vpk:V4.0 Testgegevens eOverdracht addendum: verschil tussen versies
(EOVDR-526 Mentale.Status.Probleem is weer gevuld in testscript 1.1) |
(EOVDR-478 De elementen afdelingsspecialisme, contactgegevens, adresgegevens en organisatietype van Behandelaar.Zorgverlener.Zorgaanbieder zijn verwijderd uit Kwalificatiescript 1.1b en Testscripts 1.1, 1.1b. 1,2b) |
||
Regel 377: | Regel 377: | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
− | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | + | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="7" | Medische context |
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
− | |colspan=" | + | |colspan="6" width="30%"| Gegevenselement |
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Behandelaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="16"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgverlener |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="14"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Naamgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="6"| | |rowspan="6"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Voornamen |
|style="background-color: white;"|Bart | |style="background-color: white;"|Bart | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
|style="background-color: white;"|B. | |style="background-color: white;"|B. | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="2"| | |rowspan="2"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
|style="background-color: white;"|Kuiper | |style="background-color: white;"|Kuiper | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
|style="background-color: white;"|Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |style="background-color: white;"|Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Zorgaanbieder |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Zorgaanbieder identificatienummer |
|style="background-color: white;"|06757677 (in identificerend systeem: AGB-Z) | |style="background-color: white;"|06757677 (in identificerend systeem: AGB-Z) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Organisatie naam |
|style="background-color: white;"|MC-Westland | |style="background-color: white;"|MC-Westland | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Organisatie locatie |
|style="background-color: white;"|Centrum | |style="background-color: white;"|Centrum | ||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Behandelaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="18"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgverlener |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="16"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Zorgverlener identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|03161616 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Naamgegevens |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="7"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Voornamen |
+ | |style="background-color: white;"|Alexandra | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|A. |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Voorvoegsels |
− | |style="background-color: white;"| | + | |style="background-color: white;"|van |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Breukelen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Medisch specialisten, chirurgie (code = '0303' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="4"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Zorgaanbieder identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|06757677 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Organisatie naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|MC-Westland |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Organisatie locatie |
+ | |style="background-color: white;"|Centrum | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="7"| | + | |colspan="7"|Medische diagnose |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="24"| |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|<span id="eovd-k1-1b-probleem-01" title="Intern ID = eovd-k1-1b-probleem-01">Probleem eovd-k1-1b-probleem-01</span> |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="7"| | |rowspan="7"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|ziekte van Parkinson (code = '49049000' in codeSystem 'SNOMED CT') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem begin datum |
+ | |style="background-color: white;"|T - 3 jaar | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Verificatie status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|naast beven ook somberheid en moeheid |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|<span id="eovd-k1-1b-probleem-02" title="Intern ID = eovd-k1-1b-probleem-02">Probleem eovd-k1-1b-probleem-02</span> |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="5"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|primair maligne neoplasma van blaas (code = '93689003') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem begin datum |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 30 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Probleem |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="8"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem anatomische locatie |
+ | |style="background-color: white;"|structuur van huid van schouder (code = '76552005' in codeSystem 'SNOMED Clinical Terms') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem lateraliteit |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Rechts (code = '24028007' in codeSystem 'SNOMED CT') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem type |
+ | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|melanoom (code = '372244006') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem begin datum |
+ | |style="background-color: white;"|T - 2 maanden | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |colspan="4"|Verificatie status | |
− | + | |style="background-color: white;"|Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |colspan="4"| | ||
− | |style="background-color: white;"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Voorgeschiedenis |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="8"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Probleem |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="6"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem type |
|style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|diverticulitis (code = '307496006') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem begin datum |
− | |style="background-color: white;"|T - | + | |style="background-color: white;"|T - 12 jaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem eind datum |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 1 jaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Niet actueel (code = '73425007' in codeSystem 'SNOMED CT') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Allergie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="37"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Allergie intolerantie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="12"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Veroorzakende stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|selderij (code = '256326004' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie categorie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Voeding (code = '418471000' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actief (code = 'active' in codeSystem 'HL7 ActStatus') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 10 jaar |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Mate van kritiek zijn | ||
+ | |style="background-color: white;"|Matig (code = '6736007' in codeSystem 'SNOMED CT') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Toelichting | ||
+ | |style="background-color: white;"|betreft zowel gekookte als rauwe selderij | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reactie |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="4"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Symptoom | ||
+ | |style="background-color: white;"|Misselijk en braken (code = '16932000' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Reactie beschrijving |
+ | |style="background-color: white;"|Misselijkheid en braken | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Wijze van blootstelling |
− | |style="background-color: white;"| | + | |style="background-color: white;"|via spijsverteringskanaal (code = '447964005' in codeSystem 'SNOMED Clinical Terms') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Allergie intolerantie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="22"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Veroorzakende stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|huisstofmijt (code = '264401009') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie categorie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Omgeving (code = '426232007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actief (code = 'active' in codeSystem 'HL7 ActStatus') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 500 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Mate van kritiek zijn |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Matig (code = '6736007' in codeSystem 'SNOMED CT') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Laatste reactie datum tijd |
+ | |style="background-color: white;"|T - 99 dagen | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reactie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="6"| | |rowspan="6"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Symptoom |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Overgevoeligheidsreactie van de bovenste luchtwegen (code = '490008' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Specifieke stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|eiwit van huisstofmijt (code = '720687003') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie beschrijving |
− | |style="background-color: white;"| | + | |style="background-color: white;"|veelvuldig niezen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Ernst |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Matig (code = '6736007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie tijdstip |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 99 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reactie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan | + | |rowspan="7"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Symptoom |
+ | |style="background-color: white;"|Kortademigheid (code = '267036007' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Symptoom |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Koorts (code = '386661006' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Specifieke stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|allergeen van roofmijt (code = '110171000146101') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie beschrijving |
− | |style="background-color: white;"| | + | |style="background-color: white;"|ernstige benauwdheid en koorts |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Ernst |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Ernstig (code = '24484000' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie tijdstip |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 200 dagen |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Let op | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="10"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|Alert |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Alert naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Drager VRE (code = '431109006' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 20 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Alert type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|waarschuwing (code = '74018-3' in codeSystem 'LOINC') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Alert |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Alert naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): verhoogd valrisico |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 10 jaar |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Meetwaarden | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="23"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="6"|Bloeddruk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="10"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Meetmethode |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Niet-invasief (code = '22762002' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Manchet type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Klein (code = 'S' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.15.1') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Meet locatie |
+ | |style="background-color: white;"|Linker bovenarm (code = '368208006' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Systolische bloeddruk |
− | |style="background-color: white;"| | + | |style="background-color: white;"|160 mmhg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Diastolische bloeddruk |
− | |style="background-color: white;"| | + | |style="background-color: white;"|92 mmhg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Gemiddelde bloeddruk |
− | |style="background-color: white;"| | + | |style="background-color: white;"|109 mmhg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Bloeddruk datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 2 dagen om 14:45 uur |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|mevrouw gebruikt medicatie |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Houding | ||
+ | |style="background-color: white;"|Zittende positie (code = '33586001' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|Lichaamsgewicht |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="5"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Gewicht waarde |
− | |style="background-color: white;"| | + | |style="background-color: white;"|58 kg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|mevrouw is aan het aansterken |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Gewicht datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 5 dagen om 14:30 uur |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Kleding |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Lichte kleding/ondergoed (code = 'MINIMAL' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.8.1') |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Lichaamslengte |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Lengte waarde |
− | |style="background-color: white;"| | + | |style="background-color: white;"|160 cm |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Lengte datum tijd |
− | |style="background-color: white;"|T - | + | |style="background-color: white;"|T - 2 dagen om 13:30 uur |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|zonder schoenen aan |
+ | |} | ||
+ | === Verpleegkundige context zorgplan=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="9" | Verpleegkundige context zorgplan | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="8" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="9"|Afspraken patient |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="83"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="8"|Contact | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="57"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Contact type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Poliklinisch (code = 'AMB' in codeSystem 'HL7 ActCode') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Contact met |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="11"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgverlener |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="9"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Naamgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="6"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Voornamen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Bart |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|B. |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geslachtsnaam | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Kuiper |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Contact met | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="13"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="6"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="11"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Zorgverlener identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|03282828 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Naamgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Voornamen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Sebastiaan |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | + | |style="background-color: white;"|S. | |
− | |||
− | |||
− | |style="background-color: white;"| | ||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Voorvoegsels |
− | |style="background-color: white;"| | + | |style="background-color: white;"|de |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Vries |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Medisch specialisten, chirurgie (code = '0303' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Locatie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="23"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgaanbieder |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="21"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Zorgaanbieder identificatienummer |
+ | |style="background-color: white;"|06757677 (in identificerend systeem: AGB-Z) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Organisatie naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|MC-Westland |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Organisatie locatie |
− | | | + | |style="background-color: white;"|Centrum |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Afdeling specialisme |
+ | |style="background-color: white;"|Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Contactgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Telefoonnummers | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Telefoonnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|+31174300400 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Email adressen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="2"| | |rowspan="2"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Email adres |
− | |style="background-color: white;"| | + | |style="background-color: white;"|urologie@mcw.nl |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Adresgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan | + | |rowspan="6"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Straat |
+ | |style="background-color: white;"|Wortellaan | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Huisnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|2 |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Postcode |
+ | |style="background-color: white;"|9998SO | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Woonplaats |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Monster |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Adres soort |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') |
− | |-style="vertical-align:top; background-color: #E3E3E3;;" | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | |colspan="4"| | + | |colspan="4"|Organisatie type |
+ | |style="background-color: white;"|Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="6"|Begin datum tijd |
+ | |style="background-color: white;"|T + 5 dagen om 10:00 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Eind datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T + 5 dagen om 10:30 uur |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Reden contact | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Probleem |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Zie [[#eovd-k1-1b-probleem-02|Probleem: eovd-k1-1b-probleem-02]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="8"|Contact |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="23"| | |rowspan="23"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Contact type | ||
+ | |style="background-color: white;"|Thuis (code = 'HH' in codeSystem 'HL7 ActCode') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Contact met |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="16"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="14"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Zorgverlener identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|04434343 (in identificerend systeem: AGB-Z) |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Naamgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="5"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Voornamen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Elise |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Achternaam | ||
+ | |style="background-color: white;"|Willems | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Specialisme |
+ | |style="background-color: white;"|Fysiotherapeuten, niet nader gespecificeerd (code = '0400' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Contactgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Email adressen | |colspan="4"|Email adressen | ||
Regel 958: | Regel 953: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Email adres | |colspan="2"|Email adres | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|ewillems@fysio.nl |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Begin datum tijd | ||
+ | |style="background-color: white;"|T + 9 dagen om 10:20 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Reden contact |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reden contact tekst |
− | |style="background-color: white;"| | + | |style="background-color: white;"|advies over veilige en passende lichaamsbeweging |
+ | |} | ||
+ | === Verpleegkundige context specificatie gezondheidstoestand=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Verpleegkundige context specificatie gezondheidstoestand | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="4" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Voedingvocht | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="10"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="4"|Voedingsadvies | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="4"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Dieet type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|lactosevrij |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Consistentie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|solide |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Toelichting |
