{
"description": "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.",
"_filename": "zib-DOSScore.json",
"package_name": "nictiz.fhir.nl.r4.zib2020",
"date": null,
"derivation": "constraint",
"publisher": "Nictiz",
"fhirVersion": "4.0.1",
"purpose": "This Observation resource represents the Dutch [zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) DOSScore v1.0 (2020)](https://zibs.nl/wiki/DOSScore-v1.0(2020EN)).",
"name": "ZibDOSScore",
"mapping": [ {
"uri": "https://zibs.nl/wiki/DOSScore-v1.0(2020EN)",
"name": "zib DOSScore-v1.0(2020EN)",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"abstract": true,
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
"type": "Observation",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "zib DOSScore",
"package_version": "0.10.0-beta.1",
"status": "draft",
"id": "cb2dfc09-741f-48d7-8e72-53a9b8372e3d",
"kind": "resource",
"url": "http://nictiz.nl/fhir/StructureDefinition/zib-DOSScore",
"version": null,
"differential": {
"element": [ {
"id": "Observation",
"path": "Observation",
"alias": [ "DOSScore" ],
"short": "DOSScore",
"mapping": [ {
"map": "NL-CM:18.7.1",
"comment": "DOSScore",
"identity": "zib-dosscore-v1.0-2020EN"
} ]
}, {
"id": "Observation.code",
"path": "Observation.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "160591000146109",
"system": "http://snomed.info/sct"
} ]
}
}, {
"id": "Observation.effective[x]",
"path": "Observation.effective[x]",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "Observation.effective[x]:effectiveDateTime",
"path": "Observation.effective[x]",
"type": [ {
"code": "dateTime"
} ],
"alias": [ "DOSScoreDatumTijd" ],
"short": "DOSScoreDateTime",
"mapping": [ {
"map": "NL-CM:18.7.5",
"comment": "DOSScoreDateTime",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"sliceName": "effectiveDateTime",
"definition": "The date on which the DOS score is registered."
}, {
"id": "Observation.value[x]",
"path": "Observation.value[x]",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"path": "Observation.value[x]",
"definition": "Per shift a total score is calculated (minimum 0 and maximum 13). The total scores of three shifts (day, evening and night shifts) are summed to the total score of the day (minimum 0 and maximum 39).\r\n\r\nThe DOS scale final score is calculated by dividing the total score of the day by 3 (minimum 0 and maximum 13).\r\n\r\nA DOS scale final score < 3 means that the patient is probably not delirious. A DOS scale final score > 3 means that the patient is probably delirious.",
"minValueInteger": 0,
"short": "DOSScoreTotal",
"mapping": [ {
"map": "NL-CM:18.7.3",
"comment": "DOSScoreTotal",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"sliceName": "valueInteger",
"alias": [ "DOSScoreTotaal" ],
"id": "Observation.value[x]:valueInteger",
"maxValueInteger": 13
}, {
"id": "Observation.note",
"max": "1",
"path": "Observation.note"
}, {
"id": "Observation.note.text",
"path": "Observation.note.text",
"alias": [ "Toelichting" ],
"short": "Comment",
"mapping": [ {
"map": "NL-CM:18.7.2",
"comment": "Comment",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"definition": "Comment on the DOS score."
}, {
"id": "Observation.component",
"path": "Observation.component",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "code",
"type": "value"
} ]
}
}, {
"id": "Observation.component:dozesOff",
"max": "1",
"path": "Observation.component",
"sliceName": "dozesOff"
}, {
"id": "Observation.component:dozesOff.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007006",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient dozes off during conversation or activities.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "DozesOff",
"mapping": [ {
"map": "NL-CM:18.7.6",
"comment": "DozesOff",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "ZaktWeg" ],
"id": "Observation.component:dozesOff.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:easilyDistracted",
"max": "1",
"path": "Observation.component",
"sliceName": "easilyDistracted"
}, {
"id": "Observation.component:easilyDistracted.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007007",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient is easily distracted by stimuli from the environment.\r\n\r\nSomeone 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.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "EasilyDistracted",
"mapping": [ {
"map": "NL-CM:18.7.7",
"comment": "EasilyDistracted",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "SnelAfgeleid" ],
"id": "Observation.component:easilyDistracted.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:maintainsAttention",
"max": "1",
"path": "Observation.component",
"sliceName": "maintainsAttention"
}, {
"id": "Observation.component:maintainsAttention.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007008",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient maintains attention to conversation or action.\r\n\r\nSomeone is maintaining attention to a conversation or action if he/she verbally or non-verbally shows that they are following the conversation or action.\r\n\r\nScore:\r\n1: never\r\n0: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "MaintainsAttention",
"mapping": [ {
"map": "NL-CM:18.7.8",
"comment": "MaintainsAttention",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "HeeftAandacht" ],
"id": "Observation.component:maintainsAttention.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:unfinishedQuestionAnswer",
"max": "1",
"path": "Observation.component",
"sliceName": "unfinishedQuestionAnswer"
}, {
"id": "Observation.component:unfinishedQuestionAnswer.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007009",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient does not finish question or answer.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "UnfinishedQuestionAnswer",
"mapping": [ {
"map": "NL-CM:18.7.9",
"comment": "UnfinishedQuestionAnswer",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "VraagAntwoordNietAf" ],
"id": "Observation.component:unfinishedQuestionAnswer.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:answersNoFit",
"max": "1",
"path": "Observation.component",
"sliceName": "answersNoFit"
}, {
"id": "Observation.component:answersNoFit.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007010",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient gives answers that do not fit the question.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "AnswersNoFit",
