ID

18708

Description

Hospital Routine Documentation Subform at the University Hospital Muenster. Original Form name: Wunddokumentation Sub.

Keywords

Versions (2)
  1. 11/4/16 11/4/16 -
  2. 11/17/16 11/17/16 -
Uploaded on

November 17, 2016

DOI

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License

Creative Commons BY-NC 3.0
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Wunddokumentation Sub University Hospital Muenster (UKM) Subform

German

Wunddokumentation Sub University Hospital Muenster (UKM) Subform

1 forms  
Wundbeschreibung
Description

Wundbeschreibung

Alias
UMLS CUI-1
C0558033
Pat.
Description

Name of patient

Data type

text

Alias
UMLS CUI [1]
C0421448
Gebutsdatum
Description

Date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Alter der Wunde
Description

Wound age

Data type

text

Alias
UMLS CUI [1]
C0043250
date
Description

date

Data type

boolean

Alias
UMLS CUI [1]
C0011008
Kommt mit Wunde
Description

Arrival with wound

Data type

text

Alias
UMLS CUI [1,1]
C0043250
UMLS CUI [1,2]
C0030673
Andere Einrichtung
Description

Institution

Data type

text

Alias
UMLS CUI [1]
C1301943
Entstehung am
Description

Date of emergence

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0043250
Entstehung unklar
Description

Emergence unclear

Data type

text

Alias
UMLS CUI [1]
C0043250
Entstehung unklar (Text)
Description

Emergence unclear (text)

Data type

text

Alias
UMLS CUI [1]
C0043250
Pat. hat in digitale Bilddok. eingewilligt
Description

Consent to digital documentation of images

Data type

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0920316
Wundheilung
Description

Wound healing

Data type

text

Alias
UMLS CUI [1]
C1320404
Operative Versorgung
Description

Surgical care

Data type

text

Alias
UMLS CUI [1]
C0543467
Infektionsstatus
Description

State of infection

Data type

text

Alias
UMLS CUI [1]
C0517627
Wundabstrich
Description

Wound swab

Data type

boolean

Alias
UMLS CUI [1]
C0444086
letzter Wundabstrich
Description

Latest wound swab

Data type

text

Alias
UMLS CUI [1]
C0444086
bestätigter Keim
Description

Germ confirmed

Data type

text

Alias
UMLS CUI [1]
C0004611
Infektionszeichen
Description

Signs of infection

Data type

boolean

Alias
UMLS CUI [1]
C0513965
Infektionszeichen (Text)
Description

Signs of infection (text)

Data type

text

Alias
UMLS CUI [1]
C0513965
Wundheilung beeinfl. Faktoren
Description

Factors influencing wound healing

Data type

text

Alias
UMLS CUI [1,1]
C1320404
UMLS CUI [1,2]
C0814287
Wundform/-grad
Description

Form/degree of wound

Data type

text

Alias
UMLS CUI [1]
C0558033
Wundgröße
Description

Wound size

Data type

text

Measurement units
  • cm
Alias
UMLS CUI [1]
C3853328
cm
Tiefe (Daniel)
Description

Wound depth (Daniel)

Data type

text

Alias
UMLS CUI [1]
C1543248
Zustand (Seiler)
Description

Wound condition (Seiler)

Data type

text

Alias
UMLS CUI [1]
C0548297
Wundbemerkung
Description

Comment

Data type

text

Alias
UMLS CUI [1,1]
C0043250
UMLS CUI [1,2]
C0947611
Wundstadium
Description

Wound stage

Data type

text

Alias
UMLS CUI [1]
C1276783
Wundheilungsphase
Description

Wundheilungsphase

Alias
UMLS CUI-1
C1320404
Exsudationsphase
Description

Exsudative phase

Data type

boolean

Alias
UMLS CUI [1,1]
C0021381
UMLS CUI [1,2]
C1320404
Nekrose
Description

Necrosis

Data type

integer

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0027540
UMLS CUI [1,2]
C1320404
%
Fibrin
Description

Fibrin

Data type

integer

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0015982
UMLS CUI [1,2]
C1320404
%
Exsudationsphase (Text)
Description

Exudative phase (text)

Data type

text

Alias
UMLS CUI [1,1]
C0021381
UMLS CUI [1,2]
C1320404
Granulationsphase
Description

Granulationphase

Data type

boolean

Alias
UMLS CUI [1,1]
C0574734
UMLS CUI [1,2]
C1320404
Granulationsgewebe
Description

Granulation tissue

Data type

integer

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0018180
UMLS CUI [1,2]
C1320404
%
Granulationsphase (Text)
Description

Granulation phase (text)

Data type

text

Alias
UMLS CUI [1,1]
C0574734
UMLS CUI [1,2]
C1320404
Epithelisierungsphase
Description

Epithelization phase

Data type

boolean

Alias
UMLS CUI [1,1]
C0334029
UMLS CUI [1,2]
C1320404
Epithelisierung
Description