− | + | |style="background-color: white;"|naar eigen zeggen lactose-intolerant | |
− | |||
− | | | ||
− | |style="background-color: white;"| | ||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Voedingsadvies |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Dieet type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|geen selderij |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="2"|Toelichting |
− | |-style="vertical-align:top; background-color: #E3E3E3;;" | + | |style="background-color: white;"|in verband met allergie |
− | |colspan="6"| | + | |}<section end=eOvd-SOV-kwa-1.1b-alle_zibs /> |
− | |style="background-color: white;"| | + | <section begin=eOvd-SOV-tst-1.1-alle_zibs /> |
+ | ==Test Overdracht volwassene- 1.1== | ||
+ | |||
+ | === Administratieve gegevens=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="7" | Administratieve gegevens | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="6" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Datum overplaatsing | ||
+ | |style="background-color: white;"|T + 1 dag | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="7"| | + | |colspan="7"|Persoonsgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="75"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|Patient |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="26"| |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Naamgegevens | |colspan="5"|Naamgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="6"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Voornamen | |colspan="3"|Voornamen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Erik |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Initialen | ||
+ | |style="background-color: white;"|E | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam | |colspan="4"|Geslachtsnaam | ||
Regel 1.025: | Regel 1.039: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam | |colspan="2"|Achternaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|XXX_Altenborg |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Adresgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="6"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Straat |
+ | |style="background-color: white;"|Knolweg | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Huisnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|1000 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Postcode |
− | |style="background-color: white;"| | + | |style="background-color: white;"|9999XA |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Woonplaats |
+ | |style="background-color: white;"|Stitswerd | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Adres soort |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Contactgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Telefoonnummers |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Telefoonnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|+31634567891 |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Email adressen | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Email adres |
− | |style="background-color: white;"| | + | |style="background-color: white;"|evertaltenborg@hotmail.com |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Identificatienummer |
+ | |style="background-color: white;"|999911612 (in identificerend systeem: BSN) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geboortedatum |
− | |style="background-color: white;"| | + | |style="background-color: white;"|14 aug 1964 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslacht |
− | |style="background-color: white;"|in | + | |style="background-color: white;"|Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Betaler |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="10"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Verzekeraar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="8"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Verzekering |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Eind datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T + 1 jaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Verzekeringssoort |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Identificatie nummer |
+ | |style="background-color: white;"|9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Organisatie naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Trias |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Verzekerde nummer | ||
+ | |style="background-color: white;"|12345678 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="eovd-1-1-contactpersoon-01" title="Intern ID = eovd-1-1-contactpersoon-01">Contactpersoon eovd-1-1-contactpersoon-01</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="19"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Naamgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Voornamen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Johanna |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|J |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Roepnaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Hanna |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geslachtsnaam | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Bakker |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Contactgegevens | |colspan="5"|Contactgegevens | ||
Regel 1.155: | Regel 1.147: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Telefoonnummer | |colspan="2"|Telefoonnummer | ||
− | |style="background-color: white;"|+ | + | |style="background-color: white;"|+31645678912 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Email adressen | |colspan="4"|Email adressen | ||
Regel 1.162: | Regel 1.154: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Email adres | |colspan="2"|Email adres | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|jbakker@123net.nl |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Rol |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Eerste relatie/contactpersoon (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Relatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Dochter (code = 'DAUC' in codeSystem 'HL7 RoleCode') |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|Contactpersoon |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="15"| |
− | |||
− | |||
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− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Naamgegevens | |colspan="5"|Naamgegevens | ||
Regel 1.209: | Regel 1.171: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Voornamen | |colspan="3"|Voornamen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Johannes |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Roepnaam | |colspan="3"|Roepnaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Hans |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam | |colspan="4"|Geslachtsnaam | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan="2"| | + | |rowspan="3"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Voorvoegsels | ||
+ | |style="background-color: white;"|van | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam | |colspan="2"|Achternaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Dijk |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Contactgegevens | |colspan="5"|Contactgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Telefoonnummers | |colspan="4"|Telefoonnummers | ||
Regel 1.233: | Regel 1.195: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Telefoonnummer | |colspan="2"|Telefoonnummer | ||
− | |style="background-color: white;"|+ | + | |style="background-color: white;"|+31612121212 |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Relatie | |colspan="4"|Relatie | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): achterneef |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Sturende organisatie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="34"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgaanbieder |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="21"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Zorgaanbieder identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|06590457 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Organisatie naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|AB-zkh |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Organisatie locatie |
+ | |style="background-color: white;"|Noord | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Afdeling specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Contactgegevens | |colspan="5"|Contactgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |rowspan="7"| | |
− | |||
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− | |rowspan="7"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Telefoonnummers | |colspan="4"|Telefoonnummers | ||
Regel 1.731: | Regel 1.645: | ||
|colspan="9"|Behandelaar | |colspan="9"|Behandelaar | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="16"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="8"|<span id="eovdv-1-1-behandelaar-01" title="Intern ID = eovdv-1-1-behandelaar-01">Zorgverlener eovdv-1-1-behandelaar-01</span> | |colspan="8"|<span id="eovdv-1-1-behandelaar-01" title="Intern ID = eovdv-1-1-behandelaar-01">Zorgverlener eovdv-1-1-behandelaar-01</span> | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="14"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="7"|Naamgegevens | |colspan="7"|Naamgegevens | ||
Regel 1.759: | Regel 1.673: | ||
|colspan="7"|Zorgaanbieder | |colspan="7"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Zorgaanbieder identificatienummer | |colspan="5"|Zorgaanbieder identificatienummer | ||
Regel 1.769: | Regel 1.683: | ||
|colspan="5"|Organisatie locatie | |colspan="5"|Organisatie locatie | ||
|style="background-color: white;"|Noord | |style="background-color: white;"|Noord | ||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="9"|Behandelaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="16"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="8"|<span id="eovdv-1-1-behandelaar-02" title="Intern ID = eovdv-1-1-behandelaar-02">Zorgverlener eovdv-1-1-behandelaar-02</span> |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="14"| |
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|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Zorgverlener identificatienummer | |colspan="6"|Zorgverlener identificatienummer | ||
Regel 1.843: | Regel 1.714: | ||
|colspan="7"|Zorgaanbieder | |colspan="7"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Zorgaanbieder identificatienummer | |colspan="5"|Zorgaanbieder identificatienummer | ||
Regel 1.853: | Regel 1.724: | ||
|colspan="5"|Organisatie locatie | |colspan="5"|Organisatie locatie | ||
|style="background-color: white;"|Noord | |style="background-color: white;"|Noord | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="9"|Medische diagnose | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="23"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="8"|<span id="eovd-1-1-probleem-01" title="Intern ID = eovd-1-1-probleem-01">Probleem eovd-1-1-probleem-01</span> |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="7"| | |rowspan="7"| | ||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="6"|Probleem type |
+ | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |colspan="6"|Probleem naam | |
− | + | |style="background-color: white;"|ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |colspan="6"|Probleem naam | ||
− | |style="background-color: white;"|ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Probleem begin datum | |colspan="6"|Probleem begin datum | ||
Regel 4.737: | Regel 4.565: | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
− | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | + | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="7" | Medische context |
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
− | |colspan=" | + | |colspan="6" width="30%"| Gegevenselement |
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Behandelaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="16"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgverlener |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="14"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Naamgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="6"| | |rowspan="6"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Voornamen |
|style="background-color: white;"|Joshua Pieter | |style="background-color: white;"|Joshua Pieter | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
|style="background-color: white;"|J. P. | |style="background-color: white;"|J. P. | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="2"| | |rowspan="2"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
|style="background-color: white;"|Helmond | |style="background-color: white;"|Helmond | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
|style="background-color: white;"|Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |style="background-color: white;"|Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Zorgaanbieder |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Zorgaanbieder identificatienummer |
|style="background-color: white;"|06590457 (in identificerend systeem: AGB-Z) | |style="background-color: white;"|06590457 (in identificerend systeem: AGB-Z) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Organisatie naam |
|style="background-color: white;"|AB-zkh | |style="background-color: white;"|AB-zkh | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Organisatie locatie |
|style="background-color: white;"|Noord | |style="background-color: white;"|Noord | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Behandelaar | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="16"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgverlener |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="14"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Zorgverlener identificatienummer |
+ | |style="background-color: white;"|03898989 (in identificerend systeem: AGB-Z) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Naamgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="5"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|G. |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Geslachtsnaam |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="2"| | |rowspan="2"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Achternaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Spijkerman |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Specialisme | ||
+ | |style="background-color: white;"|Medisch specialisten, gastro-enterologie (maag-darm-lever-arts) (code = '0318' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Zorgaanbieder |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Zorgaanbieder identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|06590457 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Organisatie naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|AB-zkh |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3 | + | |colspan="3"|Organisatie locatie |
− | + | |style="background-color: white;"|Noord | |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |style="background-color: white;"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Medische diagnose |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="23"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|<span id="eovd-1-1b-probleem-01" title="Intern ID = eovd-1-1b-probleem-01">Probleem eovd-1-1b-probleem-01</span> |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem naam |
+ | |style="background-color: white;"|ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem begin datum |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 100 dagen |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem status |
+ | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Verificatie status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|niet bekend met neurologische klachten |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|Probleem |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="5"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|neoplasma van colon (code = '126838000') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem begin datum |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 150 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Probleem status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Probleem |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="7"| | |rowspan="7"| | ||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem anatomische locatie |
+ | |style="background-color: white;"|oksel (code = '91470000' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Probleem lateraliteit | ||
+ | |style="background-color: white;"|Rechts en links (code = '51440002' in codeSystem 'SNOMED CT') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Probleem type | ||
+ | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|inverse psoriasis (code = '238600001') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Probleem begin datum |
+ | |style="background-color: white;"|T - 10 jaar | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Voorgeschiedenis |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan="6"| | + | |rowspan="7"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Probleem | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="5"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|diabetes mellitus (code = '73211009') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem begin datum |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 12 jaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |colspan="4"|Probleem status | |
− | + | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |
− | |||
− | |colspan="4"| | ||
− | |style="background-color: white;"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Allergie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="37"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Allergie intolerantie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="12"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Veroorzakende stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|nikkelsulfaat (code = '255848005' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie categorie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Stof of product (code = '419199007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actief (code = 'active' in codeSystem 'HL7 ActStatus') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 10 jaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Mate van kritiek zijn |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Matig (code = '6736007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|opgemerkt bij het dragen van nikkel bevattende sieraden. |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reactie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Symptoom |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Contactdermatitis (code = '40275004' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie beschrijving |
− | |style="background-color: white;"| | + | |style="background-color: white;"|last van jeuk, roodheid en irritatie op de contactplek van nikkel bevattende sieraden. |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Wijze van blootstelling |
− | |style="background-color: white;"| | + | |style="background-color: white;"|intra-epidermale route (code = '448077001' in codeSystem 'SNOMED Clinical Terms') |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Allergie intolerantie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="22"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Veroorzakende stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|pollen (code = '256259004') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie categorie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Omgeving (code = '426232007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Allergie status |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Actief (code = 'active' in codeSystem 'HL7 ActStatus') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 500 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Mate van kritiek zijn |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Matig (code = '6736007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Laatste reactie datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 99 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reactie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="6"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Symptoom |
+ | |style="background-color: white;"|Overgevoeligheidsreactie van de bovenste luchtwegen (code = '490008' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Specifieke stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|graspollen (code = '256277009') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie beschrijving |
− | |style="background-color: white;"| | + | |style="background-color: white;"|veelvuldig niezen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Ernst |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Matig (code = '6736007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie tijdstip |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 99 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reactie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan | + | |rowspan="7"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Symptoom |
+ | |style="background-color: white;"|Kortademigheid (code = '267036007' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Symptoom |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Koorts (code = '386661006' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Specifieke stof |
− | |style="background-color: white;"| | + | |style="background-color: white;"|pollen van paprikaplant (code = '110181000146104') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie beschrijving |
