{ "resourceType": "StructureDefinition", "meta": { "lastUpdated": "2020-12-03T07:50:40.537+00:00" }, "url": "http://example.org/fhir/StructureDefinition/NHSDigitalEOLCPRStatus", "name": "NHSDigitalEOLCPRStatus", "status": "draft", "description": "https://developer.nhs.uk/apis/eol-alpha/api_eol_cprstatus.html \r\n\r\nhttps://fhir.nhs.uk/STU3/StructureDefinition/EOL-CPRStatus-Flag-1", "fhirVersion": "4.0.1", "kind": "logical", "abstract": false, "type": "http://example.org/fhir/StructureDefinition/NHSDigitalEOLCPRStatus", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Element", "derivation": "specialization", "differential": { "element": [ { "id": "NHSDigitalEOLCPRStatus", "path": "NHSDigitalEOLCPRStatus", "min": 0, "max": "*", "type": [ { "code": "Element" } ] }, { "id": "NHSDigitalEOLCPRStatus.cpr_status", "path": "NHSDigitalEOLCPRStatus.cpr_status", "short": "CPR Status", "definition": "If CPR status is transmitted, then the status code is mandatory. This will be a straight binary choice of \"For\" or \"Not For\" resuscitation.\r\n\r\nWhilst there is a code for \"not aware of decision\", this is not a logical requirement for this dataset. Systems that are unaware of the status will logically not be sending this group.\r\n\r\n\"For CPR\" will generally be only used when reversing a \"Not for CPR\" status. People who haven't yet had the discussion would just not have a recorded CPR decision in file.\r\n\r\nSCR Inclusion Dataset, and advised codes:\r\n450475007 | For cardiopulmonary resuscitation (finding)\r\n450476008 | Not for cardiopulmonary resuscitation (finding)\r\n\r\nOther codes in SCR Inclusion Dataset:\r\n304252001 | For resuscitation (finding)\r\n304253006 | Not for resuscitation (finding)\r\n143021000119109 | Do not resuscitate status with supporting documentation (finding)\r\n\r\n--------\r\nhttps://fhir.nhs.uk/STU3/ValueSet/EOL-CPRStatus-Code-1\r\n\r\n143021000119109 Do not resuscitate status with supporting documentation (finding)\r\n​ 304252001 For resuscitation (finding)\r\n​ 304253006 Not for resuscitation (finding)\r\n​ 450475007 For cardiopulmonary resuscitation (finding)\r\n​ 450476008 Not for cardiopulmonary resuscitation (finding)", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept", "profile": [ "http://hl7.org/fhir/StructureDefinition/CodeableConcept" ] } ] }, { "id": "NHSDigitalEOLCPRStatus.reason_for_cpr_status", "path": "NHSDigitalEOLCPRStatus.reason_for_cpr_status", "definition": "It will be a strong recommendation that a reason for the status change is included although it is unlikely that it can be mandated from the start. Also, as this is an MVP dataset, it could be argued that UEC are most keen on seeing the status rather than additional text. However, in the example below if the text reads \"There is a valid advance decision to refuse CPR in the following circumstances...\", then the DNACPR decision is not for all circumstances. In that case, the business may wish to consider whether a non-blanket DNACPR would be better recorded as an Advance Treatment Preference so that where it is appropriate can be made clear.\r\n\r\nExample text strings could be:\r\n+ CPR is unlikely to be successful due to…\r\n+ CPR would be of no clinical benefit because of the following medical conditions...\r\n+ The outcome of the CPR would not be of overall benefit to the patient\r\n+ CPR may be successful, but followed by a length and quality of life which would not be of overall benefit to the person.\r\n+ There is a valid advance decision to refuse CPR in the following circumstances...\r\n+ CPR is against the wishes of the patient and is recorded in a valid advance decision\r\n+ CPR has been discussed with this patient. It is against their wishes and they have the mental capacity to make that decision\r\n+ DNACPR cancelled due to...", "min": 0, "max": "1", "type": [ { "code": "string", "profile": [ "http://hl7.org/fhir/StructureDefinition/string" ] } ] }, { "id": "NHSDigitalEOLCPRStatus.cpr_status_mental_capacity", "path": "NHSDigitalEOLCPRStatus.cpr_status_mental_capacity", "definition": "'Systems should also deliver the mental capacity information as a textual field. The exact text will vary from system to system - below is a selection. Some refer to \"consent\" rather than the \"capacity to be involved\". This highlights a difference across England of this concept, which is not for the dataset to resolve.\r\n\r\nExample text strings could be:\r\n+ This person has the mental capacity to participate in making these recommendations. They have been fully involved in the decision making process.\r\n+ This person lacks the capacity to to give consent (Mental Capacity Act 2005)\r\n+ This person is less than 18 (UK except Scotland) / 16 (Scotland) years old and has sufficient maturity and understanding to participate in making this decision\r\n+ This person is less than 18 (UK except Scotland) / 16 (Scotland) years old and does not currently have sufficient maturity and understanding to participate in making this decision\r\n+ This person has the mental capacity to participate in making these recommendations, but they have declined to discuss the decision.", "min": 0, "max": "*" }, { "id": "NHSDigitalEOLCPRStatus.date_time_of_cpr_status", "path": "NHSDigitalEOLCPRStatus.date_time_of_cpr_status", "definition": "We must record the effective date/time of the status.\r\n\r\nIt seems sensible to include \"time\" as things may change rapidly for some patients over a day. It is likely that most systems will only be recording a date.", "min": 0, "max": "1", "type": [ { "code": "dateTime", "profile": [ "http://hl7.org/fhir/StructureDefinition/dateTime" ] } ] } ] } }