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{
  "resourceType": "StructureDefinition",
  "id": "zib-NursingIntervention",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-NursingIntervention",
  "name": "ZibNursingIntervention",
  "title": "zib NursingIntervention",
  "status": "draft",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "email",
          "value": "info@nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "A nursing intervention is the care and/or treatment carried out by a nurse based on an expert opinion and clinical knowledge. It is part of the nursing process; interventions are determined as a result of indexed healthcare problems (nursing diagnoses) and based on treatment goals. Following the NEN-EN-ISO 18104 norm, it is possible to structure nursing interventions (or actions) in a hierarchy, where one intervention can be part of another intervention.\r\n\r\nIn a home care situation some actions can also be performed by the patient or a caregiver after a relevant instruction.",
  "purpose": "This CarePlan resource represents the Dutch [zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) NursingIntervention-v3.2(2020EN)](https://zibs.nl/wiki/NursingIntervention-v3.2(2020EN)).",
  "copyright": "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": "4.0.1",
  "mapping": [
    {
      "identity": "zib-nursingintervention-v3.2-2020EN",
      "uri": "https://zibs.nl/wiki/NursingIntervention-v3.2(2020EN)",
      "name": "zib NursingIntervention-v3.2(2020EN)"
    }
  ],
  "kind": "resource",
  "abstract": true,
  "type": "CarePlan",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/CarePlan",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "CarePlan",
        "path": "CarePlan",
        "short": "NursingIntervention",
        "alias": [
          "VerpleegkundigeInterventie"
        ],
        "constraint": [
          {
            "key": "zib-NursingIntervention-01",
            "severity": "error",
            "human": "The start and/or end date of a repeating schedule should be communicated in CarePlan.encounter as well.",
            "expression": "activity.detail.scheduledTiming.repeat.boundsPeriod.exists() implies (period = activity.detail.scheduledTiming.repeat.boundsPeriod)",
            "source": "http://nictiz.nl/fhir/StructureDefinition/zib-NursingIntervention"
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.1",
            "comment": "NursingIntervention"
          }
        ]
      },
      {
        "id": "CarePlan.status",
        "path": "CarePlan.status",
        "comment": "Sending systems that don't record an explicit status can use the following guidance to infer a value from the zib:\r\n\r\n* ProcedureEndTime present:\r\n    * and in the future: _active_\r\n    * and in the past: _completed_\r\n* ProcedureEndTime absent:\r\n    * ProcedureStartTime present: _active_\r\n    * ProcedureStartTime absent: _unknown_",
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.11",
            "comment": "ProcedureStartDateTime (implicit, main mapping is on CarePlan.period.start and optionally on CarePlan.activity.detail.scheduledTiming.repeat.boundsPeriod.start)"
          },
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.12",
            "comment": "ProcedureEndDateTime (implicit, main mapping is on CarePlan.period.end and optionally on CarePlan.activity.detail.scheduledTiming.repeat.boundsPeriod.end)"
          }
        ]
      },
      {
        "id": "CarePlan.intent",
        "path": "CarePlan.intent",
        "definition": "Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.\r\n\r\nFor zib NursingIntervention, this will normally be _plan_, but the context may specify a more suitable intent."
      },
      {
        "id": "CarePlan.category",
        "path": "CarePlan.category",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "coding"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "CarePlan.category:nursingIntervention",
        "path": "CarePlan.category",
        "sliceName": "nursingIntervention",
        "min": 1,
        "max": "1",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "9632001"
            }
          ]
        }
      },
      {
        "id": "CarePlan.subject",
        "path": "CarePlan.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient",
              "http://hl7.org/fhir/StructureDefinition/Group",
              "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"
            ]
          }
        ]
      },
      {
        "id": "CarePlan.period.start",
        "path": "CarePlan.period.start",
        "short": "ProcedureStartDateTime",
        "definition": "The start date (and if possible start time) of the procedure. The concept offers the option to indicate the start of the period of a series of repeating procedures, in which case it should be repeated in `CarePlan.activity.detail.scheduledTiming.repeat.boundsPeriod.start`.",
        "alias": [
          "ActieStartDatumTijd"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.11",
            "comment": "ProcedureStartDateTime"
          }
        ]
      },
      {
        "id": "CarePlan.period.end",
        "path": "CarePlan.period.end",
        "short": "ProcedureEndDateTime",
        "definition": "The end date (and if possible end time) of the procedure. The concept offers the option to indicate the end of the period of a series of repeating procedures, in which case it should be repeated in `CarePlan.activity.detail.scheduledTiming.repeat.boundsPeriod.end`.",
        "alias": [
          "ActieEindDatumTijd"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.12",
            "comment": "ProcedureEndDateTime"
          }
        ]
      },
      {
        "id": "CarePlan.contributor",
        "path": "CarePlan.contributor",
        "slicing": {
          "discriminator": [
            {
              "type": "exists",
              "path": "extension(url='http://nictiz.nl/fhir/StructureDefinition/ext-NursingIntervention-ContributorIsRequester')"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "CarePlan.contributor:requester",
        "path": "CarePlan.contributor",
        "sliceName": "requester",
        "short": "Requester",
        "definition": "The health professional who requested the nursing intervention. If desired, only the requester’s specialty can be entered.",