− | |style="background-color: white;"| | + | |style="background-color: white;"|ernstige benauwdheid en koorts |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Ernst |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Ernstig (code = '24484000' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Reactie tijdstip |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 200 dagen |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Let op | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="10"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|Alert |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Alert naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Drager MRSA (code = '432415000' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 20 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Alert type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|waarschuwing (code = '74018-3' in codeSystem 'LOINC') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Alert |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Alert naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): ernstige claustrofobie |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 10 jaar |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Meetwaarden | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="24"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="6"|Bloeddruk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="11"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Meetmethode |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Niet-invasief (code = '22762002' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Manchet type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Standaard (code = 'STD' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.15.1') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Meet locatie |
+ | |style="background-color: white;"|Rechter bovenarm (code = '368209003' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Diastolisch eindpunt |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Fase V (code = '255272007' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Systolische bloeddruk |
− | |style="background-color: white;"| | + | |style="background-color: white;"|170 mmhg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Diastolische bloeddruk |
− | |style="background-color: white;"| | + | |style="background-color: white;"|90 mmhg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Gemiddelde bloeddruk |
− | |style="background-color: white;"| | + | |style="background-color: white;"|110 mmhg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Bloeddruk datum tijd |
− | |style="background-color: white;"|T - | + | |style="background-color: white;"|T - 20 dagen om 14:45 uur |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Toelichting |
+ | |style="background-color: white;"|meneer gebruikt medicatie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Houding |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Liggende positie (code = '102538003' in codeSystem 'SNOMED CT') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Lichaamsgewicht | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="5"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Gewicht waarde |
− | |style="background-color: white;"| | + | |style="background-color: white;"|74 kg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|meneer volgt afvaldieet |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Gewicht datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T - 5 dagen om 14:30 uur |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Kleding |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Volledig gekleed, inclusief schoenen (code = 'FULL' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.8.1') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Lichaamslengte |
− | |||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Lengte waarde |
− | |style="background-color: white;"| | + | |style="background-color: white;"|170 cm |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Lengte datum tijd |
− | |style="background-color: white;"|T - | + | |style="background-color: white;"|T - 5 dagen om 14:30 uur |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|zonder schoenen aan |
+ | |} | ||
+ | === Verpleegkundige context zorgplan=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="9" | Verpleegkundige context zorgplan | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="8" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="9"|Afspraken patient |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="81"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="8"|Contact | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="55"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Contact type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Poliklinisch (code = 'AMB' in codeSystem 'HL7 ActCode') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Contact met |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="11"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgverlener |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="9"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Naamgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="6"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Voornamen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Joshua Pieter |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|J.P. |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geslachtsnaam | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Helmond |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Contact met | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="11"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="6"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="9"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Zorgverlener identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|03686868 (in identificerend systeem: AGB-Z) |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Naamgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="5"| | |rowspan="5"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|F. |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geslachtsnaam | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Snijder |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Medisch specialisten, neurochirurgie (code = '0308' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Locatie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="23"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgaanbieder |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="21"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Zorgaanbieder identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|06590457 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Organisatie naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|AB-zkh |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Organisatie locatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Noord |
− | + | |-style="vertical-align:top; background-color: #E3E3E3;;" | |
− | + | |colspan="4"|Afdeling specialisme | |
− | + | |style="background-color: white;"|Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |
− | |||
− | |style="background-color: # | ||
− | | | ||
− | | | ||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Contactgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Telefoonnummers |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Telefoonnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|+31182435770 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Email adressen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="2"|Email adres |
+ | |style="background-color: white;"|neurologie@ABZ.nl | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Adresgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="6"| | |rowspan="6"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Straat |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Knolweg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Huisnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|10 |
− | |-style="vertical-align:top; background-color: #E3E3E3;;" | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | |colspan=" | + | |colspan="3"|Postcode |
+ | |style="background-color: white;"|9999PO | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Woonplaats | ||
+ | |style="background-color: white;"|Stitswerd | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Adres soort | ||
+ | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Organisatie type | ||
+ | |style="background-color: white;"|Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Begin datum tijd | ||
+ | |style="background-color: white;"|T + 5 dagen om 10:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Eind datum tijd | ||
+ | |style="background-color: white;"|T + 5 dagen om 10:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Reden contact | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="2"| | |rowspan="2"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Probleem |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Zie [[#eovd-1-1b-probleem-01|Probleem: eovd-1-1b-probleem-01]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="8"|Contact | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="23"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Contact type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Thuis (code = 'HH' in codeSystem 'HL7 ActCode') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="7"|Contact met | |colspan="7"|Contact met | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="16"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Zorgverlener | |colspan="6"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="14"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Zorgverlener identificatienummer | |colspan="4"|Zorgverlener identificatienummer | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|88131313 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Naamgegevens | |colspan="5"|Naamgegevens | ||
Regel 5.255: | Regel 5.105: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Initialen | |colspan="3"|Initialen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|W. |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam | |colspan="4"|Geslachtsnaam | ||
Regel 5.262: | Regel 5.112: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam | |colspan="2"|Achternaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Bloem |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Specialisme | |colspan="4"|Specialisme | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Ergotherapeuten (code = '8800' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Contactgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Email adressen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Email adres |
− | |style="background-color: white;"| | + | |style="background-color: white;"|bloem@ergotherapie.nl |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Begin datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T + 12 dagen om 15:15 uur |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Reden contact | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Reden contact tekst |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Controle voortgang revalidatie |
+ | |} | ||
+ | === Verpleegkundige context specificatie gezondheidstoestand=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Verpleegkundige context specificatie gezondheidstoestand | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="4" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Voedingvocht |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="9"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Voedingsadvies |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Dieet type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|suikervrij, diabetes dieet |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="2"|Consistentie |
+ | |style="background-color: white;"|dik vloeibaar | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Toelichting |
− | |style="background-color: white;"| | + | |style="background-color: white;"|eet naar eigen keuze minder vlees |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Voedingsadvies |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Dieet type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|geen varkensvlees |
+ | |}<section end=eOvd-SOV-tst-1.1b-alle_zibs /> | ||
+ | <section begin=eOvd-SOV-tst-1.2b-naam_adres_contact /> | ||
+ | ==Test Overdracht 1.2b== | ||
+ | |||
+ | === Administratieve gegevens=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="7" | Administratieve gegevens | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="6" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Datum overplaatsing |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T + 1 dag |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Persoonsgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="101"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="6"|Patient | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="51"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="5"|Naamgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="13"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Voornamen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Claire |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|C |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Roepnaam | ||
+ | |style="background-color: white;"|Françoise | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Naamgebruik |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Geslachtsnaam partner gevolgd door eigen geslachtsnaam (code = 'NL3' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Voorvoegsels |
− | |style="background-color: white;"| | + | |style="background-color: white;"|van |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |colspan="2"|Achternaam | |
− | + | |style="background-color: white;"|Clinteren | |
− | |colspan=" | ||
− | |style="background-color: white;"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam partner |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="2"|Voorvoegsels partner |
+ | |style="background-color: white;"|van de | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam partner |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Put |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Adresgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="11"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Straat |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Cremstraat |
− | |-style="vertical-align:top; background-color: #E3E3E3;;" | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | |colspan=" | + | |colspan="3"|Huisnummer |
+ | |style="background-color: white;"|7 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Huisnummerletter | ||
+ | |style="background-color: white;"|G | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Huisnummertoevoeging |
+ | |style="background-color: white;"|I | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Aanduiding bij nummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Bij (code = 'by' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.3') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Postcode |
− | |style="background-color: white;"| | + | |style="background-color: white;"|1240AB |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Woonplaats |
− | | | + | |style="background-color: white;"|Finsterwolderhamrink |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Land |
+ | |style="background-color: white;"|Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Additionele informatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|tijdelijk adres |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Adres soort |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Postadres (code = 'PST' in codeSystem 'HL7 AddressUse') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Adresgegevens |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Straat |
+ | |style="background-color: white;"|Magnolialaan | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Huisnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|1 |
− | | | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | + | |colspan="3"|Postcode | |
− | + | |style="background-color: white;"|4100AA | |
− | + | |-style="vertical-align:top; background-color: #E3E3E3;;" | |
− | |style="background- | + | |colspan="3"|Woonplaats |
− | | | + | |style="background-color: white;"|Ruurlo |
− | |colspan=" | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | + | |colspan="3"|Adres soort | |
− | + | |style="background-color: white;"|Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Contactgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="13"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Telefoonnummers |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Telefoonnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|+31612121212 |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Telefoonnummers | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Telefoonnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|+31709131313 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Email adressen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="2"| | |rowspan="2"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Email adres |
− | |style="background-color: white;"| | + | |style="background-color: white;"|claire@vanclinteren.nl |
− | | | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | + | |colspan="4"|Email adressen | |
− | = | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | + | |rowspan="2"| | |
− | + | |-style="vertical-align:top; background-color: #E3E3E3;;" | |
− | + | |colspan="2"|Email adres | |
− | + | |style="background-color: white;"|clinteren@planeet.nl | |
− | |style="background-color: # | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
− | | | + | |colspan="4"|Identificatienummer |
− | |colspan=" | + | |style="background-color: white;"|999999072 (in identificerend systeem: BSN) |
− | + | |-style="vertical-align:top; background-color: #E3E3E3;;" | |
− | + | |colspan="4"|Geboortedatum | |
+ | |style="background-color: white;"|1 jul 1950 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslacht |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Betaler |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="10"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Verzekeraar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="8"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Verzekering |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Eind datum tijd |
− | |style="background-color: white;"| | + | |style="background-color: white;"|T + 250 dagen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"|Initialen | + | |colspan="2"|Verzekeringssoort |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Identificatie nummer | ||
+ | |style="background-color: white;"|9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Organisatie naam | ||
+ | |style="background-color: white;"|Trias | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Verzekerde nummer | ||
+ | |style="background-color: white;"|12345678 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Contactpersoon | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="36"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Naamgegevens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="11"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Voornamen | ||
+ | |style="background-color: white;"|Hendrike | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Initialen | ||
+ | |style="background-color: white;"|H | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Roepnaam | |colspan="3"|Roepnaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Riek |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Naamgebruik | |colspan="3"|Naamgebruik | ||
Regel 5.470: | Regel 5.373: | ||
|colspan="4"|Geslachtsnaam | |colspan="4"|Geslachtsnaam | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan | + | |rowspan="2"| |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam | |colspan="2"|Achternaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Smit |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam partner | |colspan="4"|Geslachtsnaam partner | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan | + | |rowspan="2"| |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam partner | |colspan="2"|Achternaam partner | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Timmerman |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Contactgegevens |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Telefoonnummers | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Telefoonnummer | ||
+ | |style="background-color: white;"|+31645678912 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Email adressen | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Email adres | ||
+ | |style="background-color: white;"|jbakker@123net.nl | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Adresgegevens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="10"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Straat | |colspan="3"|Straat | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Vincent van Goghplantsoen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Huisnummer | |colspan="3"|Huisnummer | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|1 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Huisnummerletter | |colspan="3"|Huisnummerletter | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|C |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Huisnummertoevoeging | |colspan="3"|Huisnummertoevoeging | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|II |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aanduiding bij nummer | |colspan="3"|Aanduiding bij nummer | ||
Regel 5.508: | Regel 5.423: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Postcode | |colspan="3"|Postcode | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|9999AA |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Woonplaats | |colspan="3"|Woonplaats | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Hoogmade |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Land | |colspan="3"|Land | ||
