ComfortScale-v1.0(2017EN)

General information

Name: nl.zorg.ComfortScale
Version: 1.0
HCIM Status:Final
Publication: 2017
Release status: Prepublished
Publication date: 04-09-2017

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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	1-8-2016
DCM::DeprecatedDate
DCM::DescriptionLanguage	nl
DCM::EndorsingAuthority.Address
DCM::EndorsingAuthority.Name	zorg
DCM::EndorsingAuthority.Telecom
DCM::Id	2.16.840.1.113883.2.4.3.11.60.40.3.12.12
DCM::KeywordList	Pijnscore, assessment, comfort, comfortneo
DCM::LifecycleStatus	Final
DCM::ModelerList	Werkgroep RadB Verpleegkundige Gegevens
DCM::Name	nl.zorg.ComfortScore
DCM::PublicationDate	04-09-2017
DCM::PublicationStatus	Prepublished
DCM::ReviewerList	Projectgroep RadB Verpleegkundige Gegevens & Kerngroep Registratie aan de Bron
DCM::RevisionDate	04-09-2017
DCM::Superseeds
DCM::Version	1.0
HCIM::PublicationLanguage	EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (04-09-2017).

Concept

The Comfort Behaviour scale /Comfortneo scale is an assessment tool, that is used to assess the pain behaviour of neonates (new born).
The Comfort Behaviour scale has 7 observation points that that need to be addressed. For each on observation is value is assigned from a 5-point scale, the final score indicates whether the observed child suffers pain and 'how much'. The score is combined with an NRS score that is completed by the nurses on basis of clinical experience.

Purpose

> A pain observation instrument is a tool in determining the intensity of pain and can be useful in order to determine the effectiveness of pain treatment interventions (pharmacological or non-pharmacological). For new born it is nevertheless difficult to differentiate between pain or distress/anxiety. This is relevant in determining the treatment. The score on a pain measurement instrument remains a snapshot in time.

Evidence Base

For determining the degree of pain in children with difficulty expressing themselves there are divers pain observation instruments available

• CPB

• Comfort behaviour scale/ Comfortneo scale

• Flacc

Patient Population

The COMFORT assessment scale is validated for young children up to the age of 4.
The COMFORT and COMFORTneo assessment score is validated for preterm neonates

Information Model

Type	Id	Concept						Card.	Definition	DefinitionCode	Reference
	NL-CM:12.12.1	ComfortScale							Rootconcept of the ComfortScale information model. This root concept contains all data elements of the ComfortScale information model.
	NL-CM:12.12.2		TotalScore					0..1	The total score is the sum of all the individual scores. The total score has a range from 0 - 35.
	NL-CM:12.12.3		Alertness					0..1	Observation of: Alertness		AlertnessCodelist
	NL-CM:12.12.4		Calmness_Agitation					0..1	Observation: Calmness/ agitation		Calmness_AgitationCodelist
	NL-CM:12.12.5		RespiratoryResponse					0..1	Observation Respiratory response (only in mechanically ventilated children)		RespiratoryResponseCodelist
	NL-CM:12.12.6		Crying					0..1	Observation Crying (only in spontaneously breathing children)		CryingCodelist
	NL-CM:12.12.8		BodyMovement					0..1	Observation Physical movement		BodyMovementCodelist
	NL-CM:12.12.9		FacialTone					0..1	Observation Facial tension		FacialToneCodelist
	NL-CM:12.12.10		BodyMuscleTone					0..1	Observation Muscle tone		BodyMuscleToneCodelist
	NL-CM:12.12.11		ScoreDateTime					1	The date and time at which the Comfort Behaviour scale/ComfortNeo scale was determined.
	NL-CM:12.12.12		Comment					0..1	A comment on the circumstances during the measurement.	48767-8 Annotation comment

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

ComfortScore
ScoreDatumTijd	21-12-2016 12:05
Alertheid	4 (wakker en alert)
Kalmte_Agitatie	2 (licht angstig)
Huilen	2 (af en toe snikken of kreunen)
Lichaamsbeweging	2 (incidentele beweging)
Gezichtsspanning	2 (normale spanning van het gelaat)
Spierspanning	2 (verminderde spierspanning)
Totaalscore	14
Toelichting	Controle na verhogen pijnmedicatie.

