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HdBe-PressureUlcer

WARNING This page contains a draft CBB, as raw output from the zib export and automatic conversion to CBB. It requires thorough review and adaption to the Belgian realm. This CBB is merely added for informative use.

CBB	Description	Status
HdBe-PressureUlcer	A pressure ulcer is localized damage to the skin and/or underlying tissue, often over a bony prominence, as a result of pressure or pressure combined with friction. A pressure ulcer involves a major disease burden and reduces the quality of life for a patient. Adequate risk evaluation, prevention and treatment of pressure ulcers can lead to a fewer incidences and prevalence of pressure ulcers. Purpose Information on the pressure ulcer is of importance in starting or continuing the best possible wound treatment, curatively and preventatively, and to be able to properly monitor the wound healing process. Evidence Base To describe the wound, there are 4 categories, based on the international NPUAP/EPUAP decubitus classification system: Category 1: non-removable redness of intact skin; Category 2: loss of a partial layer of skin or blister; Category 3: loss of an entire layer of skin (visible fat); Category 4: loss of an entire layer of tissue (visible muscle/bone).	draft

CBB

Description

Status

HdBe-PressureUlcer

A pressure ulcer is localized damage to the skin and/or underlying tissue, often over a bony prominence, as a result of pressure or pressure combined with friction. A pressure ulcer involves a major disease burden and reduces the quality of life for a patient. Adequate risk evaluation, prevention and treatment of pressure ulcers can lead to a fewer incidences and prevalence of pressure ulcers.

Purpose

Information on the pressure ulcer is of importance in starting or continuing the best possible wound treatment, curatively and preventatively, and to be able to properly monitor the wound healing process.

Evidence Base

To describe the wound, there are 4 categories, based on the international NPUAP/EPUAP decubitus classification system:

Category 1: non-removable redness of intact skin;
Category 2: loss of a partial layer of skin or blister;
Category 3: loss of an entire layer of skin (visible fat);
Category 4: loss of an entire layer of tissue (visible muscle/bone).

draft

PressureUlcer			PressureUlcer	Element id PressureUlcer Short description PressureUlcer Definition Root concept of the DecubitusWound information model. This root concept contains all data elements of the DecubitusWound information model. Data type PressureUlcer 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 PressureUlcer.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 PressureUlcer.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
DecubitusCategory		1..1	CodeableConceptBinding	Element id PressureUlcer.DecubitusCategory Short description DecubitusCategory Definition Description of the condition of the pressure ulcer, ranging from category 1 - 4. 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 DecubitusCategory codes DecubitusCategory (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
DateOfOnset		0..1	dateTime	Element id PressureUlcer.DateOfOnset Short description DateOfOnset Definition The date on which the pressure ulcer appeared. 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
AnatomicalLocation	I	0..1	Reference(HdBe-AnatomicalLocation)	Element id PressureUlcer.AnatomicalLocation Short description AnatomicalLocation Definition The location of the decubitus wound on the body. 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-AnatomicalLocation) 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)
DateOfLastDressingChange		0..1	dateTime	Element id PressureUlcer.DateOfLastDressingChange Short description DateOfLastDressingChange Definition The date on which the dressing was last changed. 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
WoundLength	I	0..1	Quantity	Element id PressureUlcer.WoundLength Short description WoundLength Definition The length of the decubitus wound. 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
WoundWidth	I	0..1	Quantity	Element id PressureUlcer.WoundWidth Short description WoundWidth Definition The width of the decubitus wound. 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
WoundDepth	I	0..1	Quantity	Element id PressureUlcer.WoundDepth Short description WoundDepth Definition The depth of the decubitus wound. 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
WoundImage		0..*	base64Binary	Element id PressureUlcer.WoundImage Short description WoundImage Definition A photo of the decubitus wound as visual information. Comments A stream of bytes, base64 encoded Data type base64Binary Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Comment		0..1	string	Element id PressureUlcer.Comment Short description Comment Definition A comment of the decubitus wound. 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

PressureUlcer		0..*
PressureUlcer.DecubitusCategory	CodeableConcept	1..1
PressureUlcer.DateOfOnset	dateTime	0..1
PressureUlcer.AnatomicalLocation	Reference(HdBe-AnatomicalLocation)	0..1
PressureUlcer.DateOfLastDressingChange	dateTime	0..1
PressureUlcer.WoundLength	Quantity	0..1
PressureUlcer.WoundWidth	Quantity	0..1
PressureUlcer.WoundDepth	Quantity	0..1
PressureUlcer.WoundImage	base64Binary	0..*
PressureUlcer.Comment	string	0..1

PressureUlcer
Definition	Root concept of the DecubitusWound information model. This root concept contains all data elements of the DecubitusWound 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
PressureUlcer.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
PressureUlcer.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
PressureUlcer.DecubitusCategory
Definition	Description of the condition of the pressure ulcer, ranging from category 1 - 4.
Cardinality	1...1
Type	CodeableConcept
Binding	DecubitusCategory codes DecubitusCategory (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
PressureUlcer.DateOfOnset
Definition	The date on which the pressure ulcer appeared.
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
PressureUlcer.AnatomicalLocation
Definition	The location of the decubitus wound on the body.
Cardinality	0...1
Type	Reference(HdBe-AnatomicalLocation)
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)
PressureUlcer.DateOfLastDressingChange
Definition	The date on which the dressing was last changed.
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
PressureUlcer.WoundLength
Definition	The length of the decubitus wound.
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
PressureUlcer.WoundWidth
Definition	The width of the decubitus wound.
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
PressureUlcer.WoundDepth
Definition	The depth of the decubitus wound.
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
PressureUlcer.WoundImage
Definition	A photo of the decubitus wound as visual information.
Cardinality	0...*
Type	base64Binary
Comments	A stream of bytes, base64 encoded
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
PressureUlcer.Comment
Definition	A comment of the decubitus wound.
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

[CBB name]
[Concept name ]	[example value]

// example of NameInformation

## Example instances

| NameInformation      |                   |
|----------------------|-------------------|
| FirstNames | Johanna Petronella Maria   
| Initials | J.P.M. 
| GivenName | Jo 
| NameUsage | Geslachtsnaam partner gevolgd door eigen geslachtsnaam
| LastName.Prefix | van
| LastName.LastName | Putten
| LastNamePartner.PartnerPrefix | van der
| LastNamePartner.PartnerLastName | Giessen
| Titles |

zib [zib name + version](https://zibs.nl/wiki/[zib name + version(release)]) difference

Concept	Category	Description
`[element.path]`	[category of change]	[Description of change]([Reference to ticket/issue/zulip chat using MarkDown link])

Terminology Bindings

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