|style="background-color: white;"|Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') | |style="background-color: white;"|Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') | ||
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Adres soort | |colspan="3"|Adres soort | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="4"|Rol |
+ | |style="background-color: white;"|Eerste relatie/contactpersoon (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Rol |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Wettelijke vertegenwoordiger (code = '24' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Relatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Dochter (code = 'DAUC' in codeSystem 'HL7 RoleCode') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Relatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): buurvrouw |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Sturende organisatie | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="65"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|Zorgaanbieder | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="32"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Zorgaanbieder identificatienummer | ||
+ | |style="background-color: white;"|06343434 (in identificerend systeem: AGB-Z) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Organisatie naam | ||
+ | |style="background-color: white;"|CD-zkh | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Organisatie locatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Zuid |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Afdeling specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Medisch specialisten, longziekten (code = '0322' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Contactgegevens | |colspan="5"|Contactgegevens | ||
Regel 5.550: | Regel 5.475: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Telefoonnummer | |colspan="2"|Telefoonnummer | ||
− | |style="background-color: white;"|+ | + | |style="background-color: white;"|+31182435770 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Telefoonnummers | |colspan="4"|Telefoonnummers | ||
Regel 5.557: | Regel 5.482: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Telefoonnummer | |colspan="2"|Telefoonnummer | ||
− | |style="background-color: white;"|+ | + | |style="background-color: white;"|+311182435000 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Email adressen | |colspan="4"|Email adressen | ||
Regel 5.564: | Regel 5.489: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Email adres | |colspan="2"|Email adres | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|longziekten@cdz.nl |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Email adressen | |colspan="4"|Email adressen | ||
Regel 5.571: | Regel 5.496: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Email adres | |colspan="2"|Email adres | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|info@cdz.nl |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Adresgegevens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="11"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Straat |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Raapweg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Huisnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|3 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Huisnummerletter |
− | |style="background-color: white;"| | + | |style="background-color: white;"|D |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Huisnummertoevoeging |
− | | | + | |style="background-color: white;"|II |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Aanduiding bij nummer |
− | | | + | |style="background-color: white;"|Bij (code = 'by' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.3') |
− | | | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Postcode |
+ | |style="background-color: white;"|9999PQ | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Woonplaats |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Bolsward |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Land |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Additionele informatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|tijdelijk adres |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Adres soort |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Organisatie type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="6"| | + | |colspan="6"|Zorgverlener |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="30"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Naamgegevens | |colspan="5"|Naamgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="13"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Voornamen | |colspan="3"|Voornamen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Charlotte Maria |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Initialen | |colspan="3"|Initialen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|C.M. |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Roepnaam | |colspan="3"|Roepnaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Lotte |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Naamgebruik | |colspan="3"|Naamgebruik | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Eigen geslachtsnaam gevolgd door geslachtsnaam partner (code = 'NL4' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam | |colspan="4"|Geslachtsnaam | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan="2"| | + | |rowspan="3"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Voorvoegsels | ||
+ | |style="background-color: white;"|van | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam | |colspan="2"|Achternaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Ieperen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam partner | |colspan="4"|Geslachtsnaam partner | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan="2"| | + | |rowspan="3"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Voorvoegsels partner | ||
+ | |style="background-color: white;"|de | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam partner | |colspan="2"|Achternaam partner | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Smet |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Specialisme | ||
+ | |style="background-color: white;"|Gespecialiseerd verpleegkundige, transfer (code = '9108' in codeSystem 'Vektis AGB-medische specialismen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Contactgegevens | |colspan="5"|Contactgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="13"| |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Telefoonnummers | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Telefoonnummer | ||
+ | |style="background-color: white;"|+31687654321 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Telefoonnummers | |colspan="4"|Telefoonnummers | ||
Regel 5.652: | Regel 5.594: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Telefoonnummer | |colspan="2"|Telefoonnummer | ||
− | |style="background-color: white;"|+ | + | |style="background-color: white;"|+31182435770 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Email adressen | |colspan="4"|Email adressen | ||
Regel 5.659: | Regel 5.601: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Email adres | |colspan="2"|Email adres | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|transfervpk@cdz.nl |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Email adressen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="2"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Email adres |
− | |style="background-color: white;"| | + | |style="background-color: white;"|info@cdz.nl |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Ontvangende organisatie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |rowspan="8"| | |
− | + | |-style="vertical-align:top; background-color: #E3E3E3;;" | |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |rowspan=" | ||
− | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Zorgaanbieder | |colspan="6"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="6"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Zorgaanbieder identificatienummer | |colspan="4"|Zorgaanbieder identificatienummer | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|75565656 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Organisatie naam | |colspan="4"|Organisatie naam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|WijkverplegingOrg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Organisatie locatie | |colspan="4"|Organisatie locatie | ||
Regel 5.722: | Regel 5.628: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Afdeling specialisme | |colspan="4"|Afdeling specialisme | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Thuiszorg, kruiswerk en gezinsverzorging (code = '7500' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Organisatie type | ||
+ | |style="background-color: white;"|Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') | ||
+ | |} | ||
+ | === Medische context=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="7" | Medische context | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="6" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="7"|Behandelaar |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="38"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Zorgverlener |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="36"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Zorgverlener identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|04232323 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="5"|Naamgegevens |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="13"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Voornamen |
+ | |style="background-color: white;"|Elizabeth | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Initialen |
− | |style="background-color: white;"| | + | |style="background-color: white;"|M. |
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="3"|Roepnaam |
+ | |style="background-color: white;"|Beth | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="3"|Naamgebruik |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Geslachtsnaam partner (code = 'NL2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="4"| | + | |colspan="4"|Geslachtsnaam |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="2"| | + | |colspan="2"|Voorvoegsels |
− | |style="background-color: white;"| | + | |style="background-color: white;"|van |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Achternaam | ||
+ | |style="background-color: white;"|Dooremaal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Geslachtsnaam partner |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Voorvoegsels partner |
− | |style="background-color: white;"| | + | |style="background-color: white;"|ter |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Achternaam partner |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Balkt |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Specialisme |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Fysiotherapeuten, fysiotherapie (code = '0401' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Contactgegevens | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="13"| |
− | |style="background-color: | + | |-style="vertical-align:top; background-color: #E3E3E3;;" |
+ | |colspan="4"|Telefoonnummers | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Telefoonnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|+31665656565 |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Telefoonnummers | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Telefoonnummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|+31201212121 |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Email adressen | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="2"|Email adres |
− | |style="background-color: white;"| | + | |style="background-color: white;"|beth@fysio.nl |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Email adressen | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="2"| |
− | |||
− | |||
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |colspan="2"|Email adres |
+ | |style="background-color: white;"|info@fysio.nl | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="5"| | + | |colspan="5"|Zorgaanbieder |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="4"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Zorgaanbieder identificatienummer |
− | |style="background-color: white;"| | + | |style="background-color: white;"|04121212 (in identificerend systeem: AGB-Z) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Organisatie naam |
− | |style="background-color: white;"| | + | |style="background-color: white;"|FysioOrg |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan="3"| | + | |colspan="3"|Organisatie locatie |
− | |style="background-color: white;"| | + | |style="background-color: white;"|West |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="7"|Medische diagnose | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | | | + | |rowspan="9"| |
− | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="6"|Probleem |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="7"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem type |
− | |style="background-color: white;"| | + | |style="background-color: white;"|Diagnose (code = '282291009' in codeSystem 'SNOMED CT') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |colspan="4"|Probleem naam | |
− | + | |style="background-color: white;"|ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | |
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|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | + | |colspan="4"|Probleem begin datum | |
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|style="background-color: white;"|T - 30 dagen | |style="background-color: white;"|T - 30 dagen | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Probleem status |
|style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |style="background-color: white;"|Actueel (code = '55561003' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Verificatie status |
|style="background-color: white;"|Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |style="background-color: white;"|Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |colspan=" | + | |colspan="4"|Toelichting |
|style="background-color: white;"|niet bekend met neurologische klachten | |style="background-color: white;"|niet bekend met neurologische klachten | ||
|} | |} |
Versie van 21 mrt 2024 om 09:46
Inhoud
[verbergen]- 1 Addenda voor inhoudelijke gegevens
- 1.1 Kwalificatie Overdracht 1.1b
- 1.2 Test Overdracht volwassene- 1.1
- 1.3 Test Overdracht 1.10b
- 1.4 Test Overdracht 1.11b
- 1.5 Test Overdracht 1.1b
- 1.6 Test Overdracht 1.2b
- 1.7 Test Overdracht 1.3b
- 1.8 Test Overdracht 1.4b
- 1.9 Test Overdracht 1.5
- 1.10 Test Overdracht 1.6
- 1.11 Test Overdracht 1.7
- 1.12 Test Overdracht 1.8
- 1.13 Test Overdracht 1.9b
1 Addenda voor inhoudelijke gegevens
1.1 Kwalificatie Overdracht 1.1b
1.1.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 2 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Voornamen | Maria | |||||
Initialen | M. | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Molog | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1000 | |||||
Postcode | 9999XA | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31620202020 | |||||
Email adressen | ||||||
Email adres | mariamolog@provider.nl | |||||
Identificatienummer | 999900080 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 1 jaar | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 3332 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Menzis | |||||
Verzekerde nummer | 6318708200 | |||||
Contactpersoon eovd-k1-1b-contactpersoon-01 | ||||||
Naamgegevens | ||||||
Voornamen | Johan | |||||
Initialen | J. | |||||
Roepnaam | Han | |||||
Geslachtsnaam | ||||||
Achternaam | Timmerman | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31645678912 | |||||
Email adressen | ||||||
Email adres | jtimmerman@123net.nl | |||||
Rol | Eerste relatie/contactpersoon (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') | |||||
Relatie | Zoon (code = 'SONC' in codeSystem 'HL7 RoleCode') | |||||
Contactpersoon | ||||||
Naamgegevens | ||||||
Voornamen | Johanna | |||||
Roepnaam | Hanna | |||||
Geslachtsnaam | ||||||
Voorvoegsels | ter | |||||
Achternaam | Stegge | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31612121212 | |||||
Relatie | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): achternicht | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06757677 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | MC-Westland | |||||
Organisatie locatie | Centrum | |||||
Afdeling specialisme | Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31174300400 | |||||
Email adressen | ||||||
Email adres | urologie@mcw.nl | |||||
Adresgegevens | ||||||
Straat | Wortellaan | |||||
Huisnummer | 2 | |||||
Postcode | 9998SO | |||||
Woonplaats | Monster | |||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Julia | |||||
Initialen | J. | |||||
Roepnaam | Lieke | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van den | |||||
Achternaam | Bos | |||||
Specialisme | Verpleegkundigen, niet nader gespecificeerd (code = '9100' in codeSystem 'Vektis AGB-medische specialismen') | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75191919 (in identificerend systeem: URA) | |||||
Organisatie naam | WijZorgen | |||||
Organisatie locatie | Honselersdijk | |||||
Afdeling specialisme | Thuiszorg, kruiswerk en gezinsverzorging (code = '7500' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.1.2 Algemene patienten context
Algemene patienten context | |||||
Gegevenselement | Waarde | ||||
Woonomgeving | |||||
Woonsituatie | |||||
Toelichting | woning is op de begane grond | ||||
Woning type | Aanleunwoning (code = 'AANLW' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.13.1') | ||||
Levensovertuiging | |||||
Wilsverklaring | |||||
Wilsverklaring type | Niet reanimeren verklaring (code = 'NR' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.14.1') | ||||
Wilsverklaring datum | T - 3 jaar | ||||
Vertegenwoordiger | |||||
Contactpersoon | Zie Contactpersoon: eovd-k1-1b-contactpersoon-01 | ||||
Toelichting | wilsverklaring bevindt zich in de portemonnee. | ||||
Wilsverklaring | |||||
Wilsverklaring type | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): Wil niet gevaccineerd worden | ||||
Wilsverklaring datum | T - 1 jaar |
1.1.3 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Bart | |||||
Initialen | B. | |||||
Geslachtsnaam | ||||||
Achternaam | Kuiper | |||||
Specialisme | Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06757677 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | MC-Westland | |||||
Organisatie locatie | Centrum | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03161616 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Voornamen | Alexandra | |||||
Initialen | A. | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Breukelen | |||||
Specialisme | Medisch specialisten, chirurgie (code = '0303' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06757677 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | MC-Westland | |||||
Organisatie locatie | Centrum | |||||
Medische diagnose | ||||||
Probleem eovd-k1-1b-probleem-01 | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | ziekte van Parkinson (code = '49049000' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 3 jaar | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Toelichting | naast beven ook somberheid en moeheid | |||||
Probleem eovd-k1-1b-probleem-02 | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | primair maligne neoplasma van blaas (code = '93689003') | |||||
Probleem begin datum | T - 30 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Probleem | ||||||
Probleem anatomische locatie | structuur van huid van schouder (code = '76552005' in codeSystem 'SNOMED Clinical Terms') | |||||
Probleem lateraliteit | Rechts (code = '24028007' in codeSystem 'SNOMED CT') | |||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | melanoom (code = '372244006') | |||||
Probleem begin datum | T - 2 maanden | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Voorgeschiedenis | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | diverticulitis (code = '307496006') | |||||
Probleem begin datum | T - 12 jaar | |||||
Probleem eind datum | T - 1 jaar | |||||
Probleem status | Niet actueel (code = '73425007' in codeSystem 'SNOMED CT') | |||||
Allergie | ||||||
Allergie intolerantie | ||||||
Veroorzakende stof | selderij (code = '256326004' in codeSystem 'SNOMED CT') | |||||
Allergie categorie | Voeding (code = '418471000' in codeSystem 'SNOMED CT') | |||||
Allergie status | Actief (code = 'active' in codeSystem 'HL7 ActStatus') | |||||
Begin datum tijd | T - 10 jaar | |||||
Mate van kritiek zijn | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||
Toelichting | betreft zowel gekookte als rauwe selderij | |||||
Reactie | ||||||
Symptoom | Misselijk en braken (code = '16932000' in codeSystem 'SNOMED CT') | |||||
Reactie beschrijving | Misselijkheid en braken | |||||
Wijze van blootstelling | via spijsverteringskanaal (code = '447964005' in codeSystem 'SNOMED Clinical Terms') | |||||
Allergie intolerantie | ||||||
Veroorzakende stof | huisstofmijt (code = '264401009') | |||||
Allergie categorie | Omgeving (code = '426232007' in codeSystem 'SNOMED CT') | |||||
Allergie status | Actief (code = 'active' in codeSystem 'HL7 ActStatus') | |||||
Begin datum tijd | T - 500 dagen | |||||
Mate van kritiek zijn | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||
Laatste reactie datum tijd | T - 99 dagen | |||||
Reactie | ||||||
Symptoom | Overgevoeligheidsreactie van de bovenste luchtwegen (code = '490008' in codeSystem 'SNOMED CT') | |||||
Specifieke stof | eiwit van huisstofmijt (code = '720687003') | |||||
Reactie beschrijving | veelvuldig niezen | |||||
Ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||
Reactie tijdstip | T - 99 dagen | |||||
Reactie | ||||||
Symptoom | Kortademigheid (code = '267036007' in codeSystem 'SNOMED CT') | |||||
Symptoom | Koorts (code = '386661006' in codeSystem 'SNOMED CT') | |||||
Specifieke stof | allergeen van roofmijt (code = '110171000146101') | |||||
Reactie beschrijving | ernstige benauwdheid en koorts | |||||
Ernst | Ernstig (code = '24484000' in codeSystem 'SNOMED CT') | |||||
Reactie tijdstip | T - 200 dagen | |||||
