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Orders and Observations Work GroupMaturity Level: 2 Trial Use Compartments: Encounter, Patient, Practitioner

Подробное описание элементов ресурса NutritionOrder.

NutritionOrder
Element IdNutritionOrder
Definition

A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to a patient/resident.

Control0..*
TypeDomainResource
Alternate NamesNutrition Order; Diet Order; Diet; Nutritional Supplement; Enteral Nutrition
Comments

Referenced by an Order Request (workflow).

Invariants
Defined on this element
nor-1Warning Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula classoralDiet.exists() or supplement.exists() or enteralFormula.exists()
NutritionOrder.identifier
Element IdNutritionOrder.identifier
Definition

Identifiers assigned to this order by the order sender or by the order receiver.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Comments

The Identifier.type element can be to indicate filler vs. placer if needed. This is explained in further detail here.

NutritionOrder.instantiatesCanonical
Element IdNutritionOrder.instantiatesCanonical
Definition

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.

Control0..*
Typecanonical(ActivityDefinition | PlanDefinition)
Summarytrue
Comments

Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

NutritionOrder.instantiatesUri
Element IdNutritionOrder.instantiatesUri
Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.

Control0..*
Typeuri
Summarytrue
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

NutritionOrder.instantiates
Element IdNutritionOrder.instantiates
Definition

The URL pointing to a protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.

Control0..*
Typeuri
NutritionOrder.status
Element IdNutritionOrder.status
Definition

The workflow status of the nutrition order/request.

Control1..1
Terminology BindingRequestStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

Typically the system placing the order sets the status to "requested". Thereafter, the order is maintained by the receiver that updates the status as the request is handled. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

NutritionOrder.intent
Element IdNutritionOrder.intent
Definition

Indicates the level of authority/intentionality associated with the NutrionOrder and where the request fits into the workflow chain.

Control1..1
Terminology BindingRequestIntent (Required)
Typecode
Is Modifiertrue (Reason: This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request)
Requirements

Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

Alternate Namescategory
Summarytrue
Comments

When resources map to this element, they are free to define as many codes as necessary to cover their space and will map to "proposal, plan or order". Can have multiple codes that map to one of these. E.g. "original order", "encoded order", "reflex order" would all map to "order". Expectation is that the set of codes is mutually exclusive or a strict all-encompassing hierarchy.

NutritionOrder.patient
Element IdNutritionOrder.patient
Definition

The person (patient) who needs the nutrition order for an oral diet, nutritional supplement and/or enteral or formula feeding.

Control1..1
TypeReference(Patient)
Summarytrue
NutritionOrder.encounter
Element IdNutritionOrder.encounter
Definition

An encounter that provides additional information about the healthcare context in which this request is made.

Control0..1
TypeReference(Encounter)
NutritionOrder.dateTime
Element IdNutritionOrder.dateTime
Definition

The date and time that this nutrition order was requested.

Control1..1
TypedateTime
Summarytrue
NutritionOrder.orderer
Element IdNutritionOrder.orderer
Definition

The practitioner that holds legal responsibility for ordering the diet, nutritional supplement, or formula feedings.

Control0..1
TypeReference(Practitioner | PractitionerRole)
Summarytrue
NutritionOrder.allergyIntolerance
Element IdNutritionOrder.allergyIntolerance
Definition

A link to a record of allergies or intolerances which should be included in the nutrition order.

Control0..*
TypeReference(AllergyIntolerance)
Comments

Information on a patient's food allergies and intolerances to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.

NutritionOrder.foodPreferenceModifier
Element IdNutritionOrder.foodPreferenceModifier
Definition

This modifier is used to convey order-specific modifiers about the type of food that should be given. These can be derived from patient allergies, intolerances, or preferences such as Halal, Vegan or Kosher. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.

Control0..*
Terminology BindingDiet (Example)
TypeCodeableConcept
Comments

Information on a patient's food preferences that inform healthcare personnel about the food that the patient should receive or consume.

NutritionOrder.excludeFoodModifier
Element IdNutritionOrder.excludeFoodModifier
Definition

This modifier is used to convey Order-specific modifier about the type of oral food or oral fluids that should not be given. These can be derived from patient allergies, intolerances, or preferences such as No Red Meat, No Soy or No Wheat or Gluten-Free. While it should not be necessary to repeat allergy or intolerance information captured in the referenced AllergyIntolerance resource in the excludeFoodModifier, this element may be used to convey additional specificity related to foods that should be eliminated from the patient’s diet for any reason. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.

Control0..*
Terminology BindingFood Type Codes (Example)
TypeCodeableConcept
Comments

Information on a patient's food allergies, intolerances and preferences to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.

