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HdBe-DecubitusWond

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	Concept	Status
HdBe-PressureUlcer	Een decubituswond is een gelokaliseerde beschadiging van de huid en/of onderliggend weefsel, meestal ter hoogte van een botuitsteeksel, als gevolg van druk of druk in samenhang met schuifkracht. Decubitus gaat gepaard met veel ziektelast en vermindert de kwaliteit van leven voor patiënten. Adequate risico-inschatting, preventie en behandeling van decubitus leiden tot een lagere incidentie en prevalentie van decubitus. Purpose Informatie over de decubitus is van belang bij het inzetten of continueren van de optimale wondbehandeling, curatief en preventief, en om de voortgang van de wondgenezing goed te kunnen monitoren. Evidence Base Voor het beschrijven van de wond wordt gebruik gemaakt van de indeling in 4 categoriën, , gebaseerd op het internationale NPUAP/EPUAP decubitus classificatiesysteem: Categorie 1: niet wegdrukbare roodheid bij een intacte huid; Categorie 2: verlies van een deel van de huidlaag of blaar; Categorie 3: verlies van een volledige huidlaag (vet zichtbaar); Categorie 4: verlies van een volledige weefsellaag (spier/bot zichtbaar). References V&VN (2011) Landelijke multidisciplinaire richtlijn. Decubitus preventie en behandeling. [Online] Beschikbaar op: www.diliguide.nl/document/1613/file/pdf/ [Geraadpleegd: 13 februari 2015]	draft

CBB

Concept

Status

HdBe-PressureUlcer

Een decubituswond is een gelokaliseerde beschadiging van de huid en/of onderliggend weefsel, meestal ter hoogte van een botuitsteeksel, als gevolg van druk of druk in samenhang met schuifkracht. Decubitus gaat gepaard met veel ziektelast en vermindert de kwaliteit van leven voor patiënten. Adequate risico-inschatting, preventie en behandeling van decubitus leiden tot een lagere incidentie en prevalentie van decubitus.

Purpose

Informatie over de decubitus is van belang bij het inzetten of continueren van de optimale wondbehandeling, curatief en preventief, en om de voortgang van de wondgenezing goed te kunnen monitoren.

Evidence Base

Voor het beschrijven van de wond wordt gebruik gemaakt van de indeling in 4 categoriën, , gebaseerd op het internationale NPUAP/EPUAP decubitus classificatiesysteem:

Categorie 1: niet wegdrukbare roodheid bij een intacte huid;
Categorie 2: verlies van een deel van de huidlaag of blaar;
Categorie 3: verlies van een volledige huidlaag (vet zichtbaar);
Categorie 4: verlies van een volledige weefsellaag (spier/bot zichtbaar).

References

V&VN (2011) *Landelijke multidisciplinaire richtlijn. Decubitus preventie en behandeling. *[Online] Beschikbaar op: www.diliguide.nl/document/1613/file/pdf/ [Geraadpleegd: 13 februari 2015]

draft

PressureUlcer			PressureUlcer	Element id PressureUlcer Short description DecubitusWond Definition Rootconcept van bouwsteen DecubitusWond. Dit concept bevat alle gegevenselementen van de bouwsteen DecubitusWond. 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 DecubitusCategorie Definition Beschrijving van de toestand van decubituswond, oplopend van categorie 1 tot en met 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 OntstaansDatum Definition De datum waarop de decubituswond is ontstaan. 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 AnatomischeLocatie Definition De locatie op het lichaam waar de decubituswond zich bevindt. 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 DatumLaatsteVerbandwissel Definition De datum waarop het verband de laatste maal verwisseld is. 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 Wondlengte Definition De lengte van de decubituswond. 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 Wondbreedte Definition De breedte van de decubituswond. 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 Wonddiepte Definition De diepte van de decubituswond. 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 WondFoto Definition Een foto van de decubituswond als visuele informatie. 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 Toelichting Definition Een toelichting op de decubituswond. 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