Let op | ||||||
Alert | ||||||
Alert naam | Drager VRE (code = '431109006' in codeSystem 'SNOMED CT') | |||||
Begin datum tijd | T - 20 dagen | |||||
Alert type | waarschuwing (code = '74018-3' in codeSystem 'LOINC') | |||||
Alert | ||||||
Alert naam | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): verhoogd valrisico | |||||
Begin datum tijd | T - 10 jaar | |||||
Meetwaarden | ||||||
Bloeddruk | ||||||
Meetmethode | Niet-invasief (code = '22762002' in codeSystem 'SNOMED CT') | |||||
Manchet type | Klein (code = 'S' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.15.1') | |||||
Meet locatie | Linker bovenarm (code = '368208006' in codeSystem 'SNOMED CT') | |||||
Systolische bloeddruk | 160 mmhg | |||||
Diastolische bloeddruk | 92 mmhg | |||||
Gemiddelde bloeddruk | 109 mmhg | |||||
Bloeddruk datum tijd | T - 2 dagen om 14:45 uur | |||||
Toelichting | mevrouw gebruikt medicatie | |||||
Houding | Zittende positie (code = '33586001' in codeSystem 'SNOMED CT') | |||||
Lichaamsgewicht | ||||||
Gewicht waarde | 58 kg | |||||
Toelichting | mevrouw is aan het aansterken | |||||
Gewicht datum tijd | T - 5 dagen om 14:30 uur | |||||
Kleding | Lichte kleding/ondergoed (code = 'MINIMAL' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.8.1') | |||||
Lichaamslengte | ||||||
Lengte waarde | 160 cm | |||||
Lengte datum tijd | T - 2 dagen om 13:30 uur | |||||
Toelichting | zonder schoenen aan |
1.1.4 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||||
Gegevenselement | Waarde | |||||||
Afspraken patient | ||||||||
Contact | ||||||||
Contact type | Poliklinisch (code = 'AMB' in codeSystem 'HL7 ActCode') | |||||||
Contact met | ||||||||
Zorgverlener | ||||||||
Naamgegevens | ||||||||
Voornamen | Bart | |||||||
Initialen | B. | |||||||
Geslachtsnaam | ||||||||
Achternaam | Kuiper | |||||||
Specialisme | Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contact met | ||||||||
Zorgverlener | ||||||||
Zorgverlener identificatienummer | 03282828 (in identificerend systeem: AGB-Z) | |||||||
Naamgegevens | ||||||||
Voornamen | Sebastiaan | |||||||
Initialen | S. | |||||||
Geslachtsnaam | ||||||||
Voorvoegsels | de | |||||||
Achternaam | Vries | |||||||
Specialisme | Medisch specialisten, chirurgie (code = '0303' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Locatie | ||||||||
Zorgaanbieder | ||||||||
Zorgaanbieder identificatienummer | 06757677 (in identificerend systeem: AGB-Z) | |||||||
Organisatie naam | MC-Westland | |||||||
Organisatie locatie | Centrum | |||||||
Afdeling specialisme | Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contactgegevens | ||||||||
Telefoonnummers | ||||||||
Telefoonnummer | +31174300400 | |||||||
Email adressen | ||||||||
Email adres | urologie@mcw.nl | |||||||
Adresgegevens | ||||||||
Straat | Wortellaan | |||||||
Huisnummer | 2 | |||||||
Postcode | 9998SO | |||||||
Woonplaats | Monster | |||||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||||
Begin datum tijd | T + 5 dagen om 10:00 uur | |||||||
Eind datum tijd | T + 5 dagen om 10:30 uur | |||||||
Reden contact | ||||||||
Probleem | Zie Probleem: eovd-k1-1b-probleem-02 | |||||||
Contact | ||||||||
Contact type | Thuis (code = 'HH' in codeSystem 'HL7 ActCode') | |||||||
Contact met | ||||||||
Zorgverlener | ||||||||
Zorgverlener identificatienummer | 04434343 (in identificerend systeem: AGB-Z) | |||||||
Naamgegevens | ||||||||
Voornamen | Elise | |||||||
Geslachtsnaam | ||||||||
Achternaam | Willems | |||||||
Specialisme | Fysiotherapeuten, niet nader gespecificeerd (code = '0400' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contactgegevens | ||||||||
Email adressen | ||||||||
Email adres | ewillems@fysio.nl | |||||||
Begin datum tijd | T + 9 dagen om 10:20 uur | |||||||
Reden contact | ||||||||
Reden contact tekst | advies over veilige en passende lichaamsbeweging |
1.1.5 Verpleegkundige context specificatie gezondheidstoestand
Verpleegkundige context specificatie gezondheidstoestand | ||||
Gegevenselement | Waarde | |||
Voedingvocht | ||||
Voedingsadvies | ||||
Dieet type | lactosevrij | |||
Consistentie | solide | |||
Toelichting | naar eigen zeggen lactose-intolerant | |||
Voedingsadvies | ||||
Dieet type | geen selderij | |||
Toelichting | in verband met allergie |
1.2 Test Overdracht volwassene- 1.1
1.2.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 1 dag | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Voornamen | Erik | |||||
Initialen | E | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Altenborg | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1000 | |||||
Postcode | 9999XA | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31634567891 | |||||
Email adressen | ||||||
Email adres | evertaltenborg@hotmail.com | |||||
Identificatienummer | 999911612 (in identificerend systeem: BSN) | |||||
Geboortedatum | 14 aug 1964 | |||||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 1 jaar | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Contactpersoon eovd-1-1-contactpersoon-01 | ||||||
Naamgegevens | ||||||
Voornamen | Johanna | |||||
Initialen | J | |||||
Roepnaam | Hanna | |||||
Geslachtsnaam | ||||||
Achternaam | Bakker | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31645678912 | |||||
Email adressen | ||||||
Email adres | jbakker@123net.nl | |||||
Rol | Eerste relatie/contactpersoon (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') | |||||
Relatie | Dochter (code = 'DAUC' in codeSystem 'HL7 RoleCode') | |||||
Contactpersoon | ||||||
Naamgegevens | ||||||
Voornamen | Johannes | |||||
Roepnaam | Hans | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Dijk | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31612121212 | |||||
Relatie | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): achterneef | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | AB-zkh | |||||
Organisatie locatie | Noord | |||||
Afdeling specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31182435770 | |||||
Email adressen | ||||||
Email adres | neurologie@ABZ.nl | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 10 | |||||
Postcode | 9999PO | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Charlotte Maria | |||||
Initialen | C. M. | |||||
Roepnaam | Lotte | |||||
Geslachtsnaam | ||||||
Achternaam | Bruinsma | |||||
Specialisme | Verpleegkundigen, niet nader gespecificeerd (code = '9100' in codeSystem 'Vektis AGB-medische specialismen') | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75131313 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | ThuiszorgOrg | |||||
Organisatie locatie | Noord | |||||
Afdeling specialisme | Thuiszorg, kruiswerk en gezinsverzorging (code = '7500' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.2.2 Algemene patienten context
Algemene patienten context | |||||||||
Gegevenselement | Waarde | ||||||||
Gezinssituatie | |||||||||
Gezinssituatie | |||||||||
Burgerlijke staat | |||||||||
Burgerlijke staat rc | |||||||||
Burgerlijke staat | Gehuwd (code = 'M' in codeSystem '2.16.840.1.113883.5.2') | ||||||||
Gezinssamenstelling | Samenwonend met partner (code = '408821002' in codeSystem 'SNOMED CT') | ||||||||
Aantal kinderen | 3 | ||||||||
Aantal kinderen inwonend | 0 | ||||||||
Zorgtaak | zorgt voor zijn vrouw die slecht ter been is | ||||||||
Zorgtaak | zorgt voor de hond | ||||||||
Kind | |||||||||
Geboortedatum | T - 30 jaar | ||||||||
Inwonend | Nee | ||||||||
Kind | |||||||||
Geboortedatum | T - 25 jaar | ||||||||
Inwonend | Nee | ||||||||
Toelichting | kinderen wonen ver weg en kunnen niet helpen bij dagelijkse zorg aan echtgenote | ||||||||
Juridische situatie | |||||||||
Juridische situatie eovd-1-1-juridischesituatie-01 | |||||||||
Vertegenwoordiging | Onder curatele stelling (code = '9' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.23.3') | ||||||||
Datum aanvang | T - 1 jaar | ||||||||
Woonomgeving | |||||||||
Woonsituatie | |||||||||
Toelichting | woning is op derde verdieping, is gelijkvloers en er is een lift aanwezig | ||||||||
Woning type | Appartement of flatwoning (code = 'FLATW' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.13.1') | ||||||||
Levensovertuiging | |||||||||
Levensovertuiging rc | |||||||||
Levensovertuiging | Geen geloof (code = 'GeenGeloof' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4') | ||||||||
Wilsverklaring | |||||||||
Wilsverklaring type | Verklaring donorschap (code = 'DO' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.14.1') | ||||||||
Wilsverklaring datum | T - 4 jaar | ||||||||
Vertegenwoordiger | |||||||||
Contactpersoon | Zie Contactpersoon: eovd-1-1-contactpersoon-01 | ||||||||
Toelichting | wilsverklaring bevindt zich in de portemonnee. | ||||||||
Wilsverklaring | |||||||||
Wilsverklaring type | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): Wil niet gevaccineerd worden | ||||||||
Wilsverklaring datum | T - 1 jaar | ||||||||
Sociale omgeving | |||||||||
Participatie in maatschappij | |||||||||
Sociaal netwerk | heeft veel contact met collega's en buren | ||||||||
Vrijetijdsbesteding | gitaar spelen | ||||||||
Arbeidssituatie | werkt als administratief medewerker bij gemeente | ||||||||
Toelichting | heeft tijdelijk contract | ||||||||
Hulp van anderen | |||||||||
Hulpverlener | |||||||||
Mantelzorger | |||||||||
Contactpersoon | |||||||||
Naamgegevens | |||||||||
Voornamen | Marriet | ||||||||
Initialen | M. | ||||||||
Naamgebruik | Eigen geslachtsnaam (code = 'NL1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') | ||||||||
Geslachtsnaam | |||||||||
Achternaam | Blauw | ||||||||
Rol | Buur (code = '19' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') | ||||||||
Aard | helpt met ondersteuning echtgenote als meneer er niet is | ||||||||
Frequentie | zo vaak als nodig | ||||||||
Soort hulp | Mantelzorg (code = '386229000' in codeSystem 'SNOMED CT') | ||||||||
Hulp van anderen | |||||||||
Hulpverlener | |||||||||
Zorgaanbieder | |||||||||
Organisatie naam | WijZorgen | ||||||||
Organisatie locatie | Stitswerd | ||||||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') | ||||||||
Aard | ondersteuning bij wassen | ||||||||
Frequentie | dagelijks | ||||||||
Soort hulp | Professionele thuiszorg (code = '60689008' in codeSystem 'SNOMED CT') | ||||||||
Toelichting | niet in het weekend | ||||||||
Hulp van anderen | |||||||||
Hulpverlener | |||||||||
Zorgverlener | |||||||||
Naamgegevens | |||||||||
Voornamen | Therese | ||||||||
Geslachtsnaam | |||||||||
Achternaam | Roep | ||||||||
Contactgegevens | |||||||||
Email adressen | |||||||||
Email adres | thereseroep@zzp.nl | ||||||||
Aard | ondersteuning bij wassen | ||||||||
Frequentie | dagelijks | ||||||||
Soort hulp | Professionele thuiszorg (code = '60689008' in codeSystem 'SNOMED CT') | ||||||||
Toelichting | alleen in het weekend | ||||||||
Communicatie | |||||||||
Taalvaardigheid | |||||||||
Communicatie taal | Nederlands (code = 'nl' in codeSystem 'ISO 639-1: Codes for the representation of names of languages -- Part 1: Alpha-2 code') | ||||||||
Taalvaardigheid begrijpen | Redelijk (code = 'F' in codeSystem '2.16.840.1.113883.5.61') | ||||||||
Taalvaardigheid spreken | Slecht (code = 'P' in codeSystem '2.16.840.1.113883.5.61') | ||||||||
Taalvaardigheid lezen | Redelijk (code = 'F' in codeSystem '2.16.840.1.113883.5.61') | ||||||||
Toelichting | t.g.v. CVA nu moeite met begrijpen, spreken gaat ook moeilijk i.v.m. afasie | ||||||||
Taalvaardigheid | |||||||||
Communicatie taal | Limburgs (code = 'li' in codeSystem 'ISO 639-1: Codes for the representation of names of languages -- Part 1: Alpha-2 code') | ||||||||
Taalvaardigheid begrijpen | Goed (code = 'G' in codeSystem '2.16.840.1.113883.5.61') | ||||||||
Taalvaardigheid spreken | Redelijk (code = 'F' in codeSystem '2.16.840.1.113883.5.61') | ||||||||
Toelichting | opgegroeid in Zuid-Limburg |
1.2.3 Medische context
Medische context | ||||||||
Gegevenselement | Waarde | |||||||
Behandelaar | ||||||||
Zorgverlener eovdv-1-1-behandelaar-01 | ||||||||
Naamgegevens | ||||||||
Voornamen | Joshua Pieter | |||||||
Initialen | J. P. | |||||||
Geslachtsnaam | ||||||||
Achternaam | Helmond | |||||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Zorgaanbieder | ||||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||||
Organisatie naam | AB-zkh | |||||||
Organisatie locatie | Noord | |||||||
Behandelaar | ||||||||
Zorgverlener eovdv-1-1-behandelaar-02 | ||||||||
Zorgverlener identificatienummer | 03898989 (in identificerend systeem: AGB-Z) | |||||||
Naamgegevens | ||||||||
Initialen | G. | |||||||
Geslachtsnaam | ||||||||
Achternaam | Spijkerman | |||||||
Specialisme | Medisch specialisten, gastro-enterologie (maag-darm-lever-arts) (code = '0318' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Zorgaanbieder | ||||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||||
Organisatie naam | AB-zkh | |||||||
Organisatie locatie | Noord | |||||||
Medische diagnose | ||||||||
Probleem eovd-1-1-probleem-01 | ||||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||||
Probleem naam | ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | |||||||
Probleem begin datum | T - 100 dagen | |||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||||
Toelichting | niet bekend met neurologische klachten | |||||||
Probleem eovd-1-1-probleem-02 | ||||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||||
Probleem naam | neoplasma van colon (code = '126838000') | |||||||
Probleem begin datum | T - 150 dagen | |||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||
Probleem eovd-1-1-probleem-03 | ||||||||
Probleem anatomische locatie | oksel (code = '91470000' in codeSystem 'SNOMED Clinical Terms') | |||||||
Probleem lateraliteit | Rechts en links (code = '51440002' in codeSystem 'SNOMED CT') | |||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||||
Probleem naam | inverse psoriasis (code = '238600001') | |||||||
Probleem begin datum | T - 10 jaar | |||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||
Voorgeschiedenis | ||||||||
Probleem | ||||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||||
Probleem naam | diabetes mellitus (code = '73211009') | |||||||
Probleem begin datum | T - 12 jaar | |||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||
Allergie | ||||||||
Allergie intolerantie | ||||||||
Veroorzakende stof | nikkelsulfaat (code = '255848005' in codeSystem 'SNOMED CT') | |||||||
Allergie categorie | Stof of product (code = '419199007' in codeSystem 'SNOMED CT') | |||||||
Allergie status | Actief (code = 'active' in codeSystem 'HL7 ActStatus') | |||||||
Begin datum tijd | T - 10 jaar | |||||||
Mate van kritiek zijn | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||||
Toelichting | opgemerkt bij het dragen van nikkel bevattende sieraden. | |||||||
Reactie | ||||||||
Symptoom | Contactdermatitis (code = '40275004' in codeSystem 'SNOMED CT') | |||||||
Reactie beschrijving | last van jeuk, roodheid en irritatie op de contactplek van nikkel bevattende sieraden. | |||||||
Wijze van blootstelling | intra-epidermale route (code = '448077001' in codeSystem 'SNOMED Clinical Terms') | |||||||
Allergie intolerantie | ||||||||
Veroorzakende stof | pollen (code = '256259004') | |||||||
Allergie categorie | Omgeving (code = '426232007' in codeSystem 'SNOMED CT') | |||||||
Allergie status | Actief (code = 'active' in codeSystem 'HL7 ActStatus') | |||||||
Begin datum tijd | T - 500 dagen | |||||||
Mate van kritiek zijn | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||||
Laatste reactie datum tijd | T - 99 dagen | |||||||
Reactie | ||||||||
Symptoom | Overgevoeligheidsreactie van de bovenste luchtwegen (code = '490008' in codeSystem 'SNOMED CT') | |||||||
Specifieke stof | graspollen (code = '256277009') | |||||||
Reactie beschrijving | veelvuldig niezen | |||||||
Ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||||
Reactie tijdstip | T - 99 dagen | |||||||
Reactie | ||||||||
Symptoom | Kortademigheid (code = '267036007' in codeSystem 'SNOMED CT') | |||||||
Symptoom | Koorts (code = '386661006' in codeSystem 'SNOMED CT') | |||||||
Specifieke stof | pollen van paprikaplant (code = '110181000146104') | |||||||
Reactie beschrijving | ernstige benauwdheid en koorts | |||||||
Ernst | Ernstig (code = '24484000' in codeSystem 'SNOMED CT') | |||||||
Reactie tijdstip | T - 200 dagen | |||||||
Let op | ||||||||
Alert | ||||||||
Alert naam | Drager MRSA (code = '432415000' in codeSystem 'SNOMED CT') | |||||||
Begin datum tijd | T - 20 dagen | |||||||
Alert type | waarschuwing (code = '74018-3' in codeSystem 'LOINC') | |||||||
Alert | ||||||||
Alert naam | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): ernstige claustrofobie | |||||||
Begin datum tijd | T - 10 jaar | |||||||
Vrijheidsbeperking | ||||||||
Vrijheidsbeperkende interventie | ||||||||
Wilsbekwaam | Ja | |||||||
Juridische situatie | Zie Juridische situatie: eovd-1-1-juridischesituatie-01 | |||||||
Soort interventie | geforceerd toedienen van voeding bij patiënt (code = '37041007' in codeSystem 'SNOMED CT') | |||||||
Reden van toepassen | bevorderen van fysieke gezondheid (code = '121581000146106' in codeSystem 'SNOMED CT') | |||||||
Instemming | Instemming patiënt (code = '2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.6.1') | |||||||
Begin | T - 50 dagen | |||||||
Meetwaarden | ||||||||
Bloeddruk | ||||||||
Meetmethode | Niet-invasief (code = '22762002' in codeSystem 'SNOMED CT') | |||||||
Manchet type | Standaard (code = 'STD' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.15.1') | |||||||
Meet locatie | Rechter bovenarm (code = '368209003' in codeSystem 'SNOMED CT') | |||||||
Diastolisch eindpunt | Fase V (code = '255272007' in codeSystem 'SNOMED CT') | |||||||
Systolische bloeddruk | 170 mmhg | |||||||
Diastolische bloeddruk | 90 mmhg | |||||||
Gemiddelde bloeddruk | 110 mmhg | |||||||
Bloeddruk datum tijd | T - 20 dagen om 14:45 uur | |||||||
Toelichting | meneer gebruikt medicatie | |||||||
Houding | Liggende positie (code = '102538003' in codeSystem 'SNOMED CT') | |||||||
Polsfrequentie | ||||||||
Polsfrequentie waarde | 90 | |||||||
Polsfrequentie datum tijd | T - 5 dagen om 14:45 uur | |||||||
Toelichting | is altijd sportief geweest | |||||||
Pols regelmatigheid | Polsslag regelmatig (code = '271636001' in codeSystem 'SNOMED CT') | |||||||
Lichaamstemperatuur | ||||||||
Temperatuur waarde | 36.8 ºc | |||||||
Temperatuur datum tijd | T - 4 dagen om 07 uur | |||||||
Toelichting | voeten voelen heel koud aan | |||||||
Temperatuur type | Tympanische temperatuur (code = '415974002' in codeSystem 'SNOMED CT') | |||||||
Ademhaling | ||||||||
Ademfrequentie | 18 /min | |||||||
Ademhaling datum tijd | T - 3 dagen om 14:45 uur | |||||||
Ritme | Abnormaal ademhalingsritme (code = '85617008' in codeSystem 'SNOMED CT') | |||||||
Diepte | Normale ademhalingsdiepte (code = '301284009' in codeSystem 'SNOMED CT') | |||||||
Afwijkend ademhalingspatroon | Apneu (code = '1023001' in codeSystem 'SNOMED CT') | |||||||
Extra zuurstof toediening | Ja | |||||||
Toelichting | meneer lijkt angstig | |||||||
Toegediende zuurstof | ||||||||
Flow rate | 2 l/min | |||||||
Fi o2 | 0.29 l | |||||||
Toediening hulpmiddel | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | Neusbril (code = '336623009' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | neusbril | |||||||
Lichaamsgewicht | ||||||||
Gewicht waarde | 74 kg | |||||||
Toelichting | meneer volgt afvaldieet | |||||||
Gewicht datum tijd | T - 5 dagen om 14:30 uur | |||||||
Kleding | Volledig gekleed, inclusief schoenen (code = 'FULL' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.8.1') | |||||||
Lichaamslengte | ||||||||
Lengte waarde | 170 cm | |||||||
Lengte datum tijd | T - 5 dagen om 14:30 uur | |||||||
Toelichting | zonder schoenen aan | |||||||
Pijnscore | ||||||||
Pijn score | ||||||||
Pijnscore waarde | 2 | |||||||
Pijnscore datum tijd | T - 5 dagen om 14:45 uur | |||||||
Pijn meetmethode | NRS (code = 'NRS' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.9.1') | |||||||
Anatomische locatie | gehele voet (code = '302545001' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||
Toelichting | Af en toe pijn, maar niet belemmerend bij het lopen |
1.2.4 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||||||
Gegevenselement | Waarde | |||||||||
Actuele patientproblemen | ||||||||||
Patientprobleem | ||||||||||
Probleem eovd-1-1-patientprobleem-01 | ||||||||||
Probleem naam | probleem met zichzelf wassen en afdrogen (code = '288552005' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||||||
Probleem begin datum | T - 100 dagen | |||||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||||
Toelichting | meneer kan niet buigen | |||||||||
Verpleegkundige interventie eovd-1-1-interventie-01 | ||||||||||
Interventie | ondersteunen bij wassen en/of persoonlijke hygiëne (code = '386420003' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Indicatie | ||||||||||
Probleem | Zie Probleem: eovd-1-1-patientprobleem-01 | |||||||||
Behandeldoel | ||||||||||
Gewenst zorgresultaat | wassen onafhankelijk | |||||||||
Actie start datum tijd | T - 90 dagen | |||||||||
Frequentie | 1 /dag | |||||||||
Instructie | let op: valrisico | |||||||||
Uitvoerder | ||||||||||
Zorgverlener | Ja | |||||||||
Patientprobleem | ||||||||||
Probleem eovd-1-1-patientprobleem-02 | ||||||||||
Probleem naam | probleem met zichzelf kleden (code = '284972002' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||||||
Probleem begin datum | T - 90 dagen | |||||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||||
Verpleegkundige interventie eovd-1-1-interventie-02 | ||||||||||
Interventie | ondersteunen bij aankleden (code = '313332003' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Indicatie | ||||||||||
Probleem | Zie Probleem: eovd-1-1-patientprobleem-02 | |||||||||
Behandeldoel | ||||||||||
Gewenst zorgresultaat | kleden onafhankelijk | |||||||||
Frequentie | 3 /dag | |||||||||
Patientprobleem | ||||||||||
Probleem eovd-1-1-patientprobleem-03 | ||||||||||
Probleem anatomische locatie | hiel (code = '76853006' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Probleem lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||||||
Probleem naam | decubitus (code = '399912005' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||||||
Probleem begin datum | T - 90 dagen | |||||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||||
Verpleegkundige interventie | ||||||||||
Interventie | aanleggen van verband op wond (code = '182531007' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Indicatie | ||||||||||
