FreedomRestrictingMeasures-v3.1(2017EN)

General information

Name: nl.zorg.FreedomRestrictingMeasures
Version: 3.1
HCIM Status:Final
Release: 2017
Release status: Published
Release date: 31-12-2017

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Metadata

DCM::CoderList	Werkgroep RadB Verpleegkundige Gegevens
DCM::ContactInformation.Address	*
DCM::ContactInformation.Name	*
DCM::ContactInformation.Telecom	*
DCM::ContentAuthorList	Werkgroep RadB Verpleegkundige Gegevens
DCM::CreationDate	5-5-2014
DCM::DeprecatedDate
DCM::DescriptionLanguage	nl
DCM::EndorsingAuthority.Address
DCM::EndorsingAuthority.Name	PM
DCM::EndorsingAuthority.Telecom
DCM::Id	2.16.840.1.113883.2.4.3.11.60.40.3.14.3
DCM::KeywordList	Vrijheidsbeperkendemaatregelen, wilsbekwaamheid, interventies
DCM::LifecycleStatus	Final
DCM::ModelerList	Werkgroep RadB Verpleegkundige Gegevens
DCM::Name	nl.zorg.VrijheidsbeperkendeMaatregelen
DCM::PublicationDate	31-12-2017
DCM::PublicationStatus	Published
DCM::ReviewerList	Projectgroep RadB Verpleegkundige Gegevens & Kerngroep Registratie aan de Bron
DCM::RevisionDate	31-12-2017
DCM::Superseeds	nl.zorg.VrijheidsbeperkendeMaatregelen-v3.0
DCM::Version	3.1
HCIM::PublicationLanguage	EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (01-07-2015)

Publicatieversie 3.0 (01-05-2016)

Publicatieversie 3.1 (04-09-2017)

ZIB-530	Verwijzingen naar de bouwsteen Verpleegkundige Interventie verwijderd
ZIB-549	De Engelse naam van de bouwsteen en het rootconcept zijn niet correct

Concept

Freedom restricting measures are (physical or verbal) measures used to deliberately restrict the freedom of the patient in question.
Many forms of freedom restricting measures fall under this definition, including but not limited to:

• involuntary treatment (e.g. forced medication)
• physical restraints (side rails fully up)
• physical fixation (arm restraints in order to prevent removal of drip)
• electronic surveillance to monitor the whereabouts of the patient.

In hospitals, these often include the use of side rails, a cushion belt (around the waist) or a Posey bed. Often sedatives are administered in combination with the freedom restricting measures. For small children it often involves fixation of e.g. hands to prevent the extraction of a nasogastric tube.
The Vereniging Verpleegkundigen & Verzorgenden Nederland (V&VN) [Dutch Nurses and Carers Association] published a set of guidelines for nurses to implement these restraints in hospitals.
The ‘Wet BOPZ’ [Dutch Psychiatric Hospitals (Compulsory Admissions) Act] protects the rights of clients who are involuntarily admitted into mental healthcare, services for the disabled and in geriatric psychiatry. The act only applies to ‘BOPZ’-marked facilities and also applies to some (closed) wards in nursing homes. Mental healthcare facilities use a national registration system to register the restraints called Argus registration.
Permission of the patient or his/hers legal representative is required before starting freedom restricting measures.
The patient’s high-risk behavior providing cause for the restraints is not described in this concept.

Purpose

Implementing medical restraints is risky and can result in damage to the patient if they are not carefully implemented. Nurses fulfil an important role in identifying risks, observing the effect of the restraints and any changes to the policy in terms of medical restraints. Recording all information on the measures is of major importance for insight into decision-making, implementing, monitoring and evaluating the measures. In the event of a transfer to the next facility, the proper preparations can be taken to safely continue the care and to limit the risks to the patient and their environment.

Information Model

Type	Id	Concept						Card.	Definition	DefinitionCode	Reference
	NL-CM:14.3.1	FreedomRestrictingMeasures							Root concept of the FreedomRestrictingMeasures information model. This root concept contains all data elements of the FreedomRestrictingMeasures information model.
	NL-CM:14.3.2		LegalStatus					0..1	The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.	303186005 Legal status of patient	LegalStatusCodelist
	NL-CM:14.3.3		LegallyCapable					1	Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.
	NL-CM:14.3.4		LegallyCapableComment					0..1	Comment on the decisions which the patient is legally capable of making.	48767-8 Annotation comment
	NL-CM:14.3.5		Intervention					0..*	Container of the Restraint concept. This container contains all data elements of the Restraint concept.
	NL-CM:14.3.6			TypeOfIntervention				1	The type of restraint describes the medical restraints.	225317005 Restriction of movement	ArgusTypeOfInterventionCodelist TypeOfInterventionCodelist
	NL-CM:14.3.7			Permission				1	The permission given to the health professional(s) by the patient or legal representative to implement the medical restraint.	309370004 Consent status	ArgusPermissionCodelist PermissionCodelist
	NL-CM:14.3.8			StartEpisode				0..1	The date and time at which the restraints started.
	NL-CM:14.3.9			EndOfEpisode				0..1	The date and time at which the restraints ended.

Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page

Example Instances

Only available in Dutch

VrijheidsbeperkendeMaatregelen
JuridischeStatus
Wilsbekwaam	Nee
WilsbekwaamToelichting	Wilsonbekwaam t.a.v. geldzaken.
Interventie
SoortInterventie	Links armspalk i.v.m. infuus.
Toestemming	Instemming wettelijke vertegenwoordiger
AanvangEpisode	01-05-2014
EindeEpisode	05-05-2014

Instructions

Mental healthcare uses a national registration system (Argus registration) when implementing medical restraints. In this context the codelists ArgusInterventieCodelijst and ArgusInstemmingCodelijs are applicable. In all other cases the codelists SoortInterventieCodelijst en ToestemmingCodelijst shall be used

References

1. Handreiking Argus [Online] Beschikbaar op:http://www.veiligezorgiederszorg.nl/speerpunt-dwang-en-drang/handreiking-argus-def.pdf [Geraadpleegd: 13 februari 2015] 2. Argus [Online] Beschikbaar op:http://www.veiligezorgiederszorg.nl/speerpunten/dwang-en-drang.html [Geraadpleegd: 13 februari 2015] 3. Handreiking "Vrijheidsbeperking in het ziekenhuis? Nee, tenzij…" (V&VN, 2013) [Online] Beschikbaar op:http://www.venvn.nl/Portals/1/Nieuws/2014%20Documenten/WEB_VenVN_Handl_VBI.pdf [Geraadpleegd: 13 februari 2015]

Valuesets

ArgusPermissionCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.14.3.5

Conceptname	Conceptcode	Codesystem name	Codesystem OID	Description
Op eigen verzoek	E1	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Op eigen verzoek
Geen verzet	E2	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Geen verzet
Verzet	E3	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Verzet

ArgusTypeOfInterventionCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.14.3.4

Conceptname	Conceptcode	Codesystem name	Codesystem OID	Description
Separatie	A1	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Separatie
Afzondering	A2	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Afzondering
Fixatie	A3	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Fixatie
Gedwongen medicatie	A4	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Gedwongen medicatie
Gedwongen voeding en/of vocht	A5	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Gedwongen voeding en/of vocht
Andere interventies	A6	ArgusCodes	2.16.840.1.113883.2.4.3.11.22.217	Andere interventies

LegalStatusCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.14.3.2

Conceptname	Conceptcode	Codesystem name	Codesystem OID	Description
Rechterlijke machtiging (rm) voorlopig / voortgezette machtiging	1	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Rechterlijke machtiging (rm) voorlopig / voortgezette machtiging
RM op eigen verzoek	2	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	RM op eigen verzoek
RM met voorwaardelijk ontslag	3	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	RM met voorwaardelijk ontslag
Onder toezichtstelling (ots)	4	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Onder toezichtstelling (ots)
In bewaringstelling (ibs)	5	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	In bewaringstelling (ibs)
Voogdij	6	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Voogdij
Bewindvoering	7	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Bewindvoering
Mentorschap	8	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Mentorschap
Onder curatele stelling	9	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Onder curatele stelling
Zaakwaarneming	10	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Zaakwaarneming
Strafrechterlijke justitiële contacten: tbs	11	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Strafrechterlijke justitiële contacten: tbs
Strafrechterlijke justitiële contacten: overig	12	Juridische Status	2.16.840.1.113883.2.4.3.11.22.232	Strafrechterlijke justitiële contacten: overig

PermissionCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.14.3.1

Conceptname	Conceptcode	Codesystem name	Codesystem OID	Description
Geen instemming patiënt	1	InstemmingStatus	2.16.840.1.113883.2.4.3.11.60.40.4.6.1	Geen instemming patiënt
Instemming patiënt	2	InstemmingStatus	2.16.840.1.113883.2.4.3.11.60.40.4.6.1	Instemming patiënt
Geen instemming wettelijk vertegenwoordiger	3	InstemmingStatus	2.16.840.1.113883.2.4.3.11.60.40.4.6.1	Geen instemming wettelijk vertegenwoordiger
Instemming wettelijke vertegenwoordiger	4	InstemmingStatus	2.16.840.1.113883.2.4.3.11.60.40.4.6.1	Instemming wettelijke vertegenwoordiger

TypeOfInterventionCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.14.3.3

Conceptname	Conceptcode	Codesystem name	Codesystem OID	Description
Secluding patient	90278001	SNOMED CT	2.16.840.1.113883.6.96	Separatie
Segregating patient	29251000146109	SNOMED CT	2.16.840.1.113883.6.96	Afzondering
Physical restraint	386423001	SNOMED CT	2.16.840.1.113883.6.96	Fixatie
Forced medication	2921100014610	SNOMED CT	2.16.840.1.113883.6.96	Gedwongen medicatie
Forced feeding of patient	37041007	SNOMED CT	2.16.840.1.113883.6.96	Gedwongen voeding en/of vocht
Other	OTH	NullFlavor	2.16.840.1.113883.5.1008	Anders

This information model in other releases

• Release 2015, (Version 1.0)
• Release 2016, (Version 3.0)

More on this information model

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:

• HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment
• HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR

This information model is also available as pdf file or as spreadsheet

About this information

The information in this wikipage is based on Release 2017
Conditions for use are located on the mainpage
This page is generated on 24/01/2018 16:11:35

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