NutritionOrder.oralDiet
Element IdNutritionOrder.oralDiet
Definition

Diet given orally in contrast to enteral (tube) feeding.

Control0..1
Invariants
Affect this element
nor-1Warning Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula classoralDiet.exists() or supplement.exists() or enteralFormula.exists()
NutritionOrder.oralDiet.type
Element IdNutritionOrder.oralDiet.type
Definition

The kind of diet or dietary restriction such as fiber restricted diet or diabetic diet.

Control0..*
Terminology BindingDiet Codes (Example)
TypeCodeableConcept
Summarytrue
NutritionOrder.oralDiet.schedule
Element IdNutritionOrder.oralDiet.schedule
Definition

The time period and frequency at which the diet should be given. The diet should be given for the combination of all schedules if more than one schedule is present.

Control0..*
TypeTiming
Alternate NamesFrequency
NutritionOrder.oralDiet.nutrient
Element IdNutritionOrder.oralDiet.nutrient
Definition

Class that defines the quantity and type of nutrient modifications (for example carbohydrate, fiber or sodium) required for the oral diet.

Control0..*
NutritionOrder.oralDiet.nutrient.modifier
Element IdNutritionOrder.oralDiet.nutrient.modifier
Definition

The nutrient that is being modified such as carbohydrate or sodium.

Control0..1
Terminology BindingNutrient Modifier Codes (Example)
TypeCodeableConcept
NutritionOrder.oralDiet.nutrient.amount
Element IdNutritionOrder.oralDiet.nutrient.amount
Definition

The quantity of the specified nutrient to include in diet.

Control0..1
TypeSimpleQuantity
NutritionOrder.oralDiet.texture
Element IdNutritionOrder.oralDiet.texture
Definition

Class that describes any texture modifications required for the patient to safely consume various types of solid foods.

Control0..*
NutritionOrder.oralDiet.texture.modifier
Element IdNutritionOrder.oralDiet.texture.modifier
Definition

Any texture modifications (for solid foods) that should be made, e.g. easy to chew, chopped, ground, and pureed.

Control0..1
Terminology BindingTexture Modifier Codes (Example)
TypeCodeableConcept
Comments

Coupled with the foodType (Meat).

NutritionOrder.oralDiet.texture.foodType
Element IdNutritionOrder.oralDiet.texture.foodType
Definition

The food type(s) (e.g. meats, all foods) that the texture modification applies to. This could be all foods types.

Control0..1
Terminology BindingTexture Modified Food Type Codes (Example)
TypeCodeableConcept
Comments

Coupled with the texture.modifier; could be (All Foods).

NutritionOrder.oralDiet.fluidConsistencyType
Element IdNutritionOrder.oralDiet.fluidConsistencyType
Definition

The required consistency (e.g. honey-thick, nectar-thick, thin, thickened.) of liquids or fluids served to the patient.

Control0..*
Terminology BindingFluid Consistency Type Codes (Example)
TypeCodeableConcept
NutritionOrder.oralDiet.instruction
Element IdNutritionOrder.oralDiet.instruction
Definition

Free text or additional instructions or information pertaining to the oral diet.

Control0..1
Typestring
Summarytrue
Comments

Free text dosage instructions can be used for cases where the instructions are too complex to code.

NutritionOrder.supplement
Element IdNutritionOrder.supplement
Definition

Oral nutritional products given in order to add further nutritional value to the patient's diet.

Control0..*
Invariants
Affect this element
nor-1Warning Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula classoralDiet.exists() or supplement.exists() or enteralFormula.exists()
NutritionOrder.supplement.type
Element IdNutritionOrder.supplement.type
Definition

The kind of nutritional supplement product required such as a high protein or pediatric clear liquid supplement.

Control0..1
Terminology BindingSupplement Type Codes (Example)
TypeCodeableConcept
Summarytrue
NutritionOrder.supplement.productName
Element IdNutritionOrder.supplement.productName
Definition

The product or brand name of the nutritional supplement such as "Acme Protein Shake".

Control0..1
Typestring
NutritionOrder.supplement.schedule
Element IdNutritionOrder.supplement.schedule
Definition

The time period and frequency at which the supplement(s) should be given. The supplement should be given for the combination of all schedules if more than one schedule is present.

Control0..*
TypeTiming
Alternate NamesFrequency
NutritionOrder.supplement.quantity
Element IdNutritionOrder.supplement.quantity
Definition

The amount of the nutritional supplement to be given.

Control0..1
TypeSimpleQuantity
NutritionOrder.supplement.instruction
Element IdNutritionOrder.supplement.instruction
Definition

Free text or additional instructions or information pertaining to the oral supplement.

Control0..1
Typestring
Summarytrue
Comments

Free text dosage instructions can be used for cases where the instructions are too complex to code.

