="Procedure.category.coding:freedomRestrictingMeasuresCode"> <path value="Procedure.category.coding" /> <sliceName value="freedomRestrictingMeasuresCode" /> <min value="1" /> <max value="1" /> </element> <element id="Procedure.category.coding:freedomRestrictingMeasuresCode.system"> <path value="Procedure.category.coding.system" /> <min value="1" /> <fixedUri value="http://snomed.info/sct" /> </element> <element id="Procedure.category.coding:freedomRestrictingMeasuresCode.code"> <path value="Procedure.category.coding.code" /> <min value="1" /> <fixedCode value="225214000" /> </element> <element id="Procedure.category.coding:freedomRestrictingMeasuresCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Procedure.category.coding.display" /> <defaultValueString value="Procedures relating to control, restraint, seclusion and segregation (procedure)" /> </element> <element id="Procedure.code"> <path value="Procedure.code" /> <min value="1" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.6" /> <comment value="TypeOfIntervention" /> </mapping> </element> <element id="Procedure.code.coding"> <path value="Procedure.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="Procedure.code.coding:typeOfInterventionCode"> <path value="Procedure.code.coding" /> <sliceName value="typeOfInterventionCode" /> <max value="1" /> <binding> <strength value="required" /> <description value="TypeOfInterventionCodelist" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.3--20171231000000" /> <display value="TypeOfInterventionCodelist" /> </valueSetReference> </binding> </element> <element id="Procedure.code.coding:typeOfInterventionCode.system"> <path value="Procedure.code.coding.system" /> <min value="1" /> </element> <element id="Procedure.code.coding:typeOfInterventionCode.code"> <path value="Procedure.code.coding.code" /> <min value="1" /> </element> <element id="Procedure.code.coding:argusTypeOfInterventionCode"> <path value="Procedure.code.coding" /> <sliceName value="argusTypeOfInterventionCode" /> <max value="1" /> <binding> <strength value="required" /> <description value="ArgusTypeOfInterventionCodelist" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.4--20171231000000" /> <display value="ArgusTypeOfInterventionCodelist" /> </valueSetReference> </binding> </element> <element id="Procedure.code.coding:argusTypeOfInterventionCode.system"> <path value="Procedure.code.coding.system" /> <min value="1" /> </element> <element id="Procedure.code.coding:argusTypeOfInterventionCode.code"> <path value="Procedure.code.coding.code" /> <min value="1" /> </element> <element id="Procedure.subject"> <path value="Procedure.subject" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" /> </type> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.11" /> <comment value="Subject" /> </mapping> </element> <element id="Procedure.performed[x]"> <path value="Procedure.performed[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.14" /> <comment value="DateTime" /> </mapping> </element> <element id="Procedure.performed[x]:performedPeriod"> <path value="Procedure.performed[x]" /> <sliceName value="performedPeriod" /> <type> <code value="Period" /> </type> </element> <element id="Procedure.performed[x]:performedPeriod.start"> <path value="Procedure.performed[x].start" /> <short value="StartEpisode" /> <definition value="The date and time at which the restraints started" /> <alias value="AanvangEpisode" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.8" /> <comment value="StartEpisode" /> </mapping> </element> <element id="Procedure.performed[x]:performedPeriod.end"> <path value="Procedure.performed[x].end" /> <short value="EndOfEpisode" /> <definition value="The date and time at which the restraints ended." /> <alias value="EindeEpisode" /> <mapping> <identity value="hcim-freedomrestrictingmeasures-v3.1-2017EN" /> <map value="NL-CM:14.3.9" /> <comment value="EndOfEpisode" /> </mapping> </element> </differential> </StructureDefinition>