ComfortNeoScore
ScoreDatumTijd	21-12-2016 12:05
Alertheid	4 (wakker en alert)
Kalmte_Agitatie	2 (licht angstig)
Ademhalingsreactie	3 (af en toe hoesten of verzet tegen de ventilator)
Lichaamsbeweging	2 (incidentele beweging)
Gezichtsspanning	2 (normale spanning van het gelaat)
Spierspanning	2 (verminderde spierspanning)
Totaalscore	15
Toelichting	Controle na verhogen pijnmedicatie.

Instructions

In the ComfortNeo scale the item crying is replaced by respiratory reaction.
In the Comfort scale the item respiratory reaction is replaced by crying.

References

1. Comfort assessment [Online] Beschikbaar op:http://www.comfortassessment.nl/ [Geraadpleegd: 2 augustus 2016] 2. Richtlijn Pijnmeting en Behandeling van pijn bij kinderen, NVK, 2007 [Online] Beschikbaar op:https://www.nvk.nl/Kwaliteit/Richtlijnenoverzicht/Details/tabid/1558/articleType/ArticleView/articleId/760/Pijn-meting-en-behandeling-van.aspx [Geraadpleegd: 21 december 2016]

Valuesets

AlertnessCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.12.12.1

Conceptname	Conceptcode	Conceptvalue	Codesystem name	Codesystem OID	Description
Deeply asleep	Alert1	1	CN_Alertheid	2.16.840.1.113883.2.4.3.11.60.40.4.20.1	Diep in slaap (ogen dicht, geen reactie op omgeving)
Lightly asleep	Alert2	2	CN_Alertheid	2.16.840.1.113883.2.4.3.11.60.40.4.20.1	Licht in slaap (ogen grotendeels gesloten, af en toe reactie)
Drowsy	Alert3	3	CN_Alertheid	2.16.840.1.113883.2.4.3.11.60.40.4.20.1	Slaperig (kind sluit vaak zijn ogen, reageert minder op omgeving)
Awake and alert	Alert4	4	CN_Alertheid	2.16.840.1.113883.2.4.3.11.60.40.4.20.1	Wakker en alert (kind reageert op omgeving)
Awake and hyperalert	Alert5	5	CN_Alertheid	2.16.840.1.113883.2.4.3.11.60.40.4.20.1	Wakker en hyper-alert (overdreven reactie op veranderingen)

BodyMovementCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.12.12.5

Conceptname	Conceptcode	Conceptvalue	Codesystem name	Codesystem OID	Description
No movement	Mov1	1	CN_Lichaamsbeweging	2.16.840.1.113883.2.4.3.11.60.40.4.20.5	Geen beweging
Occasional, slight movements	Mov2	2	CN_Lichaamsbeweging	2.16.840.1.113883.2.4.3.11.60.40.4.20.5	Incidentele (3 of minder) kleine bewegingen
Frequent, slight movements	Mov3	3	CN_Lichaamsbeweging	2.16.840.1.113883.2.4.3.11.60.40.4.20.5	Frequente (3 of meer) kleine bewegingen
Vigorous movements limited to extremities	Mov4	4	CN_Lichaamsbeweging	2.16.840.1.113883.2.4.3.11.60.40.4.20.5	Heftige bewegingen met armen en benen
Vigorous movements including torso and head	Mov5	5	CN_Lichaamsbeweging	2.16.840.1.113883.2.4.3.11.60.40.4.20.5	Heftige bewegingen ook met romp en hoofd

BodyMuscleToneCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.12.12.7

Conceptname	Conceptcode	Conceptvalue	Codesystem name	Codesystem OID	Description
Muscles fully relaxed	Musc1	1	CN_Spierspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.7	Spieren volledig ontspannen; geen spierspanning
Reduced muscle tone	Musc2	2	CN_Spierspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.7	Verminderde spierspanning; minder weerstand dan normaal
Normal muscle tone	Musc3	3	CN_Spierspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.7	Normale spierspanning
Increased muscle tone	Musc4	4	CN_Spierspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.7	Toegenomen spierspanning en buiging van vingers en tenen
Extreme muscle rigidity	Musc5	5	CN_Spierspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.7	Extreme spierstijfheid en buiging van vingers en tenen