Probleem | Zie Probleem: eovd-1-1-patientprobleem-03 | |||||||||
Frequentie | 1 /dag | |||||||||
Medisch hulpmiddel | ||||||||||
Product | ||||||||||
Product type | schuimverband (code = '448416005' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Medisch hulpmiddel | ||||||||||
Product | ||||||||||
Product type | huidvervangende wondbedekkers (code = '465239008' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Verpleegkundige interventie | ||||||||||
Interventie | wisselen van positie van patiënt (code = '225286008' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Indicatie | ||||||||||
Probleem | Zie Probleem: eovd-1-1-patientprobleem-03 | |||||||||
Behandeldoel | ||||||||||
Gewenst zorgresultaat | wondlengte < 1cm, wondbreedte < 1 cm | |||||||||
Actie start datum tijd | T - 10 dagen | |||||||||
Actie eind datum tijd | T - 1 dag | |||||||||
Interval | 4 uur | |||||||||
Uitvoerder | ||||||||||
Zorgverlener | Ja | |||||||||
Patientprobleem | ||||||||||
Probleem eovd-1-1-patientprobleem-04 | ||||||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||||||
Probleem naam | loopt risico op delier (code = '430794006' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||||||
Probleem begin datum | T - 5 dagen | |||||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||||
Toelichting | vastgesteld met DOS score | |||||||||
Verpleegkundige interventie | ||||||||||
Interventie | bevorderen van vochtinname (code = '113148007' in codeSystem 'SNOMED Clinical Terms') | |||||||||
Indicatie | ||||||||||
Probleem | Zie Probleem: eovd-1-1-patientprobleem-04 | |||||||||
Behandeldoel | ||||||||||
Gewenst zorgresultaat | vochtinname > 1,5 liter/dag | |||||||||
Instructie | Graag er op toezien dat meneer > 1,5 liter per dag drinkt | |||||||||
Uitvoerder | ||||||||||
Verzorger | ||||||||||
Contactpersoon | ||||||||||
Naamgegevens | ||||||||||
Voornamen | Gerda | |||||||||
Naamgebruik | Geslachtsnaam partner (code = 'NL2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') | |||||||||
Geslachtsnaam partner | ||||||||||
Achternaam partner | XXX_Altenborg | |||||||||
Contactgegevens | ||||||||||
Telefoonnummers | ||||||||||
Telefoonnummer | +31662626262 | |||||||||
Relatie | Echtgenoot (code = 'HUSB' in codeSystem 'HL7 RoleCode') | |||||||||
Zorgresultaat | ||||||||||
Uitkomst van zorg | ||||||||||
Zorgresultaat | doel deels behaald: kan nog niet rug wassen | |||||||||
Interventie | ||||||||||
Verpleegkundige interventie | Zie Verpleegkundige interventie: eovd-1-1-interventie-01 | |||||||||
Uitkomst van zorg | ||||||||||
Zorgresultaat | doel deels behaald, kan nog niet zelf veters strikken | |||||||||
Interventie | ||||||||||
Verpleegkundige interventie | Zie Verpleegkundige interventie: eovd-1-1-interventie-02 | |||||||||
Afspraken patient | ||||||||||
Contact | ||||||||||
Contact type | Poliklinisch (code = 'AMB' in codeSystem 'HL7 ActCode') | |||||||||
Contact met | ||||||||||
Zorgverlener | ||||||||||
Naamgegevens | ||||||||||
Voornamen | Joshua Pieter | |||||||||
Initialen | J.P. | |||||||||
Geslachtsnaam | ||||||||||
Achternaam | Helmond | |||||||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||||
Contact met | ||||||||||
Zorgverlener | ||||||||||
Zorgverlener identificatienummer | 03686868 (in identificerend systeem: AGB-Z) | |||||||||
Naamgegevens | ||||||||||
Initialen | F. | |||||||||
Geslachtsnaam | ||||||||||
Achternaam | Snijder | |||||||||
Specialisme | Medisch specialisten, neurochirurgie (code = '0308' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||||
Locatie | ||||||||||
Zorgaanbieder | ||||||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||||||
Organisatie naam | AB-zkh | |||||||||
Organisatie locatie | Noord | |||||||||
Afdeling specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||||
Contactgegevens | ||||||||||
Telefoonnummers | ||||||||||
Telefoonnummer | +31182435770 | |||||||||
Email adressen | ||||||||||
Email adres | neurologie@ABZ.nl | |||||||||
Adresgegevens | ||||||||||
Straat | Knolweg | |||||||||
Huisnummer | 10 | |||||||||
Postcode | 9999PO | |||||||||
Woonplaats | Stitswerd | |||||||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||||||
Begin datum tijd | T + 5 dagen om 10:00 uur | |||||||||
Eind datum tijd | T + 5 dagen om 10:30 uur | |||||||||
Reden contact | ||||||||||
Probleem | Zie Probleem: eovd-1-1-probleem-01 | |||||||||
Contact | ||||||||||
Contact type | Thuis (code = 'HH' in codeSystem 'HL7 ActCode') | |||||||||
Contact met | ||||||||||
Zorgverlener | ||||||||||
Zorgverlener identificatienummer | 88131313 (in identificerend systeem: AGB-Z) | |||||||||
Naamgegevens | ||||||||||
Initialen | W. | |||||||||
Geslachtsnaam | ||||||||||
Achternaam | Bloem | |||||||||
Specialisme | Ergotherapeuten (code = '8800' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||||
Contactgegevens | ||||||||||
Email adressen | ||||||||||
Email adres | bloem@ergotherapie.nl | |||||||||
Begin datum tijd | T + 12 dagen om 15:15 uur | |||||||||
Reden contact | ||||||||||
Reden contact tekst | Controle voortgang revalidatie | |||||||||
Wensen en behoeften patient enof naasten | meneer wil zo snel mogelijk weer zelfstandig kunnen functioneren en zijn vrouw kunnen verzorgen |
1.2.5 Verpleegkundige context specificatie gezondheidstoestand
Verpleegkundige context specificatie gezondheidstoestand | ||||||||
Gegevenselement | Waarde | |||||||
Zelfzorg | ||||||||
Vermogen tot drinken | ||||||||
Drinken | Hulp nodig (code = '16681000146102' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Drink beperkingen | Bereiden (openen/uitschenken) (code = '286506008' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot drinken | ||||||||
Drinken | Onafhankelijk (code = '19841000146104' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Drink beperkingen | Vastpakken (code = '307071002' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot eten | ||||||||
Eten | Hulp nodig (code = '129033007' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '1') | |||||||
Eet beperkingen | Snijden/openen (code = '289078003' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot eten | ||||||||
Eten | Onafhankelijk (code = '165224005' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '0') | |||||||
Eet beperkingen | Eetgerei hanteren (code = '289046006' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot mondverzorging | ||||||||
Verzorgen tanden | Hulp nodig (code = '16671000146104' in codeSystem 'SNOMED CT') | |||||||
Prothese | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | Gebitsprothese (code = '27606000' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | Gebitsprothese bovenkaak | |||||||
Prothese | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | Gebitsprothese (code = '27606000' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | Gebitsprothese onderkaak | |||||||
Vermogen tot zich wassen | ||||||||
Zich wassen | Hulp nodig (code = '16621000146103' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Te wassen lichaamsdeel | Onderlichaam (code = '362875007' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot zich wassen | ||||||||
Zich wassen | Hulp nodig (code = '16621000146103' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Te wassen lichaamsdeel | Bovenlichaam (code = '362874006' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot zich kleden | ||||||||
Zich kleden | Hulp nodig (code = '129039006' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Te kleden lichaamsdeel | Onderlichaam (code = '362875007' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot zich kleden | ||||||||
Zich kleden | Onafhankelijk (code = '129035000' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Te kleden lichaamsdeel | Bovenlichaam (code = '362874006' in codeSystem 'SNOMED CT') | |||||||
Vermogen tot uiterlijke verzorging | ||||||||
Uiterlijke verzorging | Hulp nodig (code = '27941000146109' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Vermogen tot toiletgang | ||||||||
Toiletgebruik | Onafhankelijk (code = '129062008' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '0') | |||||||
Vermogen tot zelfstandig medicatiegebruik | ||||||||
Zelfstandig medicatiegebruik | Hulp nodig (code = '27921000146103' in codeSystem 'SNOMED CT') | |||||||
Hulp bij toediening | ||||||||
Verpleegkundige interventie | ||||||||
Interventie | bevorderen van therapietrouw met behulp van medicijndispenser (code = '710153008' in codeSystem 'SNOMED Clinical Terms') | |||||||
Behandeldoel | ||||||||
Gewenst zorgresultaat | therapietrouw | |||||||
Frequentie | 2 /d | |||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | medicatierol (code = '713308004' in codeSystem 'SNOMED Clinical Terms') | |||||||
Product omschrijving | baxterrol | |||||||
Vermogen tot verpleegtechnische handelingen | ||||||||
Verpleegkundige interventie | ||||||||
Verpleegkundige interventie | ||||||||
Interventie | Stoma care procedure (code = '225194008' in codeSystem 'SNOMED Clinical Terms') | |||||||
Behandeldoel | ||||||||
Gewenst zorgresultaat | goede hygiene met betrekking tot stoma | |||||||
Actie start datum tijd | T - 6 dagen | |||||||
Uitvoerder | ||||||||
Patient | Ja | |||||||
Toelichting | toezicht bij uitvoer, en instructie hygiënisch werken | |||||||
Verrichten vpkhandeling | Hulp nodig (code = '27931000146101' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Vermogen tot verpleegtechnische handelingen | ||||||||
Verpleegkundige interventie | ||||||||
Verpleegkundige interventie | ||||||||
Interventie | vervangen van verband (code = '18949003' in codeSystem 'SNOMED Clinical Terms') | |||||||
Actie start datum tijd | T - 1 dag | |||||||
Interval | 2 dagen | |||||||
Verrichten vpkhandeling | Hulp nodig (code = '27931000146101' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Toelichting zelfzorg | kan zich steeds beter redden met wassen en kleden, knoopjes dichtdoen en schoenen met hulp. Ileostoma instructies gestart. | |||||||
Mobiliteit | ||||||||
Mobiliteit | ||||||||
Lopen | Hulp nodig (code = '16581000146103' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Traplopen | Volledig afhankelijk (code = '301589003' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Houding veranderen | Onafhankelijk (code = '19821000146105' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Houding handhaven | Onafhankelijk (code = '19811000146100' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Uitvoeren transfer | Hulp nodig (code = '714917003' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Medisch hulpmiddel | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | rollator (code = '404946006' in codeSystem 'SNOMED Clinical Terms') | |||||||
Product omschrijving | rollator | |||||||
Begin datum | T - 1 jaar | |||||||
Medisch hulpmiddel | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | rolstoel (code = '58938008' in codeSystem 'SNOMED Clinical Terms') | |||||||
Product omschrijving | rolstoel | |||||||
Begin datum | T - 1 maand | |||||||
Toelichting | voor langere afstanden | |||||||
Toelichting | lopen is stuk verbeterd, rechter been minder krachtig | |||||||
Voedingvocht | ||||||||
Voedingsadvies | ||||||||
Dieet type | suikervrij, diabetes dieet | |||||||
Consistentie | dik vloeibaar | |||||||
Toelichting | eet naar eigen keuze minder vlees | |||||||
Voedingsadvies | ||||||||
Dieet type | geen varkensvlees | |||||||
Snaqscore | ||||||||
Gewichtsverlies score | LossAverage (code = 'G1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.5.1 (ordinal = '2') | |||||||
Eetlust score | Eetlust (code = 'B0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.5.2 (ordinal = '0') | |||||||
Voedings score | GeenVoeding (code = 'Z0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.5.3 (ordinal = '0') | |||||||
Totaal score | 2 | |||||||
Snaqscore datum tijd | T - 6 dagen om 17 uur | |||||||
Toelichting | geen verminderde eetlust ondanks chemotherapie | |||||||
Snaqrc score | ||||||||
Gewichtsverlies score | LossHigh (code = 'G2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.19.1 (ordinal = '2') | |||||||
Eetlust score | Eetlust (code = 'B0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.19.2 (ordinal = '0') | |||||||
Bmiscore | Gezond (code = 'B0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.19.3 (ordinal = '0') | |||||||
Hulp bij eten | Onafhankelijk (code = '165224005' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '0') | |||||||
Totaal score | 2 | |||||||
Snaqrc score datum tijd | T - 6 dagen om 17 uur | |||||||
Toelichting | geen verminderde eetlust ondanks chemotherapie | |||||||
Snaq65score | ||||||||
Gewichtsverlies score | LossLow (code = 'G0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.18.1 (ordinal = '0') | |||||||
Bovenarm omtrek score | Normaal (code = 'A0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.18.4 (ordinal = '0') | |||||||
Eetlust score | Eetlust (code = 'B0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.18.2 (ordinal = '0') | |||||||
Inspannings score | Mogelijk (code = 'In0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.18.3 (ordinal = '0') | |||||||
Totaal score | 0 | |||||||
Snaq65score datum tijd | T - 6 dagen om 17 uur | |||||||
Toelichting | geen verminderde eetlust ondanks chemotherapie | |||||||
Mustscore | ||||||||
Bmiscore | BMIHigh (code = 'B0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.4.1 (ordinal = '0') | |||||||
Gewichtsverlies score | LossLow (code = 'G0' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.4.2 (ordinal = '0') | |||||||
Ziekte score | Ziek (code = 'Z1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.4.3 (ordinal = '2') | |||||||
Totaal score | 2 | |||||||
Mustscore datum tijd | T - 12 dagen om 17 uur | |||||||
Vochtbalans | ||||||||
Vocht totaal in | 1400 ml | |||||||
Vocht totaal uit | 1000 ml | |||||||
Vochtbalans starttijd | T - 6 dagen om 07 uur | |||||||
Vochtbalans stoptijd | T - 5 dagen om 07 uur | |||||||
Sonde systeem | ||||||||
Sonde | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | Neus-maagsonde (code = '17102003' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | neus- maagsonde | |||||||
Begin datum | T - 5 dagen | |||||||
Anatomische locatie | neusgat (code = '363538002' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||
Zorgverlener | Zie Zorgverlener: eovdv-1-1-behandelaar-02 | |||||||
Sonde lengte | 575 mm | |||||||
Toelichting | wegens misselijkheid door chemotherapie | |||||||
Sonde systeem | ||||||||
Sonde | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | PEJ sonde (code = '8911000146104' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | PEJ sonde | |||||||
Begin datum | T - 5 dagen | |||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | enterale voedingspomp (code = '468664004' in codeSystem 'SNOMED Clinical Terms') | |||||||
Product omschrijving | enterale voedingspomp | |||||||
Begin datum | T - 5 dagen | |||||||
Infuus | ||||||||
Infuuskatheter | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | Centraal veneuze katheter (code = '52124006' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | centraal veneuze katheter | |||||||
Begin datum | T - 20 dagen | |||||||
Toelichting | onder sleutelbeen links | |||||||
Anatomische locatie | structuur van vena subclavia (code = '9454009' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||
Zorgverlener | Zie Zorgverlener: eovdv-1-1-behandelaar-02 | |||||||
Toelichting | voor voeding | |||||||
Lumen of lijn | ||||||||
Lijn status | Lopend (code = 'LNP' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.12.1') | |||||||
Lumen locatie | Distaal (code = '46053002' in codeSystem 'SNOMED CT') | |||||||
Lumen of lijn | ||||||||
Lijn status | Afgedopt (code = 'DOP' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.12.1') | |||||||
Lumen locatie | Mediaal (code = '255561001' in codeSystem 'SNOMED CT') | |||||||
Lumen of lijn | ||||||||
Lijn status | Lopend (code = 'LNP' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.12.1') | |||||||
Lumen locatie | Distaal (code = '46053002' in codeSystem 'SNOMED CT') | |||||||
Infuus | ||||||||
Infuuskatheter | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | Perifeer intraveneus infuus (code = '82449006' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | Perifeer intraveneus infuus | |||||||
Begin datum | T - 15 dagen | |||||||
Anatomische locatie | onderarm (code = '14975008' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||
Toelichting | voor medicatie | |||||||
Lumen of lijn | ||||||||
Lijn status | Lopend (code = 'LNP' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.12.1') | |||||||
Uitscheiding | ||||||||
Blaasfunctie | ||||||||
Urine continentie | Af en toe een ongelukje (max. 1 keer per 24 uur) (code = '165233007' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '1') | |||||||
Urostoma | ||||||||
Stoma | Zie Stoma: eovd-1-1-stoma-02 | |||||||
Incontinentiemateriaal | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | inlegger voor incontinentiebroek (code = '470713005' in codeSystem 'SNOMED Clinical Terms') | |||||||
Product omschrijving | inlegger | |||||||
Darmfunctie | ||||||||
Stoma | Zie Stoma: eovd-1-1-stoma-01 | |||||||
Defecatie consistentie | Helemaal vloeibaar (code = 'Type 7' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.3.1') | |||||||
Toelichting | stoma na subtotale darmresectie wegens coloncarcinoom | |||||||
Stoma eovd-1-1-stoma-01 | ||||||||
Stoma type | eindstandige ileostoma (code = '311412005' in codeSystem 'SNOMED CT') | |||||||
Stoma materiaal | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | Ileostomy bag (code = '417136005' in codeSystem 'SNOMED Clinical Terms') | |||||||
Product omschrijving | stomazak voor ileostoma | |||||||
Anatomische locatie | onderbuik (code = '27033000' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Rechts (code = '24028007' in codeSystem 'SNOMED CT') | |||||||
Aanleg datum | T - 12 dagen | |||||||
Toelichting | na subtotale darmresectie wegens coloncarcinoom | |||||||
Stoma eovd-1-1-stoma-02 | ||||||||
Stoma type | urostoma (code = '281601009' in codeSystem 'SNOMED CT') | |||||||
Anatomische locatie | buikwand (code = '83908009' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Rechts (code = '24028007' in codeSystem 'SNOMED CT') | |||||||
Aanleg datum | T - 4 jaar | |||||||
Huid | ||||||||
Brandwond | ||||||||
Ontstaans datum | T - 2 dagen | |||||||
Uitgebreidheid | 1 % | |||||||
Brandwond soort | Thermische brandwond (code = '105594005' in codeSystem 'SNOMED CT') | |||||||
Anatomische locatie | onderarm (code = '362741001' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Rechts (code = '24028007' in codeSystem 'SNOMED CT') | |||||||
Dieptegraad | 1e graad (code = '77140003' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Toelichting | Meneer kreeg hete thee over zich heen, wond is ongeveer 2 bij 2 cm; geen verband nodig. | |||||||
Datum laatste verbandwissel | T - 1 dag | |||||||
Brandwond | ||||||||
Ontstaans datum | T - 2 dagen | |||||||
Uitgebreidheid | 1 % | |||||||
Brandwond soort | Thermische brandwond (code = '105594005' in codeSystem 'SNOMED CT') | |||||||
Anatomische locatie | handrug (code = '63125000' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Rechts (code = '24028007' in codeSystem 'SNOMED CT') | |||||||
Dieptegraad | 2e graad, oppervlakkig (code = '262587005' in codeSystem '2.16.840.1.113883.6.96 (ordinal = ) | |||||||
Decubitus wond | ||||||||
Decubitus categorie | Decubitus categorie 2 (code = '420324007' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '2') | |||||||
Ontstaans datum | T - 2 dagen | |||||||
Anatomische locatie | hiel (code = '76853006' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||
Datum laatste verbandwissel | T - 1 dag | |||||||
Wondlengte | 2 cm | |||||||
Wondbreedte | 2 cm | |||||||
Wonddiepte | 0.5 cm | |||||||
Toelichting | Wond is niet geïnfecteerd. | |||||||
Decubitus wond | ||||||||
Decubitus categorie | Decubitus categorie 1 (code = '421076008' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '1') | |||||||
Ontstaans datum | T - 20 dagen | |||||||
Anatomische locatie | stuitje (code = '182028002' in codeSystem 'SNOMED Clinical Terms') | |||||||
Datum laatste verbandwissel | T - 1 dag | |||||||
Wondlengte | 3 cm | |||||||
Wondbreedte | 1 cm | |||||||
Wonddiepte | 0.2 cm | |||||||
Huidaandoening | ||||||||
Soort aandoening | Intertrigo/smetten (code = '58759008' in codeSystem 'SNOMED CT') | |||||||
Ontstaans datum | T - 6 dagen | |||||||
Anatomische locatie | lies (code = '26893007' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Rechts (code = '24028007' in codeSystem 'SNOMED CT') | |||||||
Toelichting | Smetten zonder natten of infectie, inmiddels genezen. | |||||||
Huidaandoening | ||||||||
Soort aandoening | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): Inverse psoriasis | |||||||
Ontstaans datum | T - 10 jaar | |||||||
Oorzaak | ||||||||
Probleem | Zie Probleem: eovd-1-1-probleem-03 | |||||||
Anatomische locatie | oksel (code = '91470000' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Rechts en links (code = '51440002' in codeSystem 'SNOMED CT') | |||||||
Wond | ||||||||
Wond soort | Traumatische wond (code = '416462003' in codeSystem 'SNOMED CT') | |||||||
Wond weefsel | Rode wond (code = 'ROOD' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.7.2') | |||||||
Wond infectie | Nee | |||||||
Wond vochtigheid | Droge wond (code = 'DROOG' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.7.3') | |||||||
Wondlengte | 2 cm | |||||||
Wondbreedte | 4 cm | |||||||
Wonddiepte | 0.1 cm | |||||||
Anatomische locatie | knie (code = '72696002' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||
Wond ontstaansdatum | T - 12 dagen | |||||||
Datum laatste verbandwissel | T - 1 dag | |||||||
Toelichting | oppervlakkige schaafwond na CVA, geen verband nodig | |||||||
Wond | ||||||||
Wond soort | Chirurgische wond (code = '112633009' in codeSystem 'SNOMED CT') | |||||||
Wond infectie | Nee | |||||||
Wond vochtigheid | Vochtige wond (code = 'VOCHTIG' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.7.3') | |||||||
Wond rand | Ondermijning (code = '449752001' in codeSystem 'SNOMED CT') | |||||||
Wondlengte | 5 cm | |||||||
Wondbreedte | 1 cm | |||||||
Wonddiepte | 4 cm | |||||||
Anatomische locatie | onderbuik (code = '27033000' in codeSystem 'SNOMED Clinical Terms') | |||||||
Drain | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | wonddrain (code = '258646005' in codeSystem 'SNOMED Clinical Terms') | |||||||
Product omschrijving | wonddrain | |||||||
