FreedomRestrictingMeasures-v3.2(2019EN)
General information
Name: nl.zorg.FreedomRestrictingMeasures 
Version: 3.2
HCIM Status:Final
Release: 2019
Release status: Prepublished
Release date: 29-01-2020
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 | 29-01-2020 |
| DCM::PublicationStatus | Prepublished |
| DCM::ReviewerList | Projectgroep RadB Verpleegkundige Gegevens & Kerngroep Registratie aan de Bron |
| DCM::RevisionDate | 24-4-2018 |
| DCM::Supersedes | nl.zorg.VrijheidsbeperkendeMaatregelen-v3.1.1 |
| DCM::Version | 3.2 |
| HCIM::PublicationLanguage | EN |
Revision History
Only available in Dutch
Publicatieversie 1.0 (01-07-2015)
Publicatieversie 3.0 (01-05-2016)
| ZIB-453 | Wijziging naamgeving ZIB's en logo's door andere opzet van beheer |
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 |
Publicatieversie 3.1.1 (01-10-2018)
| ZIB-732 | Een aantal Snomed codes blijken bij nadere controle invalide. Een aantal andere codes zijn inmiddels Inactive verklaard in SNOMED |
Publicatieversie 3.2 (26-02-2019)
| ZIB-670 | Graag afzonderlijke zib maken van data element juridische status |
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:14.3.3 |  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. |
|
|||||||||||
|
NL-CM:14.3.10 | LegalSituation
|
0..1 | The legal situation that applies to the patient during the intervention. |
| |||||||||||
|
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. |
|
| ||||||||||
|
|
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. |
|
| ||||||||||
|
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 | Binding: Required |
| 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 | Binding: Required |
| 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 |
PermissionCodelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.14.3.1 | Binding: Required |
| 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 | Binding: Required |
| Conceptname | Conceptcode | Codesystem name | Codesystem OID | Description |
| Secluding patient | 90278001 | SNOMED CT | 2.16.840.1.113883.6.96 | Separatie |
| Segregation of 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 | 29211000146105 | 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)
- Release 2017, (Version 3.1)
- Release 2018, (Version 3.2)
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About this information
The information in this wikipage is based on Prerelease 2019-2
SNOMED CT and LOINC codes are based on:
- SNOMED Clinical Terms version: 20190731 [R] (July 2019 Release)
- LOINC version 2.64
Conditions for use are located on the mainpage
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