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{{Versions-2.16.840.1.113883.2.4.3.11.60.40.3.18.7(EN)|1|DOSScore-v1.2(2026-1EN)}}

==General information==
Name: '''nl.zorg.DOSScore''' [[Bestand:NL.png|link=DOSScore-v1.2(2026-1NL)]] 
Version: '''1.2''' 
HCIM Status:Final 
Release: '''2026-1''' 
Release status: Prepublished 
Release date: 17-04-2026

{{ErrataEN|2026-1|{{PAGENAME}}}}

-----
<div style="text-align: right; direction: ltr; margin-left: 1em;" >[[Bestand: Back 16.png| link= HCIM_Release_2026-1(EN)]] [[HCIM_Release_2026-1(EN) |Back to HCIM list ]]</div>

==Metadata==
{| class="wikitable" style="font-size:90%; width: 750px"
|-
|style="width:250px; "|DCM::CoderList||Werkgroep RadB Verpleegkundige Gegevens
|-
|style="width:250px; "|DCM::ContactInformation.Address||*
|-
|style="width:250px; "|DCM::ContactInformation.Name||*
|-
|style="width:250px; "|DCM::ContactInformation.Telecom||*
|-
|style="width:250px; "|DCM::ContentAuthorList||Werkgroep RadB Verpleegkundige Gegevens
|-
|style="width:250px; "|DCM::CreationDate||11-10-2016
|-
|style="width:250px; "|DCM::DeprecatedDate||
|-
|style="width:250px; "|DCM::DescriptionLanguage||nl
|-
|style="width:250px; "|DCM::EndorsingAuthority.Address||
|-
|style="width:250px; "|DCM::EndorsingAuthority.Name||
|-
|style="width:250px; "|DCM::EndorsingAuthority.Telecom||
|-
|style="width:250px; "|DCM::Id||2.16.840.1.113883.2.4.3.11.60.40.3.18.7
|-
|style="width:250px; "|DCM::KeywordList||DOS, delier
|-
|style="width:250px; "|DCM::LifecycleStatus||Final
|-
|style="width:250px; "|DCM::ModelerList||Werkgroep RadB Verpleegkundige Gegevens
|-
|style="width:250px; "|DCM::Name||nl.zorg.DOSScore
|-
|style="width:250px; "|DCM::PublicationDate||17-04-2026
|-
|style="width:250px; "|DCM::PublicationStatus||Prepublished
|-
|style="width:250px; "|DCM::ReviewerList||Projectgroep RadB Verpleegkundige Gegevens & Kerngroep Registratie aan de Bron
|-
|style="width:250px; "|DCM::RevisionDate||17-07-2023
|-
|style="width:250px; "|DCM::Supersedes||nl.zorg.DOSScore-v1.1
|-
|style="width:250px; "|DCM::Version||1.2
|-
|style="width:250px; "|HCIM::PublicationLanguage||EN
|}

==Revision History==
<div class="mw-collapsible mw-collapsed">
'' Only available in Dutch''

Publicatieversie 1.0 (04-09-2017)

Publicatieversie 1.1 (10-06-2022)
{|
|-
|style="width:75px; "|[[ZIBIssues500_3#ZIB-1674 | ZIB-1674 ]]
|Terminologie codes ontbreken in de zib
|}

Publicatieversie 1.2 (15-10-2023)
{|
|-
|style="width:75px; "|[[ZIBIssues500_3#ZIB-1925 | ZIB-1925 ]]
|Tekstuele wijzigingen zib DOSScore
|-
|style="width:75px; "|[[ZIBIssues500_3#ZIB-1977 | ZIB-1977 ]]
|Hoe om te gaan met "-" in de waarnemingen voor DOSScore?
|-
|style="width:75px; "|[[ZIBIssues500_3#ZIB-1978 | ZIB-1978 ]]
|Definitie bepaling ZIB DOSScore niet consistent met modellering
|}
</div>

==Concept==
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==
Delirium is one of the most forms of psychopathology among elderly patients and patients in the last phase of their lives. The main characteristic of delirium is the rapid onset and changing of symptoms. The DOSS is meant to qualify and quantify the nature and seriousness of delirium symptoms. This enables a quick start of treatment. The DOSS is used to signal risks and as an evaluation tool.