Begin datum | T - 12 dagen | |||||||
Wond | ||||||||
Wond soort | Oncologische ulcer (code = '94579000' in codeSystem 'SNOMED CT') | |||||||
Wond weefsel | Graad II (code = 'GRAAD2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.7.1') | |||||||
Wond infectie | Nee | |||||||
Wondlengte | 1 cm | |||||||
Wondbreedte | 1 cm | |||||||
Wonddiepte | 2 cm | |||||||
Anatomische locatie | buikwand (code = '83908009' in codeSystem 'SNOMED Clinical Terms') | |||||||
Lateraliteit | Links (code = '7771000' in codeSystem 'SNOMED CT') | |||||||
Wond ontstaansdatum | T - 1 maand | |||||||
Datum laatste verbandwissel | T - 1 dag | |||||||
Zintuigen | ||||||||
Functie horen | ||||||||
Hoor functie | Verminderde gehoorfunctie (code = '15188001' in codeSystem 'SNOMED CT') | |||||||
Horen hulpmiddel | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product id | 012345678905 (code = '012345678905Global Trade Item Number (GTIN)') | |||||||
Product type | Gehoorapparaat (code = '6012004' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | Gehoorapparaat | |||||||
Anatomische locatie | Linkeroor (code = '89644007' in codeSystem 'SNOMED CT') | |||||||
Horen hulpmiddel | ||||||||
Medisch hulpmiddel | ||||||||
Product omschrijving | Gehoorapparaat | |||||||
Anatomische locatie | Rechteroor (code = '25577004' in codeSystem 'SNOMED CT') | |||||||
Functie zien | ||||||||
Visuele functie | Verminderd gezichtsvermogen (code = '397540003' in codeSystem 'SNOMED CT') | |||||||
Zien hulpmiddel | ||||||||
Medisch hulpmiddel | ||||||||
Product | ||||||||
Product type | bril (code = '50121007' in codeSystem 'SNOMED CT') | |||||||
Product omschrijving | bril | |||||||
Toelichting | zonder bril bestaat verhoogd valrisico | |||||||
Ziektebeleving | ||||||||
Ziektebeleving | ||||||||
Ziekte inzicht van patient | meneer kan niet overzien wat de ziekte betekent in het dagelijkse leven | |||||||
Omgaan met ziekteproces door patient | meneer wil niet praten over de toekomst. | |||||||
Omgaan met ziekteproces door naasten | echtgenote maakt zich zorgen of zij de zorg voor meneer wel aan kan, omdat zij zelf ook slecht ter been is | |||||||
Mentale status | ||||||||
Probleem | ||||||||
Probleem type | Symptoom (code = '418799008' in codeSystem 'SNOMED CT') | |||||||
Probleem naam | gedaald bewustzijn (code = '443371007' in codeSystem 'SNOMED Clinical Terms') | |||||||
Probleem begin datum | T - 22 dagen | |||||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||||
Toelichting | sinds cva, verminderde alertheid | |||||||
Probleem | ||||||||
Probleem type | Klacht (code = '409586006' in codeSystem 'SNOMED CT') | |||||||
Probleem naam | toestand van verwardheid (code = '286933003' in codeSystem 'SNOMED Clinical Terms') | |||||||
Probleem begin datum | T - 22 dagen | |||||||
Probleem eind datum | T - 5 dagen | |||||||
Probleem status | Niet actueel (code = '73425007' in codeSystem 'SNOMED CT') |
1.3 Test Overdracht 1.10b
1.3.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 10 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M. | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | XXX_Hondius | |||||
Identificatienummer | 999900079 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 1 jaar | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 22345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06121212 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | EF-zkh | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 21616161616 (in identificerend systeem: 2.16.528.1.1007.5.1) | |||||
Naamgegevens | ||||||
Voornamen | Ronald | |||||
Geslachtsnaam | ||||||
Achternaam | Tuinman | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75616161 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | HomeCare |
1.3.2 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03454545 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Achternaam | Bronsgeest | |||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem naam | ziekte van Parkinson (code = '49049000' in codeSystem 'SNOMED CT') | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
1.4 Test Overdracht 1.11b
1.4.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 10 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M. | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | XXX_Hondius | |||||
Identificatienummer | 999900079 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 1 jaar | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 22345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 00123456 (in identificerend systeem: URA) | |||||
Organisatie naam | GH-zkh | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Amanda | |||||
Geslachtsnaam | ||||||
Achternaam | Kwikzilver | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 01234567 (in identificerend systeem: URA) | |||||
Organisatie naam | WijkZorg |
1.4.2 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03454545 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Achternaam | Bronsgeest | |||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem naam | ziekte van Parkinson (code = '49049000' in codeSystem 'SNOMED CT') | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
1.5 Test Overdracht 1.1b
1.5.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 1 dag | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Voornamen | Erik | |||||
Initialen | E | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Altenborg | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1000 | |||||
Postcode | 9999XA | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31634567891 | |||||
Email adressen | ||||||
Email adres | evertaltenborg@hotmail.com | |||||
Identificatienummer | 999911612 (in identificerend systeem: BSN) | |||||
Geboortedatum | 14 aug 1964 | |||||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 1 jaar | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Contactpersoon eovd-1-1b-contactpersoon-01 | ||||||
Naamgegevens | ||||||
Voornamen | Johanna | |||||
Initialen | J | |||||
Roepnaam | Hanna | |||||
Geslachtsnaam | ||||||
Achternaam | Bakker | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31645678912 | |||||
Email adressen | ||||||
Email adres | jbakker@123net.nl | |||||
Rol | Eerste relatie/contactpersoon (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') | |||||
Relatie | Dochter (code = 'DAUC' in codeSystem 'HL7 RoleCode') | |||||
Contactpersoon | ||||||
Naamgegevens | ||||||
Voornamen | Johannes | |||||
Roepnaam | Hans | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Dijk | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31612121212 | |||||
Relatie | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): achterneef | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | AB-zkh | |||||
Organisatie locatie | Noord | |||||
Afdeling specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31182435770 | |||||
Email adressen | ||||||
Email adres | neurologie@ABZ.nl | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 10 | |||||
Postcode | 9999PO | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Charlotte Maria | |||||
Initialen | C. M. | |||||
Roepnaam | Lotte | |||||
Geslachtsnaam | ||||||
Achternaam | Bruinsma | |||||
Specialisme | Verpleegkundigen, niet nader gespecificeerd (code = '9100' in codeSystem 'Vektis AGB-medische specialismen') | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75131313 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | ThuiszorgOrg | |||||
Organisatie locatie | Noord | |||||
Afdeling specialisme | Thuiszorg, kruiswerk en gezinsverzorging (code = '7500' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.5.2 Algemene patienten context
Algemene patienten context | |||||
Gegevenselement | Waarde | ||||
Woonomgeving | |||||
Woonsituatie | |||||
Toelichting | woning is op derde verdieping, is gelijkvloers en er is een lift aanwezig | ||||
Woning type | Appartement of flatwoning (code = 'FLATW' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.13.1') | ||||
Levensovertuiging | |||||
Wilsverklaring | |||||
Wilsverklaring type | Verklaring donorschap (code = 'DO' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.14.1') | ||||
Wilsverklaring datum | T - 4 jaar | ||||
Vertegenwoordiger | |||||
Contactpersoon | Zie Contactpersoon: eovd-1-1b-contactpersoon-01 | ||||
Toelichting | wilsverklaring bevindt zich in de portemonnee. | ||||
Wilsverklaring | |||||
Wilsverklaring type | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): Wil niet gevaccineerd worden | ||||
Wilsverklaring datum | T - 1 jaar |
1.5.3 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Joshua Pieter | |||||
Initialen | J. P. | |||||
Geslachtsnaam | ||||||
Achternaam | Helmond | |||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | AB-zkh | |||||
Organisatie locatie | Noord | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03898989 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | G. | |||||
Geslachtsnaam | ||||||
Achternaam | Spijkerman | |||||
Specialisme | Medisch specialisten, gastro-enterologie (maag-darm-lever-arts) (code = '0318' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | AB-zkh | |||||
Organisatie locatie | Noord | |||||
Medische diagnose | ||||||
Probleem eovd-1-1b-probleem-01 | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 100 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Toelichting | niet bekend met neurologische klachten | |||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | neoplasma van colon (code = '126838000') | |||||
Probleem begin datum | T - 150 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Probleem | ||||||
Probleem anatomische locatie | oksel (code = '91470000' in codeSystem 'SNOMED Clinical Terms') | |||||
Probleem lateraliteit | Rechts en links (code = '51440002' in codeSystem 'SNOMED CT') | |||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | inverse psoriasis (code = '238600001') | |||||
Probleem begin datum | T - 10 jaar | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Voorgeschiedenis | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | diabetes mellitus (code = '73211009') | |||||
Probleem begin datum | T - 12 jaar | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Allergie | ||||||
Allergie intolerantie | ||||||
Veroorzakende stof | nikkelsulfaat (code = '255848005' in codeSystem 'SNOMED CT') | |||||
Allergie categorie | Stof of product (code = '419199007' in codeSystem 'SNOMED CT') | |||||
Allergie status | Actief (code = 'active' in codeSystem 'HL7 ActStatus') | |||||
Begin datum tijd | T - 10 jaar | |||||
Mate van kritiek zijn | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||
Toelichting | opgemerkt bij het dragen van nikkel bevattende sieraden. | |||||
Reactie | ||||||
Symptoom | Contactdermatitis (code = '40275004' in codeSystem 'SNOMED CT') | |||||
Reactie beschrijving | last van jeuk, roodheid en irritatie op de contactplek van nikkel bevattende sieraden. | |||||
Wijze van blootstelling | intra-epidermale route (code = '448077001' in codeSystem 'SNOMED Clinical Terms') | |||||
Allergie intolerantie | ||||||
Veroorzakende stof | pollen (code = '256259004') | |||||
Allergie categorie | Omgeving (code = '426232007' in codeSystem 'SNOMED CT') | |||||
Allergie status | Actief (code = 'active' in codeSystem 'HL7 ActStatus') | |||||
Begin datum tijd | T - 500 dagen | |||||
Mate van kritiek zijn | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||
Laatste reactie datum tijd | T - 99 dagen | |||||
Reactie | ||||||
Symptoom | Overgevoeligheidsreactie van de bovenste luchtwegen (code = '490008' in codeSystem 'SNOMED CT') | |||||
Specifieke stof | graspollen (code = '256277009') | |||||
Reactie beschrijving | veelvuldig niezen | |||||
Ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||||
Reactie tijdstip | T - 99 dagen | |||||
Reactie | ||||||
Symptoom | Kortademigheid (code = '267036007' in codeSystem 'SNOMED CT') | |||||
Symptoom | Koorts (code = '386661006' in codeSystem 'SNOMED CT') | |||||
Specifieke stof | pollen van paprikaplant (code = '110181000146104') | |||||
Reactie beschrijving | ernstige benauwdheid en koorts | |||||
Ernst | Ernstig (code = '24484000' in codeSystem 'SNOMED CT') | |||||
Reactie tijdstip | T - 200 dagen | |||||
Let op | ||||||
Alert | ||||||
Alert naam | Drager MRSA (code = '432415000' in codeSystem 'SNOMED CT') | |||||
Begin datum tijd | T - 20 dagen | |||||
Alert type | waarschuwing (code = '74018-3' in codeSystem 'LOINC') | |||||
Alert | ||||||
Alert naam | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): ernstige claustrofobie | |||||
Begin datum tijd | T - 10 jaar | |||||
Meetwaarden | ||||||
Bloeddruk | ||||||
Meetmethode | Niet-invasief (code = '22762002' in codeSystem 'SNOMED CT') | |||||
Manchet type | Standaard (code = 'STD' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.15.1') | |||||
Meet locatie | Rechter bovenarm (code = '368209003' in codeSystem 'SNOMED CT') | |||||
Diastolisch eindpunt | Fase V (code = '255272007' in codeSystem 'SNOMED CT') | |||||
Systolische bloeddruk | 170 mmhg | |||||
Diastolische bloeddruk | 90 mmhg | |||||
Gemiddelde bloeddruk | 110 mmhg | |||||
Bloeddruk datum tijd | T - 20 dagen om 14:45 uur | |||||
Toelichting | meneer gebruikt medicatie | |||||
Houding | Liggende positie (code = '102538003' in codeSystem 'SNOMED CT') | |||||
Lichaamsgewicht | ||||||
Gewicht waarde | 74 kg | |||||
Toelichting | meneer volgt afvaldieet | |||||
Gewicht datum tijd | T - 5 dagen om 14:30 uur | |||||
Kleding | Volledig gekleed, inclusief schoenen (code = 'FULL' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.8.1') | |||||
Lichaamslengte | ||||||
Lengte waarde | 170 cm | |||||
Lengte datum tijd | T - 5 dagen om 14:30 uur | |||||
Toelichting | zonder schoenen aan |
1.5.4 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||||
Gegevenselement | Waarde | |||||||
Afspraken patient | ||||||||
Contact | ||||||||
Contact type | Poliklinisch (code = 'AMB' in codeSystem 'HL7 ActCode') | |||||||
Contact met | ||||||||
Zorgverlener | ||||||||
Naamgegevens | ||||||||
Voornamen | Joshua Pieter | |||||||
Initialen | J.P. | |||||||
Geslachtsnaam | ||||||||
Achternaam | Helmond | |||||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contact met | ||||||||
Zorgverlener | ||||||||
Zorgverlener identificatienummer | 03686868 (in identificerend systeem: AGB-Z) | |||||||
Naamgegevens | ||||||||
Initialen | F. | |||||||
Geslachtsnaam | ||||||||
Achternaam | Snijder | |||||||
Specialisme | Medisch specialisten, neurochirurgie (code = '0308' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Locatie | ||||||||
Zorgaanbieder | ||||||||
Zorgaanbieder identificatienummer | 06590457 (in identificerend systeem: AGB-Z) | |||||||
Organisatie naam | AB-zkh | |||||||
Organisatie locatie | Noord | |||||||
Afdeling specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contactgegevens | ||||||||
Telefoonnummers | ||||||||
Telefoonnummer | +31182435770 | |||||||
Email adressen | ||||||||
Email adres | neurologie@ABZ.nl | |||||||
Adresgegevens | ||||||||
Straat | Knolweg | |||||||
Huisnummer | 10 | |||||||
Postcode | 9999PO | |||||||
Woonplaats | Stitswerd | |||||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||||
Begin datum tijd | T + 5 dagen om 10:00 uur | |||||||
Eind datum tijd | T + 5 dagen om 10:30 uur | |||||||
Reden contact | ||||||||
Probleem | Zie Probleem: eovd-1-1b-probleem-01 | |||||||
Contact | ||||||||
Contact type | Thuis (code = 'HH' in codeSystem 'HL7 ActCode') | |||||||
Contact met | ||||||||
Zorgverlener | ||||||||
Zorgverlener identificatienummer | 88131313 (in identificerend systeem: AGB-Z) | |||||||
Naamgegevens | ||||||||
Initialen | W. | |||||||
Geslachtsnaam | ||||||||
Achternaam | Bloem | |||||||
Specialisme | Ergotherapeuten (code = '8800' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contactgegevens | ||||||||
Email adressen | ||||||||
Email adres | bloem@ergotherapie.nl | |||||||
Begin datum tijd | T + 12 dagen om 15:15 uur | |||||||
Reden contact | ||||||||
Reden contact tekst | Controle voortgang revalidatie |
1.5.5 Verpleegkundige context specificatie gezondheidstoestand
Verpleegkundige context specificatie gezondheidstoestand | ||||
Gegevenselement | Waarde | |||
Voedingvocht | ||||
Voedingsadvies | ||||
Dieet type | suikervrij, diabetes dieet | |||
Consistentie | dik vloeibaar | |||
Toelichting | eet naar eigen keuze minder vlees | |||
Voedingsadvies | ||||
Dieet type | geen varkensvlees |
1.6 Test Overdracht 1.2b
1.6.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 1 dag | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Voornamen | Claire | |||||
Initialen | C | |||||
Roepnaam | Françoise | |||||
Naamgebruik | Geslachtsnaam partner gevolgd door eigen geslachtsnaam (code = 'NL3' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Clinteren | |||||
Geslachtsnaam partner | ||||||
Voorvoegsels partner | van de | |||||
Achternaam partner | Put | |||||
Adresgegevens | ||||||
Straat | Cremstraat | |||||
Huisnummer | 7 | |||||
Huisnummerletter | G | |||||
Huisnummertoevoeging | I | |||||
Aanduiding bij nummer | Bij (code = 'by' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.3') | |||||
Postcode | 1240AB | |||||
Woonplaats | Finsterwolderhamrink | |||||
Land | Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') | |||||
Additionele informatie | tijdelijk adres | |||||
Adres soort | Postadres (code = 'PST' in codeSystem 'HL7 AddressUse') | |||||
Adresgegevens | ||||||
Straat | Magnolialaan | |||||
Huisnummer | 1 | |||||
Postcode | 4100AA | |||||
Woonplaats | Ruurlo | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31612121212 | |||||
Telefoonnummers | ||||||
Telefoonnummer | +31709131313 | |||||
Email adressen | ||||||
Email adres | claire@vanclinteren.nl | |||||
Email adressen | ||||||
Email adres | clinteren@planeet.nl | |||||
Identificatienummer | 999999072 (in identificerend systeem: BSN) | |||||
Geboortedatum | 1 jul 1950 | |||||
Geslacht | Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 250 dagen | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Contactpersoon | ||||||
Naamgegevens | ||||||
Voornamen | Hendrike | |||||
Initialen | H | |||||
Roepnaam | Riek | |||||
Naamgebruik | Geslachtsnaam partner gevolgd door eigen geslachtsnaam (code = 'NL3' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') | |||||
Geslachtsnaam | ||||||
Achternaam | Smit | |||||
Geslachtsnaam partner | ||||||
Achternaam partner | Timmerman | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31645678912 | |||||
Email adressen | ||||||
Email adres | jbakker@123net.nl | |||||
Adresgegevens | ||||||
Straat | Vincent van Goghplantsoen | |||||
Huisnummer | 1 | |||||
Huisnummerletter | C | |||||
Huisnummertoevoeging | II | |||||
Aanduiding bij nummer | Bij (code = 'by' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.3') | |||||
Postcode | 9999AA | |||||
Woonplaats | Hoogmade | |||||
Land | Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Rol | Eerste relatie/contactpersoon (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') | |||||
Rol | Wettelijke vertegenwoordiger (code = '24' in codeSystem '2.16.840.1.113883.2.4.3.11.22.472') | |||||
Relatie | Dochter (code = 'DAUC' in codeSystem 'HL7 RoleCode') | |||||
Relatie | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): buurvrouw | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06343434 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | CD-zkh | |||||
Organisatie locatie | Zuid | |||||
Afdeling specialisme | Medisch specialisten, longziekten (code = '0322' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31182435770 | |||||
Telefoonnummers | ||||||
Telefoonnummer | +311182435000 | |||||
Email adressen | ||||||
Email adres | longziekten@cdz.nl | |||||
Email adressen | ||||||
Email adres | info@cdz.nl | |||||
Adresgegevens | ||||||
Straat | Raapweg | |||||
Huisnummer | 3 | |||||
Huisnummerletter | D | |||||
Huisnummertoevoeging | II | |||||
Aanduiding bij nummer | Bij (code = 'by' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.3') | |||||
Postcode | 9999PQ | |||||
Woonplaats | Bolsward | |||||
Land | Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') | |||||
Additionele informatie | tijdelijk adres | |||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Charlotte Maria | |||||
Initialen | C.M. | |||||
Roepnaam | Lotte | |||||
Naamgebruik | Eigen geslachtsnaam gevolgd door geslachtsnaam partner (code = 'NL4' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Ieperen | |||||
Geslachtsnaam partner | ||||||
Voorvoegsels partner | de | |||||
Achternaam partner | Smet | |||||
Specialisme | Gespecialiseerd verpleegkundige, transfer (code = '9108' in codeSystem 'Vektis AGB-medische specialismen') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31687654321 | |||||
Telefoonnummers | ||||||
Telefoonnummer | +31182435770 | |||||
Email adressen | ||||||
Email adres | transfervpk@cdz.nl | |||||
Email adressen | ||||||
Email adres | info@cdz.nl | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75565656 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | WijkverplegingOrg | |||||
Organisatie locatie | Zuid | |||||
Afdeling specialisme | Thuiszorg, kruiswerk en gezinsverzorging (code = '7500' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.6.2 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 04232323 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Voornamen | Elizabeth | |||||
Initialen | M. | |||||
Roepnaam | Beth | |||||
Naamgebruik | Geslachtsnaam partner (code = 'NL2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Dooremaal | |||||
Geslachtsnaam partner | ||||||
Voorvoegsels partner | ter | |||||
Achternaam partner | Balkt | |||||
Specialisme | Fysiotherapeuten, fysiotherapie (code = '0401' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Contactgegevens | ||||||
Telefoonnummers | ||||||
Telefoonnummer | +31665656565 | |||||
Telefoonnummers | ||||||
Telefoonnummer | +31201212121 | |||||
Email adressen | ||||||
Email adres | beth@fysio.nl | |||||
Email adressen | ||||||
Email adres | info@fysio.nl | |||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 04121212 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | FysioOrg | |||||
Organisatie locatie | West | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 30 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Toelichting | niet bekend met neurologische klachten |
1.6.3 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||||
Gegevenselement | Waarde | |||||||
Afspraken patient | ||||||||