Epithelization

Data type

integer

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0334029
UMLS CUI [1,2]
C1320404
%
Epithelisierungsphase (Text)
Description

Epithelization phase (text)

Data type

text

Alias
UMLS CUI [1,1]
C0334029
UMLS CUI [1,2]
C1320404
Exsudation
Description

Exsudation

Alias
UMLS CUI-1
C0311437
Exsudation der Wunde
Description

Exudation of wound

Data type

text

Alias
UMLS CUI [1,1]
C0311437
UMLS CUI [1,2]
C0043250
Exsudat
Description

Exudate

Data type

text

Alias
UMLS CUI [1]
C0015388
Geruch Exsudation
Description

Smell exudation

Data type

boolean

Alias
UMLS CUI [1,1]
C0015388
UMLS CUI [1,2]
C0037361
Geruch Exsudation (Text)
Description

Smell exudation (text)

Data type

text

Alias
UMLS CUI [1,1]
C0015388
UMLS CUI [1,2]
C0037361
Menge Exsudation
Description

Amount of exudation

Data type

integer

Measurement units
  • ml
Alias
UMLS CUI [1,1]
C0015388
UMLS CUI [1,2]
C1265611
ml
Menge Exsudation (Genauigkeit)
Description

Amount of exudation (accuracy)

Data type

text

Alias
UMLS CUI [1,1]
C0015388
UMLS CUI [1,2]
C1265611
Weitere Faktoren
Description

Weitere Faktoren

Geruch der Wunde
Description

Smell of wound

Data type

boolean

Alias
UMLS CUI [1,1]
C0043250
UMLS CUI [1,2]
C0037361
Geruch der Wunde (Text)
Description

Smell of wound (text)

Data type

text

Alias
UMLS CUI [1,1]
C0043250
UMLS CUI [1,2]
C0037361
Wundränder
Description

Margin of wound

Data type

text

Alias
UMLS CUI [1]
C1545981
Wundumgebung
Description

Wound environment

Data type

text

Alias
UMLS CUI [1]
C2116843
Intensität Wundschmerz
Description

Intensity of wound pain

Data type

text

Alias
UMLS CUI [1,1]
C3840282
UMLS CUI [1,2]
C0043250
Wundschmerz Bemerkungen
Description

Wound pain, comments

Data type

text

Alias
UMLS CUI [1,1]
C3840282
UMLS CUI [1,2]
C0043250
Schmerzbehandlung
Description

Treatment of wound pain

Data type

text

Alias
UMLS CUI [1,1]
C0002766
UMLS CUI [1,2]
C0043250
Bemerkungen
Description

Comments

Data type

text

Alias
UMLS CUI [1]
C0947611
Digitale Bilder
Description

Digital images

Data type

boolean

Alias
UMLS CUI [1]
C0920316
Pat. hat eingewilligt
Description

Patient consented

Data type

boolean

Alias
UMLS CUI [1]
C0021430
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Similar models