==Evidence Base==
The DOSS contains 13 observations of behaviour (verbal and non-verbal) that reflect the symptoms of delirium. These observations can be made during regular contacts with the patient. A total score is calculated per shift (minimum 0 and maximum 13). The total scores of three shifts (day, late and night shift) are added up to the total score of this day (minimum 0 and maximum 39). This HCIM defines the total score and underlying scores of one shift. 
 
For a DOS scale final score, 3 instances of this HCIM, one for each shift, will have to be combined (DOS SCALE FINAL SCORE = TOTAL SCORE THIS DAY / 3). A DOS scale final score < 3 means that the patient is unlikely to be delirious. A DOS scale final score > 3 means the patient is likely to be delirious. DOS SCALE FINAL SCORE is not part of this concept and can be derived or calculated from the 3 HCIM instances.

==Information Model==
 
<imagemap> Bestand:DOSScore-v1.2Model(2026-1EN).png | center
rect 787 43 891 113 [[#3171]]
rect 789 135 893 205 [[#3178]]
rect 789 227 893 297 [[#3168]]
rect 789 319 893 389 [[#3174]]
rect 789 411 893 481 [[#3170]]
rect 672 411 777 481 [[#3180]]
rect 557 412 662 482 [[#3172]]
rect 442 411 547 481 [[#3182]]
rect 303 411 432 481 [[#3181]]
rect 180 411 293 481 [[#3169]]
rect 180 319 293 389 [[#3164]]
rect 180 227 293 297 [[#3166]]
rect 181 134 294 204 [[#3175]]
rect 431 43 537 136 [[#3179]]
rect 671 43 779 113 [[#3177]]
rect 180 43 293 113 [[#3173]]
rect 496 227 586 297 [[#3176]]
desc none
</imagemap>
 
{| border= "1" width="1500px" style = "font-size: 9.5pt; border: solid 1px silver; border-collapse:collapse;" cellpadding = "3px" cellspacing ="0px"
|-style="background-color: #1F497D; color: white; font-weight: bold; font-variant: small-caps; "
|style="width:30px;"|Type||style="width:100px;"|Id||colspan="6 " style="width:140px;"|Concept||Card.||style="width: 600px;"|Definition||style="width:200px;"|DefinitionCode||style="width:200px;"|Reference
|-style="vertical-align:top; background-color: #E3E3E3; "
|style = "text-align:center" |[[Bestand: block.png| 20px | link=]]
||NL-CM:18.7.1
|colspan ="6" style ="padding-left: 0px"|[[Bestand: arrowdown.png | 10px | link=]]DOSScore
|
|Root concept of the DOSScore information model. This root concept contains all data elements of the DOSScore information model.
|
{|
|-
|[https://terminologie.nictiz.nl/art-decor/snomed-ct?conceptId=160591000146109 160591000146109] Delirium observation screening assessment scale
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.3
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]DOSScoreTotal
|0..1
|The total score for this shift (minimum 0 and maximum 13).
|
{|
|-
|[https://terminologie.nictiz.nl/art-decor/snomed-ct?conceptId=55681000146102 55681000146102] Delirium observation score
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: TS.png| 16px | link=]]
||NL-CM:18.7.5
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]DOSScoreDateTime
|1
|The date on which the DOS score is registered.
|
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.6
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]DozesOff
|0..1
|DOS observation: patient dozes off during conversation or activities.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007006] DOSScore DozesOff
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.7
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]EasilyDistracted
|0..1
|DOS observation: patient is easily distracted by stimuli from the environment.

Someone 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.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007007] DOSScore EasilyDistracted
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.8
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]MaintainsAttention
|0..1
|DOS observation: patient maintains attention to conversation or action.