Calmness_AgitationCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.12.12.2

Conceptname	Conceptcode	Conceptvalue	Codesystem name	Codesystem OID	Description
Calm	Calm1	1	CN_Kalmte_Agitatie	2.16.840.1.113883.2.4.3.11.60.40.4.20.2	Kalm (kind helder en rustig)
Slightly anxious	Calm2	2	CN_Kalmte_Agitatie	2.16.840.1.113883.2.4.3.11.60.40.4.20.2	Licht angstig (kind toont lichte onrust)
Anxious	Calm3	3	CN_Kalmte_Agitatie	2.16.840.1.113883.2.4.3.11.60.40.4.20.2	Angstig (kind lijkt onrustig, kan zich beheersen)
Very anxious	Calm4	4	CN_Kalmte_Agitatie	2.16.840.1.113883.2.4.3.11.60.40.4.20.2	Zeer angstig (kind lijkt zeer onrustig, kan zich nog net beheersen)
Panicky	Calm5	5	CN_Kalmte_Agitatie	2.16.840.1.113883.2.4.3.11.60.40.4.20.2	Paniekerig (ernstige onrust met verlies van beheersing)

CryingCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.12.12.4

Conceptname	Conceptcode	Conceptvalue	Codesystem name	Codesystem OID	Description
Quiet breathing	Cry1	1	CN_Huilen	2.16.840.1.113883.2.4.3.11.60.40.4.20.4	Geen huilgeluiden
Occasional sobbing or moaning	Cry2	2	CN_Huilen	2.16.840.1.113883.2.4.3.11.60.40.4.20.4	Af en toe snikken of kreunen (nasnikken)
Whining	Cry3	3	CN_Huilen	2.16.840.1.113883.2.4.3.11.60.40.4.20.4	Jengelen of dreinen (monotoon geluid)
Crying	Cry4	4	CN_Huilen	2.16.840.1.113883.2.4.3.11.60.40.4.20.4	Huilen
Screaming or shrieking	Cry5	5	CN_Huilen	2.16.840.1.113883.2.4.3.11.60.40.4.20.4	Schreewen of krijsen

FacialToneCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.12.12.6

Conceptname	Conceptcode	Conceptvalue	Codesystem name	Codesystem OID	Description
Facial muscles totally relaxed	Face1	1	CN_Gezichtsspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.6	Gezichtsspieren volkomen ontspannen
Normal facial tone	Face2	2	CN_Gezichtsspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.6	Normale spanning van het gezicht
Tension evident in some facial muscles	Face3	3	CN_Gezichtsspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.6	Spanning duidelijk in sommige gelaatsspieren (niet aanhoudend)
Tension evident throughout facial muscles	Face4	4	CN_Gezichtsspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.6	Spanning duidelijk in alle gelaatsspieren (aanhoudend)
Facial muscles contorted and grimacing	Face5	5	CN_Gezichtsspanning	2.16.840.1.113883.2.4.3.11.60.40.4.20.6	Gezichtsspieren verwrongen en in een grimas

RespiratoryResponseCodelist

Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.12.12.3

Conceptname	Conceptcode	Conceptvalue	Codesystem name	Codesystem OID	Description
No spontaneous respiration	Vent1	1	CN_Ademhalingsreactie	2.16.840.1.113883.2.4.3.11.60.40.4.20.3	Geen spontane ademhaling
Spontaneous respiration on ventilator	Vent2	2	CN_Ademhalingsreactie	2.16.840.1.113883.2.4.3.11.60.40.4.20.3	Spontane ademhaling aan de beademing
Unrest or resistance to ventilator	Vent3	3	CN_Ademhalingsreactie	2.16.840.1.113883.2.4.3.11.60.40.4.20.3	Onrust of verzet tegen de beademing
Actively breathes against ventilator or coughs regularly	Vent4	4	CN_Ademhalingsreactie	2.16.840.1.113883.2.4.3.11.60.40.4.20.3	Ademt actief tegen de beademing in of hoest regelmatig
Fights ventilator	Vent5	5	CN_Ademhalingsreactie	2.16.840.1.113883.2.4.3.11.60.40.4.20.3	Vecht tegen de beademing

More on this information model

More technical information and HL7/XML documentation you can find on the Nictiz Art-Decor page about this information model[1]
This information model is also available as pdf file or as spreadsheet

About this information

The information in this wikipage is based on Prerelease 2017 #1
Conditions for use are located on the mainpage
This page is generated on 21/09/2017 18:14:17

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