NutritionOrder.enteralFormula
Element IdNutritionOrder.enteralFormula
Definition

Feeding provided through the gastrointestinal tract via a tube, catheter, or stoma that delivers nutrition distal to the oral cavity.

Control0..1
Invariants
Affect this element
nor-1Warning Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula classoralDiet.exists() or supplement.exists() or enteralFormula.exists()
NutritionOrder.enteralFormula.baseFormulaType
Element IdNutritionOrder.enteralFormula.baseFormulaType
Definition

The type of enteral or infant formula such as an adult standard formula with fiber or a soy-based infant formula.

Control0..1
Terminology BindingEnteral Formula Type Codes (Example)
TypeCodeableConcept
Summarytrue
NutritionOrder.enteralFormula.baseFormulaProductName
Element IdNutritionOrder.enteralFormula.baseFormulaProductName
Definition

The product or brand name of the enteral or infant formula product such as "ACME Adult Standard Formula".

Control0..1
Typestring
NutritionOrder.enteralFormula.additiveType
Element IdNutritionOrder.enteralFormula.additiveType
Definition

Indicates the type of modular component such as protein, carbohydrate, fat or fiber to be provided in addition to or mixed with the base formula.

Control0..1
Terminology BindingEnteral Formula Additive Type Code (Example)
TypeCodeableConcept
NutritionOrder.enteralFormula.additiveProductName
Element IdNutritionOrder.enteralFormula.additiveProductName
Definition

The product or brand name of the type of modular component to be added to the formula.

Control0..1
Typestring
NutritionOrder.enteralFormula.caloricDensity
Element IdNutritionOrder.enteralFormula.caloricDensity
Definition

The amount of energy (calories) that the formula should provide per specified volume, typically per mL or fluid oz. For example, an infant may require a formula that provides 24 calories per fluid ounce or an adult may require an enteral formula that provides 1.5 calorie/mL.

Control0..1
TypeSimpleQuantity
NutritionOrder.enteralFormula.routeofAdministration
Element IdNutritionOrder.enteralFormula.routeofAdministration
Definition

The route or physiological path of administration into the patient's gastrointestinal tract for purposes of providing the formula feeding, e.g. nasogastric tube.

Control0..1
Terminology BindingEnteral Route Codes (Extensible)
TypeCodeableConcept
NutritionOrder.enteralFormula.administration
Element IdNutritionOrder.enteralFormula.administration
Definition

Formula administration instructions as structured data. This repeating structure allows for changing the administration rate or volume over time for both bolus and continuous feeding. An example of this would be an instruction to increase the rate of continuous feeding every 2 hours.

Control0..*
Comments

See implementation notes below for further discussion on how to order continuous vs bolus enteral feeding using this resource.

NutritionOrder.enteralFormula.administration.schedule
Element IdNutritionOrder.enteralFormula.administration.schedule
Definition

The time period and frequency at which the enteral formula should be delivered to the patient.

Control0..1
TypeTiming
Alternate NamesFrequency
NutritionOrder.enteralFormula.administration.quantity
Element IdNutritionOrder.enteralFormula.administration.quantity
Definition

The volume of formula to provide to the patient per the specified administration schedule.

Control0..1
TypeSimpleQuantity
NutritionOrder.enteralFormula.administration.rate[x]
Element IdNutritionOrder.enteralFormula.administration.rate[x]
Definition

The rate of administration of formula via a feeding pump, e.g. 60 mL per hour, according to the specified schedule.

Control0..1
TypeSimpleQuantity|Ratio
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

Ratio is used when the quantity value in the denominator is not "1", otherwise use Quantity. For example, the Ratio datatype is used for "200 mL/4 hrs" versus the Quantity datatype for "50 mL/hr".

NutritionOrder.enteralFormula.maxVolumeToDeliver
Element IdNutritionOrder.enteralFormula.maxVolumeToDeliver
Definition

The maximum total quantity of formula that may be administered to a subject over the period of time, e.g. 1440 mL over 24 hours.

Control0..1
TypeSimpleQuantity
NutritionOrder.enteralFormula.administrationInstruction
Element IdNutritionOrder.enteralFormula.administrationInstruction
Definition

Free text formula administration, feeding instructions or additional instructions or information.

Control0..1
Typestring
Summarytrue
Comments

Free text dosage instructions can be used for cases where the instructions are too complex to code.

NutritionOrder.note
Element IdNutritionOrder.note
Definition

Comments made about the {{title}} by the requester, performer, subject or other participants.

Control0..*
TypeAnnotation
Comments

This element SHALL NOT be used to supply free text instructions for the diet which are represented in the .oralDiet.instruction, supplement.instruction, or enteralFormula.administrationInstruction elements.