Someone is maintaining attention to a conversation or action if he/she verbally or non-verbally shows that they are following the conversation or action.

Score:
1: never
0: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007008] DOSScore MaintainsAttention
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.9
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]UnfinishedQuestionAnswer
|0..1
|DOS observation: patient does not finish question or answer.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007009] DOSScore UnfinishedQuestionAnswer
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.10
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]AnswersNoFit
|0..1
|DOS observation: patient gives answers that do not fit the question.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007010] DOSScore AnswersNoFit
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.11
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]ReactsSlowly
|0..1
|DOS observation: patient reacts slowly to instructions.

Someone reacts slowly to instructions when acting is delayed and/or there are moments of stillness/inactivity before moving into action.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007011] DOSScore ReactsSlowly
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.12
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]ThinksSomewhereElse
|0..1
|DOS observation: patient thinks they are somewhere else.

Someone thinks they are somewhere else when he/she shows this in words or actions.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007012] DOSScore ThinksSomewhereElse
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.13
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]KnowsPartDay
|0..1
|DOS observation: patient knows which part of the day it is.

Someone knows what part of the day it is when he/she shows such in words or actions.

Score:
1: never
0: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007013] DOSScore KnowsPartDay
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.14
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]RemembersRecent
|0..1
|DOS observation: patient remembers recent events.

Someone remembers recent events when he/she can for example tell whether they had visitors or what he/she ate.

Score:
1: never
0: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007014] DOSScore RemembersRecent
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.15
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]Restless
|0..1
|DOS observation: patient is picking, disorderly, restless.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007015] DOSScore Restless
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.16
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]PullsWires
|0..1
|DOS observation: patient pulls IV tubing, feeding tubes, catheters, etc.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007016] DOSScore PullsWires
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.17
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]EasilyEmotional
|0..1
|DOS observation: patient is easily or suddenly emotional.

Someone 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.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007017] DOSScore EasilyEmotional
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: INT.png| 16px | link=]]
||NL-CM:18.7.18
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]Hallucinations
|0..1
|DOS observation: patient sees/hears things which are not there.

Someone sees/hears things which are not there when he/she shows this verbally (ask!) or non-verbally.

Score:
0: never
1: sometimes-always
(is the answer "don't know" then don't instantiate this concept)
|
{|
|-
|[https://zibs.nl/wiki/Zib_Codestelsels#Codestelsels_voor_concepten 18007018] DOSScore Hallucinations
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: ST.png| 16px | link=]]
||NL-CM:18.7.2
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px | link=]]Comment
|0..1
|Comment on the DOS score.
|
{|
|-
|[https://terminologie.nictiz.nl/art-decor/loinc?conceptId=48767-8 48767-8] Annotation comment [Interpretation] Narrative
|}
|
|}
Columns Concept and DefinitionCode: hover over the values for more information 
For explanation of the symbols, please see the legend page [[Bestand:list2.png|link=Legend]]

==Example Instances==
''Only available in Dutch''

