{ "resourceType": "StructureDefinition", "id": "zib-DOSScore", "text": { "status": "empty", "div": "
No narrative is provided for definitional resources. A human-readable rendering can be found in the implementation guide(s) where this resource is used.
" }, "url": "http://nictiz.nl/fhir/StructureDefinition/zib-DOSScore", "name": "ZibDOSScore", "title": "zib DOSScore", "status": "draft", "publisher": "Nictiz", "contact": [ { "name": "Nictiz", "telecom": [ { "system": "url", "value": "https://www.nictiz.nl", "use": "work" } ] } ], "description": "The Delirium Observation Screening Scale is a tool to determine whether a patient has delirium. The DOSS includes 13 observations of behavior (verbal and non-verbal) which represent the symptoms of a delirium. These observations can be performed during regular contact with the patient.", "purpose": "This Observation resource represents the Dutch [zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) DOSScore v1.0 (2020)](https://zibs.nl/wiki/DOSScore-v1.0(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-dosscore-v1.0-2020EN", "uri": "https://zibs.nl/wiki/DOSScore-v1.0(2020EN)", "name": "zib DOSScore-v1.0(2020EN)" } ], "kind": "resource", "abstract": true, "type": "Observation", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation", "derivation": "constraint", "differential": { "element": [ { "id": "Observation", "path": "Observation", "short": "DOSScore", "alias": [ "DOSScore" ], "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.1", "comment": "DOSScore" } ] }, { "id": "Observation.code", "path": "Observation.code", "comment": "The code to identify this concept (SNOMED 55681000146102) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "http://snomed.info/sct", "code": "55681000146102" } ] } }, { "id": "Observation.effective[x]", "path": "Observation.effective[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "rules": "open" } }, { "id": "Observation.effective[x]:effectiveDateTime", "path": "Observation.effective[x]", "sliceName": "effectiveDateTime", "short": "DOSScoreDateTime", "definition": "The date on which the DOS score is registered.", "alias": [ "DOSScoreDatumTijd" ], "type": [ { "code": "dateTime" } ], "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.5", "comment": "DOSScoreDateTime" } ] }, { "id": "Observation.value[x]", "path": "Observation.value[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "rules": "open" } }, { "id": "Observation.value[x]:valueInteger", "path": "Observation.value[x]", "sliceName": "valueInteger", "short": "DOSScoreTotal", "definition": "Per shift a total score is calculated (minimum 0 and maximum 13). The total scores of three shifts (day, evening and night shifts) are summed to the total score of the day (minimum 0 and maximum 39).\r\n\r\nThe DOS scale final score is calculated by dividing the total score of the day by 3 (minimum 0 and maximum 13).\r\n\r\nA DOS scale final score < 3 means that the patient is probably not delirious. A DOS scale final score > 3 means that the patient is probably delirious.", "alias": [ "DOSScoreTotaal" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 13, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.3", "comment": "DOSScoreTotal" } ] }, { "id": "Observation.note", "path": "Observation.note", "max": "1" }, { "id": "Observation.note.text", "path": "Observation.note.text", "short": "Comment", "definition": "Comment on the DOS score.", "alias": [ "Toelichting" ], "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.2", "comment": "Comment" } ] }, { "id": "Observation.component", "path": "Observation.component", "slicing": { "discriminator": [ { "type": "value", "path": "code" } ], "rules": "open" } }, { "id": "Observation.component:dozesOff", "path": "Observation.component", "sliceName": "dozesOff", "max": "1" }, { "id": "Observation.component:dozesOff.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007006 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007006" } ] } }, { "id": "Observation.component:dozesOff.value[x]", "path": "Observation.component.value[x]", "short": "DozesOff", "definition": "DOS observation: patient dozes off during conversation or activities.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "ZaktWeg" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.6", "comment": "DozesOff" } ] }, { "id": "Observation.component:easilyDistracted", "path": "Observation.component", "sliceName": "easilyDistracted", "max": "1" }, { "id": "Observation.component:easilyDistracted.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007007 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007007" } ] } }, { "id": "Observation.component:easilyDistracted.value[x]", "path": "Observation.component.value[x]", "short": "EasilyDistracted", "definition": "DOS observation: patient is easily distracted by stimuli from the environment.\r\n\r\nSomeone is easily distracted by stimuli from the environment when he/she responds verbally or non-verbally to sounds or movements that have no relation to him/her and the nature of which does not make you expect a reaction from him/her.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "SnelAfgeleid" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.7", "comment": "EasilyDistracted" } ] }, { "id": "Observation.component:maintainsAttention", "path": "Observation.component", "sliceName": "maintainsAttention", "max": "1" }, { "id": "Observation.component:maintainsAttention.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007008 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007008" } ] } }, { "id": "Observation.component:maintainsAttention.value[x]", "path": "Observation.component.value[x]", "short": "MaintainsAttention", "definition": "DOS observation: patient maintains attention to conversation or action.\r\n\r\nSomeone is maintaining attention to a conversation or action if he/she verbally or non-verbally shows that they are following the conversation or action.\r\n\r\nScore:\r\n1: never\r\n0: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "HeeftAandacht" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.8", "comment": "MaintainsAttention" } ] }, { "id": "Observation.component:unfinishedQuestionAnswer", "path": "Observation.component", "sliceName": "unfinishedQuestionAnswer", "max": "1" }, { "id": "Observation.component:unfinishedQuestionAnswer.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007009 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007009" } ] } }, { "id": "Observation.component:unfinishedQuestionAnswer.value[x]", "path": "Observation.component.value[x]", "short": "UnfinishedQuestionAnswer", "definition": "DOS observation: patient does not finish question or answer.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "VraagAntwoordNietAf" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.9", "comment": "UnfinishedQuestionAnswer" } ] }, { "id": "Observation.component:answersNoFit", "path": "Observation.component", "sliceName": "answersNoFit", "max": "1" }, { "id": "Observation.component:answersNoFit.