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.
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
Voorbeeld file fout: Kan het opgegeven bestand niet vinden. : C:\Users\Spruyt\Dropbox\ZIBs\Prepublicatieversie 2017-1\VZIBS_Examples\nl.zorg.VrijheidsbeperkendeMaatregelen-v3.1(NL)_Voorbeeld.docx
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
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
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 18:16:49
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FreedomRestrictingMeasures
LegalStatus
or as spreadsheet 