DOSScore-v1.2(2023EN)
General information
Name: nl.zorg.DOSScore 
Version: 1.2
HCIM Status:Final
Release: 2023
Release status: Prepublished
Release date: 15-10-2023
Metadata
| DCM::CoderList | Werkgroep RadB Verpleegkundige Gegevens |
| DCM::ContactInformation.Address | * |
| DCM::ContactInformation.Name | * |
| DCM::ContactInformation.Telecom | * |
| DCM::ContentAuthorList | Werkgroep RadB Verpleegkundige Gegevens |
| DCM::CreationDate | 11-10-2016 |
| DCM::DeprecatedDate | |
| DCM::DescriptionLanguage | nl |
| DCM::EndorsingAuthority.Address | |
| DCM::EndorsingAuthority.Name | |
| DCM::EndorsingAuthority.Telecom | |
| DCM::Id | 2.16.840.1.113883.2.4.3.11.60.40.3.18.7 |
| DCM::KeywordList | DOS, delier |
| DCM::LifecycleStatus | Final |
| DCM::ModelerList | Werkgroep RadB Verpleegkundige Gegevens |
| DCM::Name | nl.zorg.DOSScore |
| DCM::PublicationDate | 15-10-2023 |
| DCM::PublicationStatus | Prepublished |
| DCM::ReviewerList | Projectgroep RadB Verpleegkundige Gegevens & Kerngroep Registratie aan de Bron |
| DCM::RevisionDate | 17-07-2023 |
| DCM::Supersedes | nl.zorg.DOSScore-v1.1 |
| DCM::Version | 1.2 |
| HCIM::PublicationLanguage | EN |
Revision History
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
| Type | Id | Concept | Card. | Definition | DefinitionCode | Reference | ||||||
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NL-CM:18.7.1 |  DOSScore
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Root concept of the DOSScore information model. This root concept contains all data elements of the DOSScore information model. |
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NL-CM:18.7.3 |  DOSScoreTotal
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0..1 | The total score for this shift (minimum 0 and maximum 13). |
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NL-CM:18.7.5 | DOSScoreDateTime
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1 | The date on which the DOS score is registered. | ||||||||
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NL-CM:18.7.6 | DozesOff
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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) |
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NL-CM:18.7.7 | EasilyDistracted
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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) |
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NL-CM:18.7.8 | MaintainsAttention
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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) |
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NL-CM:18.7.9 | UnfinishedQuestionAnswer
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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) |
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NL-CM:18.7.10 | AnswersNoFit
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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) |
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NL-CM:18.7.11 | ReactsSlowly
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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) |
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NL-CM:18.7.12 | ThinksSomewhereElse
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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) |
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NL-CM:18.7.13 | KnowsPartDay
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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) |
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NL-CM:18.7.14 | RemembersRecent
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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) |
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NL-CM:18.7.15 | Restless
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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) |
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NL-CM:18.7.16 | PullsWires
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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) |
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NL-CM:18.7.17 | EasilyEmotional
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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) |
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NL-CM:18.7.18 | Hallucinations
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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) |
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NL-CM:18.7.2 | Comment
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0..1 | Comment on the DOS score. |
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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
| DOSScore | |
| ZaktWeg | 1 |
| SnelAfgeleid | 1 |
| HeeftAandacht | 0 |
| VraagAntwoordNietAf | - |
| AntwoordenNietPassend | 1 |
| ReageertTraag | - |
| DenktErgensAnders | 0 |
| BeseftDagdeel | 0 |
| HerinnertRecent | 0 |
| Rusteloos | 0 |
| TrektDraden | 0 |
| SnelGeemotioneerd | 1 |
| Hallucinaties | 0 |
| DOSScoreTotaal | 4 |
| DOSScoreDatumTijd | 19-12-2016 10:35 |
| Toelichting | - |
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
- Release 2017, (Version 1.0)
- Prerelease 2018-2, (Version 1.0)
- Prerelease 2019-2, (Version 1.0)
- Release 2020, (Version 1.0)
- Prerelease 2021-2, (Version 1.0)
- Prerelease 2022-1, (Version 1.1)
- Prerelease 2024-1, (Version 1.2)
Information model references
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About this information
The information in this wikipage is based on Prerelease 2023-1
SNOMED CT and LOINC codes are based on:
- SNOMED Clinical Terms versie: 20230930 [R] (september 2023-editie)
- LOINC version 2.76
Conditions for use are located on the mainpage
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