"mapping": [ {
"map": "NL-CM:18.7.10",
"comment": "AnswersNoFit",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "AntwoordenNietPassend" ],
"id": "Observation.component:answersNoFit.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:reactsSlowly",
"max": "1",
"path": "Observation.component",
"sliceName": "reactsSlowly"
}, {
"id": "Observation.component:reactsSlowly.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007011",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient reacts slowly to instructions.\r\n\r\nSomeone reacts slowly to instructions when acting is delayed and/or there are moments of stillness/inactivity before moving into action.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "ReactsSlowly",
"mapping": [ {
"map": "NL-CM:18.7.11",
"comment": "ReactsSlowly",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "ReageertTraag" ],
"id": "Observation.component:reactsSlowly.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:thinksSomewhereElse",
"max": "1",
"path": "Observation.component",
"sliceName": "thinksSomewhereElse"
}, {
"id": "Observation.component:thinksSomewhereElse.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007012",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient thinks they are somewhere else.\r\n\r\nSomeone thinks they are somewhere else when he/she shows this in words or actions.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "ThinksSomewhereElse",
"mapping": [ {
"map": "NL-CM:18.7.12",
"comment": "ThinksSomewhereElse",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "DenktErgensAnders" ],
"id": "Observation.component:thinksSomewhereElse.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:knowsPartDay",
"max": "1",
"path": "Observation.component",
"sliceName": "knowsPartDay"
}, {
"id": "Observation.component:knowsPartDay.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007013",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient knows which part of the day it is.\r\n\r\nSomeone knows what part of the day it is when he/she shows such in words or actions.\r\n\r\nScore:\r\n1: never\r\n0: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "KnowsPartDay",
"mapping": [ {
"map": "NL-CM:18.7.13",
"comment": "KnowsPartDay",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "BeseftDagdeel" ],
"id": "Observation.component:knowsPartDay.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:remembersRecent",
"max": "1",
"path": "Observation.component",
"sliceName": "remembersRecent"
}, {
"id": "Observation.component:remembersRecent.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007014",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient remembers recent events.\r\n\r\nSomeone remembers recent events when he/she can for example tell whether they had visitors or what he/she ate.\r\n\r\nScore:\r\n1: never\r\n0: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "RemembersRecent",
"mapping": [ {
"map": "NL-CM:18.7.14",
"comment": "RemembersRecent",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "HerinnertRecent" ],
"id": "Observation.component:remembersRecent.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:restless",
"max": "1",
"path": "Observation.component",
"sliceName": "restless"
}, {
"id": "Observation.component:restless.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007015",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient is picking, disorderly, restless.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "Restless",
"mapping": [ {
"map": "NL-CM:18.7.15",
"comment": "Restless",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "Rusteloos" ],
"id": "Observation.component:restless.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:pullsWires",
"max": "1",
"path": "Observation.component",
"sliceName": "pullsWires"
}, {
"id": "Observation.component:pullsWires.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007016",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient pulls IV tubing, feeding tubes, catheters, etc.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "PullsWires",
"mapping": [ {
"map": "NL-CM:18.7.16",
"comment": "PullsWires",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "TrektDraden" ],
"id": "Observation.component:pullsWires.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:easilyEmotional",
"max": "1",
"path": "Observation.component",
"sliceName": "easilyEmotional"
}, {
"id": "Observation.component:easilyEmotional.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007017",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient is easily or suddenly emotional.\r\n\r\nSomeone 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.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "EasilyEmotional",
"mapping": [ {
"map": "NL-CM:18.7.17",
"comment": "EasilyEmotional",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "SnelGeemotioneerd" ],
"id": "Observation.component:easilyEmotional.value[x]",
"maxValueInteger": 1
}, {
"id": "Observation.component:hallucinations",
"max": "1",
"path": "Observation.component",
"sliceName": "hallucinations"
}, {
"id": "Observation.component:hallucinations.code",
"path": "Observation.component.code",
"comment": "This code aligns with the future version of this zib. See [ZIB-1674](https://bits.nictiz.nl/browse/ZIB-1674) for details.",
"patternCodeableConcept": {
"coding": [ {
"code": "18007018",
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0.1"
} ]
}
}, {
"path": "Observation.component.value[x]",
"definition": "DOS observation: patient sees/hears things which are not there.\r\n\r\nSomeone sees/hears things which are not there when he/she shows this verbally (ask!) or non-verbally.\r\n\r\nScore:\r\n0: never\r\n1: sometimes-always\r\n(if the answer is \"don't know\", do not instantiate this concept)",
"minValueInteger": 0,
"short": "Hallucinations",
"mapping": [ {
"map": "NL-CM:18.7.18",
"comment": "Hallucinations",
"identity": "zib-dosscore-v1.0-2020EN"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "Hallucinaties" ],
"id": "Observation.component:hallucinations.value[x]",
"maxValueInteger": 1
} ]
},
"contact": [ {
"name": "Nictiz",
"telecom": [ {
"use": "work",
"value": "https://www.nictiz.nl",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation"
}