        "comment": "Each occurence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [zib-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [zib-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-Practitioner)). The reference to the Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource.\r\n\r\nIn rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here.",
        "alias": [
          "Aanvrager"
        ],
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole",
              "http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-Practitioner"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.8",
            "comment": "Requester"
          }
        ]
      },
      {
        "id": "CarePlan.contributor:requester.extension",
        "path": "CarePlan.contributor.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "CarePlan.contributor:requester.extension:contributorIsRequester",
        "path": "CarePlan.contributor.extension",
        "sliceName": "contributorIsRequester",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://nictiz.nl/fhir/StructureDefinition/ext-NursingIntervention-ContributorIsRequester"
            ]
          }
        ]
      },
      {
        "id": "CarePlan.addresses",
        "path": "CarePlan.addresses",
        "short": "Indication",
        "definition": "The nursing-related problem (indication) providing cause for the intervention.",
        "alias": [
          "Indicatie"
        ],
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Condition",
              "http://nictiz.nl/fhir/StructureDefinition/zib-Problem"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.6",
            "comment": "Indication"
          }
        ]
      },
      {
        "id": "CarePlan.goal",
        "path": "CarePlan.goal",
        "short": "TreatmentObjective",
        "definition": "The description of the treatment goal that the intervention decision is based on.",
        "alias": [
          "Behandeldoel"
        ],
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Goal",
              "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentObjective"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.14",
            "comment": "TreatmentObjective"
          }
        ]
      },
      {
        "id": "CarePlan.activity",
        "path": "CarePlan.activity",
        "comment": "A nursing intervention in the Dutch realm always consists of a single activity. For this reason, the cardinality of `.activity` is restricted to 0..1.",
        "max": "1"
      },
      {
        "id": "CarePlan.activity.detail.extension",
        "path": "CarePlan.activity.detail.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "CarePlan.activity.detail.extension:medicalDevice",
        "path": "CarePlan.activity.detail.extension",
        "sliceName": "medicalDevice",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://nictiz.nl/fhir/StructureDefinition/ext-CarePlan-MaterialUsed"
            ]
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.extension:medicalDevice.value[x]",
        "path": "CarePlan.activity.detail.extension.value[x]",
        "short": "MedicalDevice",
        "definition": "Description of the materials used for the nursing procedure, such as bandages.",
        "alias": [
          "MedischHulpmiddel"
        ],
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Device",
              "http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.13",
            "comment": "MedicalDevice"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.code",
        "path": "CarePlan.activity.detail.code",
        "short": "Intervention",
        "definition": "A nursing intervention is a treatment carried out by a nurse based on an expert opinion and clinical knowledge for the benefit of the person requesting healthcare. The intervention is targeted towards a certain problem (diagnosis) and has a predetermined healthcare result. It is possible to build a hierarchy of nursing interventions (where one intervention is part of another).",
        "alias": [
          "Interventie"
        ],
        "binding": {
          "strength": "required",
          "valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.18--20200901000000"
        },
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.2",
            "comment": "Intervention"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]",
        "path": "CarePlan.activity.detail.scheduled[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming",
        "path": "CarePlan.activity.detail.scheduled[x]",
        "sliceName": "scheduledTiming",
        "type": [
          {
            "code": "Timing"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.bounds[x]",
        "path": "CarePlan.activity.detail.scheduled[x].repeat.bounds[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.bounds[x]:boundsPeriod",
        "path": "CarePlan.activity.detail.scheduled[x].repeat.bounds[x]",
        "sliceName": "boundsPeriod",
        "type": [
          {
            "code": "Period"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.bounds[x]:boundsPeriod.start",
        "path": "CarePlan.activity.detail.scheduled[x].repeat.bounds[x].start",
        "short": "ProcedureStartDateTime",
        "definition": "Zib concept ProcedureStartDateTime should primarily be communicated using `CarePlan.period.start`, but it should be repeated here if it indicates the end of a series of repeating procedures.",
        "alias": [
          "ActieStartDatumTijd"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.11",
            "comment": "ProcedureStartDateTime"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.bounds[x]:boundsPeriod.end",
        "path": "CarePlan.activity.detail.scheduled[x].repeat.bounds[x].end",
        "short": "ProcedureEndDateTime",
        "definition": "Zib concept ProcedureEndDateTime should primarily be communicated using `CarePlan.period.end`, but it should be repeated here if it indicates the end of a series of repeating procedures.",
        "alias": [
          "ActieEindDatumTijd"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.12",
            "comment": "ProcedureEndDateTime"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.frequency",
