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HdBe-NursingIntervention

CBB	Description	Status
HdBe-NursingIntervention	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. It is possible to structure nursing interventions (or actions) in a hierarchy, where one intervention can be part of another intervention. In a home care situation some actions can also be performed by the patient or a caregiver after a relevant instruction. Purpose The nursing interventions are an essential part of the nursing process. A nursing intervention is recorded to document the nursing policy and to update other health professionals on the intervention. The documentation of nursing interventions offers the option to determine whether the interventions outlined in the treatment plan have been carried out. This way, we can facilitate optimal nursing and continuity of care. Instructions For the nursing domain: when two parties use different classification systems, the SNOMED CT based nursing problem list is used for exchange of information, so that data becomes comparable and interchangeable.	active

CBB

Description

Status

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. It is possible to structure nursing interventions (or actions) in a hierarchy, where one intervention can be part of another intervention. In a home care situation some actions can also be performed by the patient or a caregiver after a relevant instruction.

Purpose

The nursing interventions are an essential part of the nursing process. A nursing intervention is recorded to document the nursing policy and to update other health professionals on the intervention. The documentation of nursing interventions offers the option to determine whether the interventions outlined in the treatment plan have been carried out. This way, we can facilitate optimal nursing and continuity of care.

Instructions

For the nursing domain: when two parties use different classification systems, the SNOMED CT based nursing problem list is used for exchange of information, so that data becomes comparable and interchangeable.

active

NursingIntervention			NursingIntervention	Element id NursingIntervention Short description NursingIntervention Definition Root concept of the NursingIntervention information model. This root concept contains all data elements of the NursingIntervention information model. Data type NursingIntervention Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id NursingIntervention.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id NursingIntervention.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
Intervention		1..1	CodeableConceptBinding	Element id NursingIntervention.Intervention Short description 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 toward 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). Comments 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. Data type CodeableConcept Binding Intervention codes Intervention (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Indication	I	0..1	Reference(HdBe-Problem)	Element id NursingIntervention.Indication Short description Indication Definition The nursing-related problem (indication) providing cause for the intervention. Comments 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. Data type Reference(HdBe-Problem) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
TreatmentObjective	I	0..1	Reference(HdBe-TreatmentObjective)	Element id NursingIntervention.TreatmentObjective Short description TreatmentObjective Definition The description of the treatment goal that the intervention decision is based on. Comments 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. Data type Reference(HdBe-TreatmentObjective) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Interval	I	0..1	Quantity	Element id NursingIntervention.Interval Short description Interval 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. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Quantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
Frequency	I	0..1	Quantity	Element id NursingIntervention.Frequency Short description Frequency Definition The frequency describes how often and in which period certain procedures are carried out, e.g. 3x a day. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Quantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
ProcedureStartDateTime		0..1	dateTime	Element id NursingIntervention.ProcedureStartDateTime Short description 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ProcedureEndDateTime		0..1	dateTime	Element id NursingIntervention.ProcedureEndDateTime Short description 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
MedicalDevice	I	0..*	Reference(HdBe-MedicalDevice)	Element id NursingIntervention.MedicalDevice Short description MedicalDevice Definition Description of the materials used for the nursing procedure, such as bandages. Comments 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. Data type Reference(HdBe-MedicalDevice) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Instruction		0..1	string	Element id NursingIntervention.Instruction Short description Instruction Definition Instructions for performing the nursing action. This is particularly at issue when the action is performed by the patient themselves or by a caregiver. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Performer		0..1	BackboneElement	Element id NursingIntervention.Performer Short description Performer Definition The person carrying out the nursing procedure. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id NursingIntervention.Performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id NursingIntervention.Performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id NursingIntervention.Performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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). Requirements 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
HealthcareProfessional	I	0..1	Reference(HdBe-HealthProfessional)	Element id NursingIntervention.Performer.HealthcareProfessional Short description HealthcareOrganization Definition The health professional carrying out the nursing procedure. Comments 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. Data type Reference(HdBe-HealthProfessional) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Caregiver	I	0..1	Reference(HdBe-ContactPerson)	Element id NursingIntervention.Performer.Caregiver Short description Caregiver Definition The caregiver carrying out the nursing procedure. Comments 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. Data type Reference(HdBe-ContactPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Patient	I	0..1	Reference(HdBe-Patient)	Element id NursingIntervention.Performer.Patient Short description Patient Definition The patient carrying out the nursing procedure. Comments 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. Data type Reference(HdBe-Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Requester	I	0..*	Reference(HdBe-HealthProfessional)	Element id NursingIntervention.Requester Short description Requester Definition The health professional who requested the nursing intervention. If desired, only the requester’s specialty can be entered. Comments 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. Data type Reference(HdBe-HealthProfessional) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Comment		0..1	string	Element id NursingIntervention.Comment Short description Comment Definition Comment on the nursing intervention. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