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007010 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007010" } ] } }, { "id": "Observation.component:answersNoFit.value[x]", "path": "Observation.component.value[x]", "short": "AnswersNoFit", "definition": "DOS observation: patient gives answers that do not fit the question.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "AntwoordenNietPassend" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.10", "comment": "AnswersNoFit" } ] }, { "id": "Observation.component:reactsSlowly", "path": "Observation.component", "sliceName": "reactsSlowly", "max": "1" }, { "id": "Observation.component:reactsSlowly.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007011 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007011" } ] } }, { "id": "Observation.component:reactsSlowly.value[x]", "path": "Observation.component.value[x]", "short": "ReactsSlowly", "definition": "DOS observation: patient reacts slowly to instructions.\r\n\r\nSomeone reacts slowly to instructions when acting is delayed and/or there are moments of stillness/inactivity before moving into action.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "ReageertTraag" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.11", "comment": "ReactsSlowly" } ] }, { "id": "Observation.component:thinksSomewhereElse", "path": "Observation.component", "sliceName": "thinksSomewhereElse", "max": "1" }, { "id": "Observation.component:thinksSomewhereElse.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007012 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007012" } ] } }, { "id": "Observation.component:thinksSomewhereElse.value[x]", "path": "Observation.component.value[x]", "short": "ThinksSomewhereElse", "definition": "DOS observation: patient thinks they are somewhere else.\r\n\r\nSomeone thinks they are somewhere else when he/she shows this in words or actions.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "DenktErgensAnders" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.12", "comment": "ThinksSomewhereElse" } ] }, { "id": "Observation.component:knowsPartDay", "path": "Observation.component", "sliceName": "knowsPartDay", "max": "1" }, { "id": "Observation.component:knowsPartDay.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007013 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007013" } ] } }, { "id": "Observation.component:knowsPartDay.value[x]", "path": "Observation.component.value[x]", "short": "KnowsPartDay", "definition": "DOS observation: patient knows which part of the day it is.\r\n\r\nSomeone knows what part of the day it is when he/she shows such in words or actions.\r\n\r\nScore:\r\n1: never\r\n0: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "BeseftDagdeel" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.13", "comment": "KnowsPartDay" } ] }, { "id": "Observation.component:remembersRecent", "path": "Observation.component", "sliceName": "remembersRecent", "max": "1" }, { "id": "Observation.component:remembersRecent.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007014 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007014" } ] } }, { "id": "Observation.component:remembersRecent.value[x]", "path": "Observation.component.value[x]", "short": "RemembersRecent", "definition": "DOS observation: patient remembers recent events.\r\n\r\nSomeone remembers recent events when he/she can for example tell whether they had visitors or what he/she ate.\r\n\r\nScore:\r\n1: never\r\n0: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "HerinnertRecent" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.14", "comment": "RemembersRecent" } ] }, { "id": "Observation.component:restless", "path": "Observation.component", "sliceName": "restless", "max": "1" }, { "id": "Observation.component:restless.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007015 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007015" } ] } }, { "id": "Observation.component:restless.value[x]", "path": "Observation.component.value[x]", "short": "Restless", "definition": "DOS observation: patient is picking, disorderly, restless.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "Rusteloos" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.15", "comment": "Restless" } ] }, { "id": "Observation.component:pullsWires", "path": "Observation.component", "sliceName": "pullsWires", "max": "1" }, { "id": "Observation.component:pullsWires.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007016 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007016" } ] } }, { "id": "Observation.component:pullsWires.value[x]", "path": "Observation.component.value[x]", "short": "PullsWires", "definition": "DOS observation: patient pulls IV tubing, feeding tubes, catheters, etc.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "TrektDraden" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.16", "comment": "PullsWires" } ] }, { "id": "Observation.component:easilyEmotional", "path": "Observation.component", "sliceName": "easilyEmotional", "max": "1" }, { "id": "Observation.component:easilyEmotional.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007017 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007017" } ] } }, { "id": "Observation.component:easilyEmotional.value[x]", "path": "Observation.component.value[x]", "short": "EasilyEmotional", "definition": "DOS observation: patient is easily or suddenly emotional.\r\n\r\nSomeone is easily or suddenly emotional when he/she responds with a fierce emotion without provocation or when the fierceness of the emotion does not seem to match the provocation.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "SnelGeemotioneerd" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.17", "comment": "EasilyEmotional" } ] }, { "id": "Observation.component:hallucinations", "path": "Observation.component", "sliceName": "hallucinations", "max": "1" }, { "id": "Observation.component:hallucinations.code", "path": "Observation.component.code", "comment": "The code to identify this concept (18007018 in code system urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1) aligns with the next version of the zib, since the current version doesn't provide a code. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for more information.", "patternCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1", "code": "18007018" } ] } }, { "id": "Observation.component:hallucinations.value[x]", "path": "Observation.component.value[x]", "short": "Hallucinations", "definition": "DOS observation: patient sees/hears things which are not there.\r\n\r\nSomeone sees/hears things which are not there when he/she shows this verbally (ask!) or non-verbally.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)", "alias": [ "Hallucinaties" ], "type": [ { "code": "integer" } ], "minValueInteger": 0, "maxValueInteger": 1, "mapping": [ { "identity": "zib-dosscore-v1.0-2020EN", "map": "NL-CM:18.7.18", "comment": "Hallucinations" } ] } ] } }