        "path": "CarePlan.activity.detail.scheduled[x].repeat.frequency",
        "short": "Interval / Frequency",
        "definition": "* Interval indicates the time between planned procedures. When entering an interval, the focus is on the time between the consecutive procedures, such as in the treatment of a wound, for example. The exact times are of lesser importance.\r\n* The frequency describes how often and in which period certain procedures are carried out, e.g. 3x a day.",
        "comment": "Both the zib concepts Interval and Frequency are communicated using a combination of `.frequency`, `.period` and `.periodUnit`. If the Interval concept is communicated, `.frequency` SHOULD have a fixed value of 1 (see \"Meaning when missing\" for `.frequency`).",
        "alias": [
          "Interval",
          "Frequentie"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.3",
            "comment": "Interval"
          },
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.4",
            "comment": "Frequency"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.period",
        "path": "CarePlan.activity.detail.scheduled[x].repeat.period",
        "short": "Interval / Frequency",
        "definition": "* Interval indicates the time between planned procedures. When entering an interval, the focus is on the time between the consecutive procedures, such as in the treatment of a wound, for example. The exact times are of lesser importance.\r\n* The frequency describes how often and in which period certain procedures are carried out, e.g. 3x a day.",
        "comment": "Both the zib concepts Interval and Frequency are communicated using a combination of `.frequency`, `.period` and `.periodUnit`. If the Interval concept is communicated, `.frequency` SHOULD have a fixed value of 1 (see \"Meaning when missing\" for `.frequency`).",
        "alias": [
          "Interval",
          "Frequentie"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.3",
            "comment": "Interval"
          },
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.4",
            "comment": "Frequency"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.periodUnit",
        "path": "CarePlan.activity.detail.scheduled[x].repeat.periodUnit",
        "short": "Interval / Frequency",
        "definition": "* Interval indicates the time between planned procedures. When entering an interval, the focus is on the time between the consecutive procedures, such as in the treatment of a wound, for example. The exact times are of lesser importance.\r\n* The frequency describes how often and in which period certain procedures are carried out, e.g. 3x a day.",
        "comment": "Both the zib concepts Interval and Frequency are communicated using a combination of `.frequency`, `.period` and `.periodUnit`. If the Interval concept is communicated, `.frequency` SHOULD have a fixed value of 1 (see \"Meaning when missing\" for `.frequency`).",
        "alias": [
          "Interval",
          "Frequentie"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.3",
            "comment": "Interval"
          },
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.4",
            "comment": "Frequency"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.performer",
        "path": "CarePlan.activity.detail.performer",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "max": "1"
      },
      {
        "id": "CarePlan.activity.detail.performer:healthcareProvider",
        "path": "CarePlan.activity.detail.performer",
        "sliceName": "healthcareProvider",
        "short": "HealthcareProvider",
        "definition": "The health professional carrying out the nursing procedure.",
        "comment": "Each occurence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [zib-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [zib-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-Practitioner)). The reference to the Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource.\r\n\r\nIn rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here.",
        "alias": [
          "Zorgverlener"
        ],
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole",
              "http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-Practitioner"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.7",
            "comment": "HealthcareProvider"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.performer:caregiver",
        "path": "CarePlan.activity.detail.performer",
        "sliceName": "caregiver",
        "short": "Caregiver",
        "definition": "The caregiver carrying out the nursing procedure.",
        "alias": [
          "Verzorger"
        ],
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://nictiz.nl/fhir/StructureDefinition/zib-ContactPerson"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.16",
            "comment": "Caregiver"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.performer:patient",
        "path": "CarePlan.activity.detail.performer",
        "sliceName": "patient",
        "short": "Patient",
        "definition": "The patient carrying out the nursing procedure.",
        "alias": [
          "Patient"
        ],
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://nictiz.nl/fhir/StructureDefinition/zib-Patient"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.17",
            "comment": "Patient"
          }
        ]
      },
      {
        "id": "CarePlan.activity.detail.description",
        "path": "CarePlan.activity.detail.description",
        "short": "Instruction",
        "definition": "Instructions for performing the nursing action. This is particularly at issue when the action is performed by the patient himself or by a caregiver.",
        "alias": [
          "Instructie"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.18",
            "comment": "Instruction"
          }
        ]
      },
      {
        "id": "CarePlan.note.text",
        "path": "CarePlan.note.text",
        "short": "Comment",
        "definition": "Comment on the nursing intervention.",
        "alias": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "zib-nursingintervention-v3.2-2020EN",
            "map": "NL-CM:14.2.5",
            "comment": "Comment"
          }
        ]
      }
    ]
  }
}

name : ZibNursingIntervention

{

}