NursingIntervention		0..*
NursingIntervention.Intervention	CodeableConcept	1..1
NursingIntervention.Indication	Reference(HdBe-Problem)	0..1
NursingIntervention.TreatmentObjective	Reference(HdBe-TreatmentObjective)	0..1
NursingIntervention.Interval	Quantity	0..1
NursingIntervention.Frequency	Quantity	0..1
NursingIntervention.ProcedureStartDateTime	dateTime	0..1
NursingIntervention.ProcedureEndDateTime	dateTime	0..1
NursingIntervention.MedicalDevice	Reference(HdBe-MedicalDevice)	0..*
NursingIntervention.Instruction	string	0..1
NursingIntervention.Performer	BackboneElement	0..1
NursingIntervention.Performer.HealthcareProfessional	Reference(HdBe-HealthProfessional)	0..1
NursingIntervention.Performer.Caregiver	Reference(HdBe-ContactPerson)	0..1
NursingIntervention.Performer.Patient	Reference(HdBe-Patient)	0..1
NursingIntervention.Requester	Reference(HdBe-HealthProfessional)	0..*
NursingIntervention.Comment	string	0..1

NursingIntervention
Definition	Root concept of the NursingIntervention information model. This root concept contains all data elements of the NursingIntervention information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
NursingIntervention.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
NursingIntervention.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
NursingIntervention.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 toward 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).
Cardinality	1...1
Type	CodeableConcept
Binding	Intervention codes Intervention (required)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
NursingIntervention.Indication
Definition	The nursing-related problem (indication) providing cause for the intervention.
Cardinality	0...1
Type	Reference(HdBe-Problem)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
NursingIntervention.TreatmentObjective
Definition	The description of the treatment goal that the intervention decision is based on.
Cardinality	0...1
Type	Reference(HdBe-TreatmentObjective)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
NursingIntervention.Interval
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.
Cardinality	0...1
Type	Quantity
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
NursingIntervention.Frequency
Definition	The frequency describes how often and in which period certain procedures are carried out, e.g. 3x a day.
Cardinality	0...1
Type	Quantity
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
NursingIntervention.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.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
NursingIntervention.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.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
NursingIntervention.MedicalDevice
Definition	Description of the materials used for the nursing procedure, such as bandages.
Cardinality	0...*
Type	Reference(HdBe-MedicalDevice)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
NursingIntervention.Instruction
Definition	Instructions for performing the nursing action. This is particularly at issue when the action is performed by the patient themselves or by a caregiver.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
NursingIntervention.Performer
Definition	The person carrying out the nursing procedure.
Cardinality	0...1
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
NursingIntervention.Performer.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
NursingIntervention.Performer.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
NursingIntervention.Performer.modifierExtension
Definition	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).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	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.
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
NursingIntervention.Performer.HealthcareProfessional
Definition	The health professional carrying out the nursing procedure.
Cardinality	0...1
Type	Reference(HdBe-HealthProfessional)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
NursingIntervention.Performer.Caregiver
Definition	The caregiver carrying out the nursing procedure.
Cardinality	0...1
Type	Reference(HdBe-ContactPerson)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
NursingIntervention.Performer.Patient
Definition	The patient carrying out the nursing procedure.
Cardinality	0...1
Type	Reference(HdBe-Patient)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
NursingIntervention.Requester
Definition	The health professional who requested the nursing intervention. If desired, only the requester’s specialty can be entered.
Cardinality	0...*
Type	Reference(HdBe-HealthProfessional)
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
NursingIntervention.Comment
Definition	Comment on the nursing intervention.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a

Example instances

NursingIntervention
Intervention	386420003 - Ondersteunen bij wassen en/of persoonlijke hygiene (code by SNOMED CT)
Indication	Probleem met zichzelf wassen en drogen
TreatmentObjective	Wassen onafhankelijk
Interval
Frequency	1/dag
ProcedureStartDateTime	10-09-2021
ProcedureEndDateTime
MedicalDevice
Instruction	Let op: valrisico
Performer
Performer.HealthcareOrganization
Performer.Caregiver
Performer.Patient
Requester
Comment

zib NursingIntervention-v3.2 difference

Concept	Category	Description
description.concept	textual	Added a period after 'a relevant instruction'.
description.concept	textual	Removed the Dutch context 'NEN-EN-ISO 18104 norm'.
description.instructions	textual	Removed the Dutch context.
`Intervention`	terminology	Only allowed SNOMED codes. Removed NIC codelist.
`Performer.HealthcareOrganization`	element	Renamed element to `Performer.HealthcareProfessional` to align with reference being made. This will be fixed in a future version of the zib.
`Intervention`	textual	Replaced 'towards' by 'toward'.
`Instruction`	textual	Replaced 'himself' by 'themselves'.

Terminology Bindings

Path	Name	Strength	URL
Intervention	Intervention	required	https://fhir.healthdata.be/ValueSet/Intervention