Contact | ||||||||
Contact type | Poliklinisch (code = 'AMB' in codeSystem 'HL7 ActCode') | |||||||
Contact met | ||||||||
Zorgverlener | ||||||||
Zorgverlener identificatienummer | 01454545 (in identificerend systeem: AGB-Z) | |||||||
Naamgegevens | ||||||||
Voornamen | Nicolaas | |||||||
Initialen | N. | |||||||
Roepnaam | Klaas | |||||||
Naamgebruik | Geslachtsnaam partner gevolgd door eigen geslachtsnaam (code = 'NL3' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.4') | |||||||
Geslachtsnaam | ||||||||
Voorvoegsels | van | |||||||
Achternaam | Pinxteren | |||||||
Geslachtsnaam partner | ||||||||
Voorvoegsels partner | de | |||||||
Achternaam partner | Mol | |||||||
Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contactgegevens | ||||||||
Telefoonnummers | ||||||||
Telefoonnummer | +31689898989 | |||||||
Telefoonnummers | ||||||||
Telefoonnummer | +31203232323 | |||||||
Email adressen | ||||||||
Email adres | klaas@huisartspraktijk.nl | |||||||
Email adressen | ||||||||
Email adres | info@huisartspraktijk.nl | |||||||
Locatie | ||||||||
Zorgaanbieder | ||||||||
Zorgaanbieder identificatienummer | 01565656 (in identificerend systeem: AGB-Z) | |||||||
Organisatie naam | Huisartspraktijk de Huisarts | |||||||
Afdeling specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||||
Contactgegevens | ||||||||
Telefoonnummers | ||||||||
Telefoonnummer | +31203232323 | |||||||
Telefoonnummers | ||||||||
Telefoonnummer | +31203232000 | |||||||
Email adressen | ||||||||
Email adres | info@huisartspraktijk.nl | |||||||
Email adressen | ||||||||
Email adres | assistente@huisartspraktijk.nl | |||||||
Adresgegevens | ||||||||
Straat | Knolweg | |||||||
Huisnummer | 100 | |||||||
Huisnummerletter | a | |||||||
Huisnummertoevoeging | III | |||||||
Aanduiding bij nummer | Bij (code = 'by' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.3') | |||||||
Postcode | 4000KK | |||||||
Woonplaats | Stitswerd | |||||||
Land | Nederland (code = 'NL' in codeSystem 'ISO 3166-1 (alpha-2)') | |||||||
Additionele informatie | bedrijfsgebouw "De Stits" | |||||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | |||||||
Organisatie type | Huisartspraktijk (zelfstandig of groepspraktijk) (code = 'Z3' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||||
Begin datum tijd | T + 5 dagen |
1.7 Test Overdracht 1.3b
1.7.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 2 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Ven | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1002 | |||||
Postcode | 9999ZZ | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Identificatienummer | 999900018 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Betaler persoon | ||||||
Betaler naam | J. Rijk | |||||
Bankgegevens | ||||||
Bank naam | ING | |||||
Bankcode | INGBNL2A | |||||
Rekeningnummer | NL98INGB0003856625 | |||||
Bankgegevens | ||||||
Bank naam | Triodos | |||||
Bankcode | TRIONL2U | |||||
Rekeningnummer | NL98TRIO0254712320 | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 250 dagen | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Verzekering | ||||||
Begin datum tijd | T + 25 dagen | |||||
Eind datum tijd | T + 390 dagen | |||||
Verzekeringssoort | Aanvullend verzekerd (code = 'A' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06121212 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | EF-zkh | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Bart | |||||
Geslachtsnaam | ||||||
Achternaam | Moorman | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75616161 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | HomeCare | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.7.2 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03454545 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Achternaam | Bronsgeest | |||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 30 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Toelichting | niet bekend met neurologische klachten |
1.8 Test Overdracht 1.4b
1.8.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 2 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Birkholz | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1003 | |||||
Postcode | 9999ZA | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Identificatienummer | 999900031 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 250 dagen | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06121212 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | EF-zkh | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Bart | |||||
Geslachtsnaam | ||||||
Achternaam | Moorman | |||||
Specialisme | Verpleegkundigen, niet nader gespecificeerd (code = '9100' in codeSystem 'Vektis AGB-medische specialismen') | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75616161 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | HomeCare | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.8.2 Algemene patienten context
Algemene patienten context | ||||
Gegevenselement | Waarde | |||
Woonomgeving | ||||
Woonsituatie | ||||
Toelichting | woont tijdelijk in hotel | |||
Woning type | Anders (code = 'OTH' in codeSystem 'HL7 NullFlavor'): hotel |
1.8.3 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03454545 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Achternaam | Bronsgeest | |||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | ischemisch cerebrovasculair accident (code = '422504002' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 30 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Toelichting | niet bekend met neurologische klachten |
1.9 Test Overdracht 1.5
1.9.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 2 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van de | |||||
Achternaam | XXX_Quigleys | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1000 | |||||
Postcode | 9999ZA | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Identificatienummer | 999900912 (in identificerend systeem: BSN) | |||||
Geboortedatum | 5 nov 1963 | |||||
Geslacht | Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 250 dagen | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75616161 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | HomeCare | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Bart | |||||
Geslachtsnaam | ||||||
Achternaam | Moorman | |||||
Specialisme | Verpleegkundigen, niet nader gespecificeerd (code = '9100' in codeSystem 'Vektis AGB-medische specialismen') | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06121212 (in identificerend systeem: URA) | |||||
Organisatie naam | AB-zkh | |||||
Afdeling specialisme | Medisch specialisten, obstetrie en gynaecologie (code = '0307' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.9.2 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03171717 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Achternaam | Oosterhout | |||||
Specialisme | Medisch specialisten, obstetrie en gynaecologie (code = '0307' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | zwangerschapsgeïnduceerde hypertensie (code = '48194001' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 10 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Pijnscore | ||||||
Pijn score | ||||||
Pijnscore waarde | 2 | |||||
Pijnscore datum tijd | T - 1 dag om 12:30 uur | |||||
Pijn meetmethode | VAS10 (code = 'VAS10' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.9.1') | |||||
Anatomische locatie | structuur van rug exclusief nek (code = '77568009' in codeSystem 'SNOMED Clinical Terms') |
1.9.3 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||
Gegevenselement | Waarde | |||||
Actuele patientproblemen | ||||||
Patientprobleem | ||||||
Probleem eovd-1-5-probleem-01 | ||||||
Probleem anatomische locatie | structuur van rug exclusief nek (code = '77568009' in codeSystem 'SNOMED Clinical Terms') | |||||
Probleem naam | pijn (bevinding) (code = '22253000' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||
Probleem begin datum | T - 10 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Toelichting | bij lopen | |||||
Verpleegkundige interventie eovd-1-5-interventie-01 | ||||||
Interventie | afleiden (code = '414039005' in codeSystem 'SNOMED Clinical Terms') | |||||
Indicatie | ||||||
Probleem | Zie Probleem: eovd-1-5-probleem-01 | |||||
Zorgresultaat | ||||||
Uitkomst van zorg | ||||||
Zorgresultaat | zie pijnscore | |||||
Interventie | ||||||
Verpleegkundige interventie | Zie Verpleegkundige interventie: eovd-1-5-interventie-01 |
1.9.4 Verpleegkundige context specificatie gezondheidstoestand
Verpleegkundige context specificatie gezondheidstoestand | ||||
Gegevenselement | Waarde | |||
Voortplanting | ||||
Zwangerschap | ||||
Zwanger | Ja | |||
Aterme datum | T + 120 dagen | |||
Datum laatste menstruatie | T - 170 dagen | |||
Zwangerschapsduur | 160 dagen | |||
Graviditeit | 1 | |||
Pariteit | 0 | |||
Toelichting | Mevrouw is vaak misselijk in de ochtend. |
1.10 Test Overdracht 1.6
1.10.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 1 dag | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Arcken | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1000 | |||||
Postcode | 9999XA | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Identificatienummer | 999900043 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 250 dagen | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75616161 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | HomeCare | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Bart | |||||
Geslachtsnaam | ||||||
Achternaam | Moorman | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75727272 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | St. Geestelijk Welzijn | |||||
Organisatie type | Geestelijke Gezondheidszorg (code = 'G5' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.10.2 Algemene patienten context
Algemene patienten context | ||||
Gegevenselement | Waarde | |||
Juridische situatie | ||||
Juridische situatie eovd-1-6-juridischesituatie-01 | ||||
Juridische status | Rechterlijke machtiging (code = 'RM' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.23.2') | |||
Datum aanvang | T - 3 dagen | |||
Datum einde | T + 3 maanden | |||
Juridische situatie | ||||
Vertegenwoordiging | Mentorschap (code = '8' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.23.3') | |||
Datum aanvang | T - 6 maanden |
1.10.3 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 01171717 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Eindhoven | |||||
Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | niet-organische psychose (code = '191525009' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 5 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verificatie status | Bevestigd (code = '410605003' in codeSystem 'SNOMED CT') | |||||
Vrijheidsbeperking | ||||||
Vrijheidsbeperkende interventie | ||||||
Wilsbekwaam | Nee | |||||
Wilsbekwaam toelichting | wegens psychose | |||||
Juridische situatie | Zie Juridische situatie: eovd-1-6-juridischesituatie-01 | |||||
Soort interventie | geslotendeurprocedure (code = '225210009' in codeSystem 'SNOMED CT') | |||||
Reden van toepassen | afwenden van situatie die kan resulteren in toebrengen van schade aan zichzelf of aan anderen (code = '121481000146105' in codeSystem 'SNOMED CT') | |||||
Instemming | Geen instemming patiënt (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.6.1') | |||||
Begin | T + 1 dag | |||||
Vrijheidsbeperkende interventie | ||||||
Wilsbekwaam | Nee | |||||
Wilsbekwaam toelichting | wegens psychose | |||||
Juridische situatie | Zie Juridische situatie: eovd-1-6-juridischesituatie-01 | |||||
Soort interventie | separeren in extra beveiligde kamer (code = '124041000146108' in codeSystem 'SNOMED CT') | |||||
Reden van toepassen | afwenden van situatie die kan resulteren in toebrengen van schade aan zichzelf of aan anderen (code = '121481000146105' in codeSystem 'SNOMED CT') | |||||
Instemming | Geen instemming patiënt (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.6.1') | |||||
Begin | T + 1 dag | |||||
Einde | T + 3 dagen |
1.10.4 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||
Gegevenselement | Waarde | |||||
Actuele patientproblemen | ||||||
Patientprobleem | ||||||
Probleem eovd-1-6-probleem-01 | ||||||
Probleem naam | fysieke agressie (code = '248004009' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||
Probleem begin datum | T - 5 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verpleegkundige interventie eovd-1-6-interventie-01 | ||||||
Interventie | rustige en geruststellende houding aannemen (code = '225980008' in codeSystem 'SNOMED Clinical Terms') | |||||
Indicatie | ||||||
Probleem | Zie Probleem: eovd-1-6-probleem-01 | |||||
Behandeldoel | ||||||
Gewenst zorgresultaat | Veilige omgeving is gerealiseerd voor patient/ naasten; duur VBI beperken | |||||
Zorgresultaat | ||||||
Uitkomst van zorg | ||||||
Zorgresultaat | doel is behaald | |||||
Interventie | ||||||
Verpleegkundige interventie | Zie Verpleegkundige interventie: eovd-1-6-interventie-01 |
1.11 Test Overdracht 1.7
1.11.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 5 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Schouten-Baak | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1001 | |||||
Postcode | 9999XX | |||||
Woonplaats | Stitswerd | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Identificatienummer | 999900055 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 250 dagen | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75616161 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | HomeCare | |||||
Organisatie type | Thuiszorg (code = 'T2' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Bart | |||||
Geslachtsnaam | ||||||
Achternaam | Moorman | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 47707070 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | St. Zonnehof | |||||
Organisatie type | Verpleeghuis (code = 'R5' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.11.2 Algemene patienten context
Algemene patienten context | ||||
Gegevenselement | Waarde | |||
Juridische situatie | ||||
Juridische situatie eovd-1-7-juridischesituatie-01 | ||||
Juridische status | Besluit tot opname en verblijf (code = 'OPM' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.23.2') | |||
Datum aanvang | T - 5 dagen | |||
Juridische situatie | ||||
Vertegenwoordiging | Zaakwaarneming (code = '10' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.23.3') | |||
Datum aanvang | T - 6 maanden |
1.11.3 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 01171717 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | Eindhoven | |||||
Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem type | Diagnose (code = '282291009' in codeSystem 'SNOMED CT') | |||||
Probleem naam | delier (code = '2776000' in codeSystem 'SNOMED CT') | |||||
Probleem begin datum | T - 10 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Vrijheidsbeperking | ||||||
Vrijheidsbeperkende interventie | ||||||
Wilsbekwaam | Nee | |||||
Wilsbekwaam toelichting | Kan eigen situatie niet beoordelen | |||||
Juridische situatie | Zie Juridische situatie: eovd-1-7-juridischesituatie-01 | |||||
Soort interventie | constante supervisie met camera (code = '121411000146104' in codeSystem 'SNOMED CT') | |||||
Reden van toepassen | afwenden van crisissituatie (code = '121491000146107' in codeSystem 'SNOMED CT') | |||||
Instemming | Instemming wettelijke vertegenwoordiger (code = '4' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.6.1') | |||||
Begin | T - 4 dagen | |||||
Vrijheidsbeperkende interventie | ||||||
Wilsbekwaam | Nee | |||||
Wilsbekwaam toelichting | Kan zich niet orienteren | |||||
Juridische situatie | Zie Juridische situatie: eovd-1-7-juridischesituatie-01 | |||||
Soort interventie | constante supervisie met elektronisch traceringsmiddel (code = '121451000146100' in codeSystem 'SNOMED CT') | |||||
Reden van toepassen | afwenden van situatie die kan resulteren in toebrengen van schade aan zichzelf of aan anderen (code = '121481000146105' in codeSystem 'SNOMED CT') | |||||
Instemming | Instemming wettelijke vertegenwoordiger (code = '4' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.6.1') | |||||
Begin | T - 4 dagen |
1.11.4 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||
Gegevenselement | Waarde | |||||
Actuele patientproblemen | ||||||
Patientprobleem | ||||||
Probleem eovd-1-7-probleem-01 | ||||||
Probleem naam | acute verwardheid (code = '130987000' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||
Probleem begin datum | T - 5 dagen | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verpleegkundige interventie eovd-1-7-interventie-01 | ||||||
Interventie | omgevingsstimuli minimaliseren (code = '710978006' in codeSystem 'SNOMED Clinical Terms') | |||||
Indicatie | ||||||
Probleem | Zie Probleem: eovd-1-7-probleem-01 | |||||
Behandeldoel | ||||||
Gewenst zorgresultaat | DOSS < 3 | |||||
Zorgresultaat | ||||||
Uitkomst van zorg | ||||||
Zorgresultaat | DOSS = 2 | |||||
Interventie | ||||||
Verpleegkundige interventie | Zie Verpleegkundige interventie: eovd-1-7-interventie-01 |
1.12 Test Overdracht 1.8
1.12.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 2 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M. | |||||
Geslachtsnaam | ||||||
Achternaam | XXX_Koutrik | |||||
Adresgegevens | ||||||
Straat | Knolweg | |||||
Huisnummer | 1002 | |||||
Postcode | 9999ZZ | |||||
Woonplaats | STITSWERD | |||||
Adres soort | Woon-/verblijfadres (code = 'PHYS' in codeSystem 'HL7 AddressUse') | |||||
Identificatienummer | 999900067 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 1 jaar | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 12345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06121212 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | EF-zkh | |||||
Afdeling specialisme | Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Naamgegevens | ||||||
Voornamen | Bart | |||||
Geslachtsnaam | ||||||
Achternaam | Moorman | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 47707070 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | St. Zonnehof | |||||
Organisatie type | Verpleeghuis (code = 'R5' in codeSystem '2.16.840.1.113883.2.4.15.1060') |
1.12.2 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03848484 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | P. | |||||
Geslachtsnaam | ||||||
Achternaam | Boomsma | |||||
Specialisme | Medisch specialisten, urologie (code = '0306' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem naam | fistel tussen blaas en sigmoïd (code = '197861003') | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') |
1.12.3 Verpleegkundige context zorgplan
Verpleegkundige context zorgplan | ||||||
Gegevenselement | Waarde | |||||
Actuele patientproblemen | ||||||
Patientprobleem | ||||||
Probleem eovd-1.8-patientprobleem-01 | ||||||
Probleem naam | incontinentie voor feces (code = '72042002' in codeSystem 'Referentieset Nationale kernset patientproblemen') | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') | |||||
Verpleegkundige interventie | ||||||
Interventie | zorg bij fecale incontinentie (code = '386223004' in codeSystem 'SNOMED Clinical Terms') | |||||
Indicatie | ||||||
Probleem | Zie Probleem: eovd-1.8-patientprobleem-01 |
1.12.4 Verpleegkundige context specificatie gezondheidstoestand
Verpleegkundige context specificatie gezondheidstoestand | |||||||
Gegevenselement | Waarde | ||||||
Uitscheiding | |||||||
Blaasfunctie | |||||||
Urine katheter | |||||||
Medisch hulpmiddel | |||||||
Product | |||||||
Product type | Verblijfskatheter (code = '23973005' in codeSystem 'SNOMED CT') | ||||||
Product omschrijving | Verblijfskatheter | ||||||
Begin datum | T - 5 dagen | ||||||
Darmfunctie | |||||||
Feces continentie | Incontinent (code = '72042002' in codeSystem '2.16.840.1.113883.6.96 (ordinal = '0') | ||||||
Frequentie | 2 per dag | ||||||
Defecatie consistentie | Zachte stukjes met gehavende randen (code = 'Type 6' in codeSystem '2.16.840.1.113883.2.4.3.11.60.40.4.3.1') | ||||||
Defecatie kleur | Grijswit (code = '267056008' in codeSystem 'SNOMED CT') | ||||||
Incontinentiemateriaal | |||||||
Medisch hulpmiddel | |||||||
Product | |||||||
Product type | opvangzak voor fecesincontinentie (code = '469627000' in codeSystem 'SNOMED Clinical Terms') | ||||||
Product omschrijving | opvangzak voor fecesincontinentie |
1.13 Test Overdracht 1.9b
1.13.1 Administratieve gegevens
Administratieve gegevens | ||||||
Gegevenselement | Waarde | |||||
Datum overplaatsing | T + 10 dagen | |||||
Persoonsgegevens | ||||||
Patient | ||||||
Naamgegevens | ||||||
Initialen | M. | |||||
Geslachtsnaam | ||||||
Voorvoegsels | van | |||||
Achternaam | XXX_Hondius | |||||
Identificatienummer | 999900079 (in identificerend systeem: BSN) | |||||
Geboortedatum | 18 sep 1963 | |||||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | |||||
Betaler | ||||||
Verzekeraar | ||||||
Verzekering | ||||||
Eind datum tijd | T + 1 jaar | |||||
Verzekeringssoort | Basis (code = 'B' in codeSystem '2.16.840.1.113883.2.4.3.11.60.101.5.1') | |||||
Identificatie nummer | 9664 (in identificerend systeem: 2.16.840.1.113883.2.4.6.4) | |||||
Organisatie naam | Trias | |||||
Verzekerde nummer | 22345678 | |||||
Sturende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 06121212 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | EF-zkh | |||||
Organisatie type | Algemeen ziekenhuis (code = 'V6' in codeSystem '2.16.840.1.113883.2.4.15.1060') | |||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 91343434 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Voornamen | Veerle | |||||
Geslachtsnaam | ||||||
Achternaam | Henneman | |||||
Ontvangende organisatie | ||||||
Zorgaanbieder | ||||||
Zorgaanbieder identificatienummer | 75616161 (in identificerend systeem: AGB-Z) | |||||
Organisatie naam | HomeCare |
1.13.2 Medische context
Medische context | ||||||
Gegevenselement | Waarde | |||||
Behandelaar | ||||||
Zorgverlener | ||||||
Zorgverlener identificatienummer | 03454545 (in identificerend systeem: AGB-Z) | |||||
Naamgegevens | ||||||
Initialen | K. | |||||
Geslachtsnaam | ||||||
Achternaam | Bronsgeest | |||||
Specialisme | Medisch specialisten, neurologie (code = '0330' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | |||||
Medische diagnose | ||||||
Probleem | ||||||
Probleem naam | ziekte van Parkinson (code = '49049000' in codeSystem 'SNOMED CT') | |||||
Probleem status | Actueel (code = '55561003' in codeSystem 'SNOMED CT') |