ID
25591
Description
Muster 12 - Verordnung häuslicher Krankenpflege (Freigabe 01.09.2014). Formulare für die vertragsärztliche Versorgung - Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php --- Template 12 - Prescription of Home Nursing Care (Released 09-01-2014). Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php
Link
Keywords
Versions (5)
- 2/9/17 2/9/17 -
- 2/9/17 2/9/17 -
- 8/15/17 8/15/17 -
- 8/15/17 8/15/17 -
- 9/7/17 9/7/17 -
Copyright Holder
KBV
Uploaded on
September 7, 2017
DOI
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License
Creative Commons BY-NC 3.0
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KBV Prescription of Home Nursing Care Template 12
KBV Prescription of Home Nursing Care Template 12a
Description
Verordnung häuslicher Krankenpflege
Description
help by relatives
Data type
boolean
Alias
- UMLS CUI [1]
- C0581904
Description
primary prescription
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0033080
- UMLS CUI [1,2]
- C0205225
Description
subsequent prescription
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0033080
- UMLS CUI [1,2]
- C0332282
Description
Home Nursing start date
Data type
date
Alias
- UMLS CUI [1,1]
- C0019860
- UMLS CUI [1,2]
- C3173309
Description
Home Nursing end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0019860
- UMLS CUI [1,2]
- C1115730
Description
Accident
Data type
boolean
Alias
- UMLS CUI [1]
- C0000924
- UMLS CUI [2,1]
- C0686907
- UMLS CUI [2,2]
- C0000924
Description
prescription indication
Data type
text
Alias
- UMLS CUI [1,1]
- C0033080
- UMLS CUI [1,2]
- C0392360
Description
diagnosis
Data type
text
Alias
- UMLS CUI [1]
- C0011900
Description
Home Nursing
Data type
integer
Alias
- UMLS CUI [1]
- C0019860
Description
Folgende Maßnahmen sind notwendig
Description
instruction for treatment care
Data type
boolean
Alias
- UMLS CUI [1]
- C1828372
Description
treatment care
Data type
text
Alias
- UMLS CUI [1]
- C0011017
Description
application count
Data type
integer
Alias
- UMLS CUI [1,1]
- C0011017
- UMLS CUI [1,2]
- C0449788
Description
blood glucose
Data type
boolean
Alias
- UMLS CUI [1]
- C0392201
Description
blood glucose daily measurement frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C0392201
Description
blood glucose weekly measurement frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C0392201
Description
blood glucose measurement start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0392201
Description
blood glucose measurement end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0392201
Description
pressure ulcer
Data type
boolean
Alias
- UMLS CUI [1]
- C0011127
Description
pressure ulcer daily measurement frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C0011127
Description
pressure ulcer weekly measurement frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C0011127
Description
pressure ulcer measurement start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0011127
Description
pressure ulcer measurement end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0011127
Description
pressure ulcer
Data type
text
Alias
- UMLS CUI [1]
- C0558031
Description
Injection
Data type
boolean
Alias
- UMLS CUI [1]
- C1533685
Description
prepare Injection
Data type
boolean
Alias
- UMLS CUI [1,1]
- C1533685
- UMLS CUI [1,2]
- C0677212
Description
intramuscular Injection
Data type
boolean
Alias
- UMLS CUI [1]
- C0021492
Description
subcutaneous Injection
Data type
boolean
Alias
- UMLS CUI [1]
- C0021499
Description
injection daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C1533685
Description
injection weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C1533685
Description
injection start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C1533685
Description
injection end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C1533685
Description
Medication
Data type
boolean
Alias
- UMLS CUI [1]
- C0013227
Description
prepare medication
Data type
boolean
Alias
- UMLS CUI [1]
- C0677212
Description
drug administration
Data type
boolean
Alias
- UMLS CUI [1]
- C3469597
Description
injection daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C1533685
Description
injection weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0449237
- UMLS CUI [1,2]
- C1533685
Description
injection start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C1533685
Description
injection end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C1533685
Description
(auch bei Injektionen):
Data type
text
Alias
- UMLS CUI [1]
- C0013227
Description
dressing
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0278286
- UMLS CUI [1,2]
- C0179212
Description
dressing daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
wound dressing weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
dressingstart date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
dressing end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
dressing compression
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0278286
- UMLS CUI [1,2]
- C0179212
Description
dressing daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
wound dressing weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
dressingstart date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
dressing end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0278286
- UMLS CUI [1,3]
- C0179212
Description
dressing change
Data type
boolean
Alias
- UMLS CUI [1]
- C0085671
Description
dressing change daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0085671
Description
wound dressing change weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0085671
Description
dressingchange start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0085671
Description
dressing change end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0085671
Description
wound localization
Data type
text
Alias
- UMLS CUI [1,1]
- C3266792
Description
other treatment care
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0087111
- UMLS CUI [2,2]
- C0439603
- UMLS CUI [3,1]
- C0087111
- UMLS CUI [3,2]
- C0444921
Description
other treatment care
Data type
text
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0087111
- UMLS CUI [2,2]
- C0439603
- UMLS CUI [3,1]
- C0087111
- UMLS CUI [3,2]
- C0444921
Description
Grundpflege
Description
basic care education
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0509072
- UMLS CUI [1,2]
- C1828372
Description
basic care
Data type
text
Alias
- UMLS CUI [1]
- C0509072
Description
basic care application count
Data type
integer
Alias
- UMLS CUI [1,1]
- C0509072
- UMLS CUI [1,2]
- C0449788
Description
excretion
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0221102
Description
excretion daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0221102
Description
excretion weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0221102
Description
excretion start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0221102
Description
excretion end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0221102
Description
nutrition
Data type
boolean
Alias
- UMLS CUI [1]
- C0392209
Description
nutrition daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0392209
Description
nutrition weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0392209
Description
nutrition start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0392209
Description
nutrition end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0392209
Description
body care
Data type
boolean
Alias
- UMLS CUI [1]
- C0036592
Description
body care daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0036592
Description
body care weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0036592
Description
body care start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0036592
Description
body care end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0036592
Description
Hauswirtschaftliche Versorgung:
Description
housework help daily frequency
Data type
integer
Measurement units
- x tgl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0442519
- UMLS CUI [1,3]
- C1290949
Description
housework help weekly frequency
Data type
integer
Measurement units
- x wtl.