Wunddokumentation Sub University Hospital Muenster (UKM) Subform

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Wundbeschreibung
C0558033 (UMLS CUI-1)
Name of patient
Item
Pat.
text
C0421448 (UMLS CUI [1])
Date of birth
Item
Gebutsdatum
date
C0421451 (UMLS CUI [1])
Item
Alter der Wunde
text
C0043250 (UMLS CUI [1])
Wound age
Code List
Alter der Wunde
CL Item
akut (< 8 Wochen) (akut (< 8 Wochen))
CL Item
chronisch (> 8 Wochen) (chronisch (> 8 Wochen))
date
Item
boolean
C0011008 (UMLS CUI [1])
Item
Kommt mit Wunde
text
C0043250 (UMLS CUI [1,1])
C0030673 (UMLS CUI [1,2])
Arrival with wound
Code List
Kommt mit Wunde
CL Item
zu Hause (zu Hause)
CL Item
andere Einrichtung (andere Einrichtung)
Institution
Item
Andere Einrichtung
text
C1301943 (UMLS CUI [1])
Date of emergence
Item
Entstehung am
date
C0011008 (UMLS CUI [1,1])
C0043250 (UMLS CUI [1,2])
Emergence unclear
Item
Entstehung unklar
text
C0043250 (UMLS CUI [1])
Emergence unclear (text)
Item
Entstehung unklar (Text)
text
C0043250 (UMLS CUI [1])
Consent to digital documentation of images
Item
Pat. hat in digitale Bilddok. eingewilligt
boolean
C0021430 (UMLS CUI [1,1])
C0920316 (UMLS CUI [1,2])
Item
Wundheilung
text
C1320404 (UMLS CUI [1])
Wound healing
Code List
Wundheilung
CL Item
operative Versorgung (operative Versorgung)
CL Item
primär (primär)
CL Item
sekundär (sekundär)
Surgical care
Item
Operative Versorgung
text
C0543467 (UMLS CUI [1])
Item
Infektionsstatus
text
C0517627 (UMLS CUI [1])
State of infection
Code List
Infektionsstatus
CL Item
aseptisch (aseptisch)
CL Item
kontaminiert (kontaminiert)
CL Item
infiziert/septisch (infiziert/septisch)
Wound swab
Item
Wundabstrich
boolean
C0444086 (UMLS CUI [1])
Latest wound swab
Item
letzter Wundabstrich
text
C0444086 (UMLS CUI [1])
Germ confirmed
Item
bestätigter Keim
text
C0004611 (UMLS CUI [1])
Signs of infection
Item
Infektionszeichen
boolean
C0513965 (UMLS CUI [1])
Signs of infection (text)
Item
Infektionszeichen (Text)
text
C0513965 (UMLS CUI [1])
Factors influencing wound healing
Item
Wundheilung beeinfl. Faktoren
text
C1320404 (UMLS CUI [1,1])
C0814287 (UMLS CUI [1,2])
Form/degree of wound
Item
Wundform/-grad
text
C0558033 (UMLS CUI [1])
Wound size
Item
Wundgröße
text
C3853328 (UMLS CUI [1])
Wound depth (Daniel)
Item
Tiefe (Daniel)
text
C1543248 (UMLS CUI [1])
Wound condition (Seiler)
Item
Zustand (Seiler)
text
C0548297 (UMLS CUI [1])
Comment
Item
Wundbemerkung
text
C0043250 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Wound stage
Item
Wundstadium
text
C1276783 (UMLS CUI [1])
Item Group
Wundheilungsphase
C1320404 (UMLS CUI-1)
Exsudative phase
Item
Exsudationsphase
boolean
C0021381 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Necrosis
Item
Nekrose
integer
C0027540 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Fibrin
Item
Fibrin
integer
C0015982 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Exudative phase (text)
Item
Exsudationsphase (Text)
text
C0021381 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Granulationphase
Item
Granulationsphase
boolean
C0574734 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Granulation tissue
Item
Granulationsgewebe
integer
C0018180 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Granulation phase (text)
Item
Granulationsphase (Text)
text
C0574734 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Epithelization phase
Item
Epithelisierungsphase
boolean
C0334029 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Epithelization
Item
Epithelisierung
integer
C0334029 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Epithelization phase (text)
Item
Epithelisierungsphase (Text)
text
C0334029 (UMLS CUI [1,1])
C1320404 (UMLS CUI [1,2])
Item Group
Exsudation
C0311437 (UMLS CUI-1)
Exudation of wound
Item
Exsudation der Wunde
text
C0311437 (UMLS CUI [1,1])
C0043250 (UMLS CUI [1,2])
Exudate
Item
Exsudat
text
C0015388 (UMLS CUI [1])
Smell exudation
Item
Geruch Exsudation
boolean
C0015388 (UMLS CUI [1,1])
C0037361 (UMLS CUI [1,2])
Smell exudation (text)
Item
Geruch Exsudation (Text)
text
C0015388 (UMLS CUI [1,1])
C0037361 (UMLS CUI [1,2])
Amount of exudation
Item
Menge Exsudation
integer
C0015388 (UMLS CUI [1,1])
C1265611 (UMLS CUI [1,2])
Item
Menge Exsudation (Genauigkeit)
text
C0015388 (UMLS CUI [1,1])
C1265611 (UMLS CUI [1,2])
Amount of exudation measures/estimated
Code List
Menge Exsudation (Genauigkeit)
CL Item
gemessen (gemessen)
CL Item
geschätzt (geschätzt)
Item Group
Weitere Faktoren
Smell of wound
Item
Geruch der Wunde
boolean
C0043250 (UMLS CUI [1,1])
C0037361 (UMLS CUI [1,2])
Smell of wound (text)
Item
Geruch der Wunde (Text)
text
C0043250 (UMLS CUI [1,1])
C0037361 (UMLS CUI [1,2])
Margin of wound
Item
Wundränder
text
C1545981 (UMLS CUI [1])
Wound environment
Item
Wundumgebung
text
C2116843 (UMLS CUI [1])
Intensity of wound pain
Item
Intensität Wundschmerz
text
C3840282 (UMLS CUI [1,1])
C0043250 (UMLS CUI [1,2])
Wound pain, comments
Item
Wundschmerz Bemerkungen
text
C3840282 (UMLS CUI [1,1])
C0043250 (UMLS CUI [1,2])
Treatment of wound pain
Item
Schmerzbehandlung
text
C0002766 (UMLS CUI [1,1])
C0043250 (UMLS CUI [1,2])
Comments
Item
Bemerkungen
text
C0947611 (UMLS CUI [1])
Digital images
Item
Digitale Bilder
boolean
C0920316 (UMLS CUI [1])
Patient consented
Item
Pat. hat eingewilligt
boolean
C0021430 (UMLS CUI [1])
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