{|class="wikitable" width="360px" style= "font-size: 9.5pt;"
|-style=vertical-align:top;
|colspan="2" style="background-color: #1F497D; width: 100%; "|DOSScore
|-style=vertical-align:top;
| style="width: 56%; "|ZaktWeg
| style="width: 44%; "|1
|-style=vertical-align:top;
| style="width: 56%; "|SnelAfgeleid
| style="width: 44%; "|1
|-style=vertical-align:top;
| style="width: 56%; "|HeeftAandacht
| style="width: 44%; "|0
|-style=vertical-align:top;
| style="width: 56%; "|VraagAntwoordNietAf
| style="width: 44%; "|<noWiki>-</noWiki>
|-style=vertical-align:top;
| style="width: 56%; "|AntwoordenNietPassend
| style="width: 44%; "|1
|-style=vertical-align:top;
| style="width: 56%; "|ReageertTraag
| style="width: 44%; "|<noWiki>-</noWiki>
|-style=vertical-align:top;
| style="width: 56%; "|DenktErgensAnders
| style="width: 44%; "|0
|-style=vertical-align:top;
| style="width: 56%; "|BeseftDagdeel
| style="width: 44%; "|0
|-style=vertical-align:top;
| style="width: 56%; "|HerinnertRecent
| style="width: 44%; "|0
|-style=vertical-align:top;
| style="width: 56%; "|Rusteloos
| style="width: 44%; "|0
|-style=vertical-align:top;
| style="width: 56%; "|TrektDraden
| style="width: 44%; "|0
|-style=vertical-align:top;
| style="width: 56%; "|SnelGeemotioneerd
| style="width: 44%; "|1
|-style=vertical-align:top;
| style="width: 56%; "|Hallucinaties
| style="width: 44%; "|0
|-style=vertical-align:top;
| style="width: 56%; "|DOSScoreTotaal
| style="width: 44%; "|4
|-style=vertical-align:top;
| style="width: 56%; "|DOSScoreDatumTijd
| style="width: 44%; "|19-12-2016 10:35
|-style=vertical-align:top;
| style="width: 56%; "|Toelichting
| style="width: 44%; "|<noWiki>-</noWiki>
|}

==References==
1. DOS vragenlijst. Beschikbaar op:https://www.vmszorg.nl/wp-content/uploads/2017/07/DOSS-observatieschaal.pdf [Geraadpleegd: 11 juli 2023].
2. Richtlijn Delier Volwassenen. Beschikbaar op:https://www.venvn.nl/media/gteiurur/richtlijn-delier.pdf [Geraadpleegd: 11 juli 2023].

==This information model in other releases==

{{Versions-2.16.840.1.113883.2.4.3.11.60.40.3.18.7(EN)|2|2026-1}}

==Information model references==
====This information model refers to====
:--
====This information model is used in====
:--
==Technical specifications in HL7v3 CDA and HL7 FHIR==
To exchange information based on health and care information models, additional, more technical specifications are required. 
Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:
<ul>
<li>HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment {{ArtDecorLinks|2026-1|18.7}}</li>
<li>HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR {{SimplefierLinks|2026-1|DOSScore}}</li>
</ul>
==Downloads==
This information model is also available as [[Media:nl.zorg.DOSScore-v1.2(2026-1EN).pdf|pdf file]] [[File:PDF.png|link=]] or as [[Media:nl.zorg.DOSScore-v1.2(2026-1EN).xlsx|spreadsheet]] [[File:xlsx.png|link=]]
==About this information==
The information in this wikipage is based on prerelease 2026-1 
SNOMED CT and LOINC codes are based on:
<ul>
<li>SNOMED Clinical Terms versie: 20260331 [R] (maart 2026-editie)</li>
<li>LOINC version 2.81</li>
</ul>
Conditions for use are located on the mainpage [[Bestand:list2.png|link=HCIM_Mainpage]] 
This page is generated on 18/04/2026 18:37:29 with ZibExtraction v. 10.0.9604.31200 
-----
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DOSScore-v1.2(2026-1EN) - Bewerkingsoverzicht

Update bot: Nieuwe pagina aangemaakt met ' {{Versions-2.16.840.1.113883.2.4.3.11.60.40.3.18.7(EN)|1|DOSScore-v1.2(2026-1EN)}} ==General information== Name: '''nl.zorg.DOSScore''' link=DOSScore-v1.2(2026-1NL) Version: '''1.2''' HCIM Status:Final Release: '''2026-1''' Release st…'

Update bot: Nieuwe pagina aangemaakt met ' {{Versions-2.16.840.1.113883.2.4.3.11.60.40.3.18.7(EN)|1|DOSScore-v1.2(2026-1EN)}} ==General information== Name: '''nl.zorg.DOSScore''' link=DOSScore-v1.2(2026-1NL)
Version: '''1.2'''
HCIM Status:Final
Release: '''2026-1'''
Release st…'