TEMPLATE Wound Assessment Panel (Wound Assessment Panel)

TEMPLATE IDWound Assessment Panel
ConceptWound Assessment Panel
DescriptionTo represent the HL7 FHIR Profile: Skin and Wound Assessment, Release 1 in openEHR
PurposeTo represent the HL7 FHIR Profile: Skin and Wound Assessment, Release 1 in openEHR
References
Authorsdate: 2019-03-18; author: Heather Leslie
Other Details Languagedate: 2019-03-18; author: Heather Leslie
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=openEHR Foundation, PARENT:MD5-CAM-1.0.1=42A758CADEF3767E390EB8187F98AFF5, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=6620f07f03a829fa5fce883098b4c41f}
Language useden
Citeable Identifier1013.26.215
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Units:
  • cm
  • [in_i]
  • mm
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0037], code=at0037, itemType=ELEMENT, level=2, text=woundWidth, description=Width of the wound (perpendicular to longest dimension)., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_QUANTITY, bindings=null, values=>=0; >=0; >=0
Units:
  • cm
  • mm
  • [in_i]
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Units:
  • cm
  • mm
  • [in_i]
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Units:
  • cm2
  • mm2
  • [sin_i]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0048], code=at0048, itemType=ELEMENT, level=2, text=woundEdgeDescription, description=Description about the edge of the wound., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0049], code=at0049, itemType=ELEMENT, level=2, text=woundEdgeColor, description=Colour of the wound edge., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0057], code=at0057, itemType=ELEMENT, level=2, text=woundPeriwoundDescription, description=Description of the skin surrounding the wound., comment=Multiple occurrences allow for the use of coded text to describe various aspects of the skin around the wound., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0060], code=at0060, itemType=CLUSTER, level=2, text=woundPressureUlcerAssociation, description=Details about factors that may be associated with the wound., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0060]/items[at0061], code=at0061, itemType=ELEMENT, level=3, text=Factor, description=Associated factor that may causing or influencing the healing of the wound., comment=For example: a device; or pressure point., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=
  • Device
  • Pressure point
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  • Present 
  • Absent 
  • Indeterminate 
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  • Percent
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  • Percent
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0014], code=at0014, itemType=CLUSTER, level=2, text=woundVisibleInternalStructure, description=Details about the observation of any exposed body structures, devices, and/or foreign bodies visible by the naked eye in a wound., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0014]/items[at0015], code=at0015, itemType=ELEMENT, level=3, text=Object/structure, description=Idnetification of an exposed body structure, device, and/or foreign body visible by the naked eye within the wound., comment=Coding of the visible internal structure if preferred, if possible., uncommonOntologyItems=null, occurencesFormal=1..*, occurencesText=Mandatory, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0014]/items[at0020], code=at0020, itemType=ELEMENT, level=3, text=Present or absent?, description=Is the object/structure present?, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present 
  • Absent 
  • Indeterminate 
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0017], code=at0017, itemType=ELEMENT, level=2, text=woundTunnellingPresentOrAbsent, description=Is tunnelling present in the wound?, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present 
  • Absent 
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0045], code=at0045, itemType=CLUSTER, level=2, text=woundTunnellingObservation, description=Details about tunnelling into other tissues., comment=Multiple occurrences of this cluster will allow recording about each tunnel that leads from the wound., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0045]/items[at0046], code=at0046, itemType=ELEMENT, level=3, text=woundTunnelLength, description=Length of an identified tunnel radiating out from the centre of the wound., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_QUANTITY, bindings=null, values=>=0; >=0; >=0
Units:
  • cm
  • mm
  • [in_i]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0045]/items[at0047], code=at0047, itemType=ELEMENT, level=3, text=woundTunnelClockDirection, description=Direction of the tunnel radiating outward from the centre of the wound, as described by a clock-face., comment=For example: one o'clock., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0013], code=at0013, itemType=ELEMENT, level=2, text=woundUnderminingPresentOrAbsent, description=Is undermining present in the wound?, comment=For example: color; induration; warmth; or oedema., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present 
  • Absent 
  • Indeterminate 
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0041], code=at0041, itemType=CLUSTER, level=2, text=woundUnderminingObservation, description=Details about undermining of the wound., comment=Multiple occurrences of this cluster will allow recording of the undermining occurring in different parts of the wound., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[at0041]/items[at0042], code=at0042, itemType=ELEMENT, level=3, text=woundUnderminingLength, description=Amount of tissue destruction that extends under the intact wound edge., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_QUANTITY, bindings=null, values=>=0; >=0; >=0
Units:
  • cm
  • mm
  • [in_i]
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  • Present 
  • Absent 
  • Indeterminate 
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[openEHR-EHR-CLUSTER.exam_body_fluid.v0]/items[at0003], code=at0003, itemType=ELEMENT, level=2, text=woundExudateAppearance, description=Narrative description about the fluid., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[openEHR-EHR-CLUSTER.exam_body_fluid.v0]/items[at0014], code=at0014, itemType=ELEMENT, level=2, text=woundExudateAmount, description=Description of the amount of fluid observed at the identified body site., comment=The intent of this data element is to record either a narrative description of the amount, or to code with a value set such as small/medium/profuse or normal/increased where appropriate in a template. This data element is not intended for quantitative assessment of body fluids - use OBSERVATION.fluid_output for this purpose., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[openEHR-EHR-CLUSTER.exam_body_fluid.v0]/items[at0018], code=at0018, itemType=ELEMENT, level=2, text=woundExudateColor, description=Description of the colour of the body fluid., comment=The intent of this data element is to record either a narrative description of the colour, or to code with a value set where appropriate in a template., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-OBSERVATION.exam.v1]/data[at0001]/events[at0002]/data[at0003]/items[openEHR-EHR-CLUSTER.exam_wound.v0]/items[openEHR-EHR-CLUSTER.exam_body_fluid.v0]/items[at0017], code=at0017, itemType=ELEMENT, level=2, text=woundExudateOdor, description=Description of the smell of the body fluid., comment=The intent of this data element is to record either a narrative description of the odour, or to code with a value set where appropriate in a template., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=Value set: external, extendedValues=null], ResourceSimplifiedHierarchyItem 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