Alias
- UMLS CUI [1,1]
- C0439603
- UMLS CUI [1,2]
- C0442519
- UMLS CUI [1,3]
- C1290949
Description
housework help start date
Data type
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0442519
- UMLS CUI [1,3]
- C1290949
Description
housework help end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0806020
- UMLS CUI [1,2]
- C0442519
- UMLS CUI [1,3]
- C1290949
Description
Antrag des Versicherten auf Genehmigung häuslicher Krankenpflege
Description
nursing care start date
Data type
date
Alias
- UMLS CUI [1,1]
- C0019860
- UMLS CUI [1,2]
- C0808070
Description
nursing care end date
Data type
date
Alias
- UMLS CUI [1,1]
- C0019860
- UMLS CUI [1,2]
- C0806020
Description
home nursing location
Data type
integer
Alias
- UMLS CUI [1,1]
- C0019860
- UMLS CUI [1,2]
- C0450429
Description
Name
Data type
text
Alias
- UMLS CUI [1]
- C0027365
Description
Street
Data type
text
Alias
- UMLS CUI [1]
- C1301826
Description
postal code
Data type
text
Alias
- UMLS CUI [1]
- C1514254
- UMLS CUI [2]
- C2316883
Description
telephone number
Data type
integer
Alias
- UMLS CUI [1]
- C1515258
Description
care by relatives
Data type
text
Alias
- UMLS CUI [1]
- C0581007
Description
no care from relatives
Data type
boolean
Alias
- UMLS CUI [1]
- C0581007
Description
visiting nurses
Data type
boolean
Alias
- UMLS CUI [1]
- C0042799
Description
Brieffuß
Description
Angaben des Pflegedienstes
Description
Leistungen
Description
Die Pflege wird durchgeführt von einem zugelassenen Pflegedienst:
Description
nursing service
Data type
text
Alias
- UMLS CUI [1]
- C0028697
Description
Address
Data type
text
Alias
- UMLS CUI [1]
- C0376649
Description
Facility Identifier
Data type
text
Alias
- UMLS CUI [1]
- C2986045
Description
Contact person
Data type
text
Alias
- UMLS CUI [1]
- C0337611
Description
telephone number
Data type
integer
Alias
- UMLS CUI [1]
- C1515258
Description
fax number
Data type
integer
Alias
- UMLS CUI [1]
- C1549619
Description
Brieffuß
Similar models
KBV Prescription of Home Nursing Care Template 12a
C0205225 (UMLS CUI [1,2])
C0332282 (UMLS CUI [1,2])
C3173309 (UMLS CUI [1,2])
C1115730 (UMLS CUI [1,2])
C0686907 (UMLS CUI [2,1])
C0000924 (UMLS CUI [2,2])
C0392360 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0392201 (UMLS CUI [1,2])
C0392201 (UMLS CUI [1,2])
C0392201 (UMLS CUI [1,2])
C0392201 (UMLS CUI [1,2])
C0011127 (UMLS CUI [1,2])
C0011127 (UMLS CUI [1,2])
C0011127 (UMLS CUI [1,2])
C0011127 (UMLS CUI [1,2])
C0677212 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C1533685 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,2])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0179212 (UMLS CUI [1,2])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0278286 (UMLS CUI [1,2])
C0179212 (UMLS CUI [1,3])
C0085671 (UMLS CUI [1,2])
C0085671 (UMLS CUI [1,2])
C0085671 (UMLS CUI [1,2])
C0085671 (UMLS CUI [1,2])
C0087111 (UMLS CUI [2,1])
C0439603 (UMLS CUI [2,2])
C0087111 (UMLS CUI [3,1])
C0444921 (UMLS CUI [3,2])
C0087111 (UMLS CUI [2,1])
C0439603 (UMLS CUI [2,2])
C0087111 (UMLS CUI [3,1])
C0444921 (UMLS CUI [3,2])
C1828372 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0221102 (UMLS CUI [1,2])
C0221102 (UMLS CUI [1,2])
C0221102 (UMLS CUI [1,2])
C0221102 (UMLS CUI [1,2])
C0392209 (UMLS CUI [1,2])
C0392209 (UMLS CUI [1,2])
C0392209 (UMLS CUI [1,2])
C0392209 (UMLS CUI [1,2])
C0036592 (UMLS CUI [1,2])
C0036592 (UMLS CUI [1,2])
C0036592 (UMLS CUI [1,2])
C0036592 (UMLS CUI [1,2])
C0442519 (UMLS CUI [1,2])
C1290949 (UMLS CUI [1,3])
C0442519 (UMLS CUI [1,2])
C1290949 (UMLS CUI [1,3])
C0442519 (UMLS CUI [1,2])
C1290949 (UMLS CUI [1,3])
C0442519 (UMLS CUI [1,2])
C1290949 (UMLS CUI [1,3])
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