FreedomRestrictingMeasures-v3.1.1(2018EN)

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General information

Name: nl.zorg.FreedomRestrictingMeasures NL.png
Version: 3.1.1
HCIM Status:Final
Release: 2018
Release status: Prepublished
Release date: 01-10-2018


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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 01-10-2018
DCM::PublicationStatus Prepublished
DCM::ReviewerList Projectgroep RadB Verpleegkundige Gegevens & Kerngroep Registratie aan de Bron
DCM::RevisionDate 31-12-2017
DCM::Superseeds nl.zorg.VrijheidsbeperkendeMaatregelen-v3.1
DCM::Version 3.1.1
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

Publicatieversie 3.1.1 (01-10-2018)

ZIB-732 Geen informatie

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


#ArgusPermissionCodelist#ArgusTypeOfInterventionCodelist#TypeOfInterventionCodelist#12473#PermissionCodelist#12476#12468#12466#12475#12467#LegalStatusCodelist#12471#12463#12470FreedomRestrictingMeasures-v3.1.1Model(EN).png


Type Id Concept Card. Definition DefinitionCode Reference
Block.png NL-CM:14.3.1 Arrowdown.pngFreedomRestrictingMeasures Root concept of the FreedomRestrictingMeasures information model. This root concept contains all data elements of the FreedomRestrictingMeasures information model.
CD.png NL-CM:14.3.2 Arrowright.pngLegalStatus 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
List2.png LegalStatusCodelist
BL.png NL-CM:14.3.3 Arrowright.pngLegallyCapable 1 Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.
ST.png NL-CM:14.3.4 Arrowright.pngLegallyCapableComment 0..1 Comment on the decisions which the patient is legally capable of making.
48767-8 Annotation comment [Interpretation] Narrative
Folder.png NL-CM:14.3.5 Arrowdown.pngIntervention 0..* Container of the Restraint concept. This container contains all data elements of the Restraint concept.
CD.png NL-CM:14.3.6 Arrowright.pngTypeOfIntervention 1 The type of restraint describes the medical restraints.
225317005 Restriction of movement
List2.png ArgusTypeOfInterventionCodelist
List2.png TypeOfInterventionCodelist
CD.png NL-CM:14.3.7 Arrowright.pngPermission 1 The permission given to the health professional(s) by the patient or legal representative to implement the medical restraint.
309370004 Consent status
List2.png ArgusPermissionCodelist
List2.png PermissionCodelist
TS.png NL-CM:14.3.8 Arrowright.pngStartEpisode 0..1 The date and time at which the restraints started.
TS.png NL-CM:14.3.9 Arrowright.pngEndOfEpisode 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 List2.png

Example Instances

Only available in Dutch

Voorbeeld file fout: Kan het opgegeven bestand niet vinden. : C:\Users\Spruyt\OneDrive - Nictiz\ZIB publicaties\Prepublicatieversie 2018-1\VZIBS_Examples_2018\nl.zorg.VrijheidsbeperkendeMaatregelen-v3.1.1(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

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: Extensible
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: Extensible
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 Binding: Extensible
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 Binding: Extensible
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: Extensible
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

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To exchange information based on health and care information models, additional, more technical specifications are required.
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This information model is also available as pdf file PDF.png or as spreadsheet Xlsx.png

About this information

The information in this wikipage is based on Prerelease 2018 #1
SNOMED CT and LOINC codes are based on:

  • SNOMED Clinical Terms version: 20180731 [R] (July 2018 Release)
  • LOINC version 2.64

Conditions for use are located on the mainpage List2.png
This page is generated on 01/11/2018 22:25:44 with ZibExtraction v. 2.0.6879.31307


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