ID

20173

Description

Muster 12 - Verordnung häuslicher Krankenpflege (Freigabe 01.09.2014). 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

www.kbv.de

Keywords

Versions (5)
  1. 2/9/17 2/9/17 -
  2. 2/9/17 2/9/17 -
  3. 8/15/17 8/15/17 -
  4. 8/15/17 8/15/17 -
  5. 9/7/17 9/7/17 -
Uploaded on

February 9, 2017

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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KBV Prescription of Home Nursing Care Template 12

German

KBV Prescription of Home Nursing Care Template 12

1 forms  
Briefkopf
Description

Briefkopf

Name der Krankenversicherung
Description

Health Insurance name

Data type

text

Alias
UMLS CUI [1]
C0021682
Nachname
Description

Patient surname

Data type

text

Alias
UMLS CUI [1]
C0421448
Patientenname
Description

Patient Name

Data type

text

Alias
UMLS CUI [1]
C1299487
Adresse des Patienten
Description

Patient address

Data type

text

Alias
UMLS CUI [1]
C0421449
Patient Geburtsdatum
Description

Patient Birth Date

Data type

date

Alias
UMLS CUI [1]
C0421451
Kostenträgerkennung
Description

Insurance ID

Data type

integer

Alias
UMLS CUI [1]
C1547687
Versichertennummer
Description

Insurance number

Data type

integer

Alias
UMLS CUI [1]
C1549712
Status
Description

Status

Data type

integer

Alias
UMLS CUI [1]
C0449438
Betriebsstättennummer
Description

Facility number

Data type

integer

Alias
UMLS CUI [1]
C1549700
Arzt- Nr.
Description

Physician ID number

Data type

integer

Alias
UMLS CUI [1]
C1548646
Datum
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
Verordnung häuslicher Krankenpflege
Description

Verordnung häuslicher Krankenpflege

Die Beurteilung, ob eine im Haushalt lebende Person die verordnete(n) Maßnahme(n) übernehmen kann, ist nicht möglich.
Description

help by relatives

Data type

boolean

Alias
UMLS CUI [1]
C0581904
Erstverordnung
Description

primary prescription

Data type

boolean

Alias
UMLS CUI [1,1]
C0033080
UMLS CUI [1,2]
C0205225
Folgeverordnung
Description

subsequent prescription

Data type

boolean

Alias
UMLS CUI [1,1]
C0033080
UMLS CUI [1,2]
C0332282
vom
Description

Home Nursing start date

Data type

date

Alias
UMLS CUI [1,1]
C0019860
UMLS CUI [1,2]
C3173309
bis
Description

Home Nursing end date

Data type

date

Alias
UMLS CUI [1,1]
C0019860
UMLS CUI [1,2]
C1115730
Unfall Unfallfolgen
Description

accident

Data type

boolean

Alias
UMLS CUI [1]
C0000924
UMLS CUI [2,1]
C0686907
UMLS CUI [2,2]
C0000924
Begründung bei Verordnungsdauer über 14 Tagen:
Description

prescription indication

Data type

text

Alias
UMLS CUI [1,1]
C0033080
UMLS CUI [1,2]
C0392360
Verordnungsrelevante Diagnose(n) Besonderheiten lt. Verzeichnis:
Description

diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
Häusliche Krankenpflege erfolgt:
Description

Home Nursing

Data type

integer

Alias
UMLS CUI [1]
C0019860
Folgende Maßnahmen sind notwendig
Description

Folgende Maßnahmen sind notwendig

Anleitung zur Behandlungspflege
Description

instruction for treatment care

Data type

boolean

Alias
UMLS CUI [1]
C1828372
folgende Leistungen
Description

treatment care

Data type

text

Alias
UMLS CUI [1]
C0011017
Anzahl/Einsätze
Description

application count

Data type

integer

Alias
UMLS CUI [1,1]
C0011017
UMLS CUI [1,2]
C0449788
Blutzuckermessung
Description

blood glucose

Data type

boolean

Alias
UMLS CUI [1]
C0392201
Häufigkeit
Description

blood glucose daily measurement frequency

Data type

integer

Measurement units
  • x tgl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C0392201
x tgl.
Häufigkeit
Description

blood glucose weekly measurement frequency

Data type

integer

Measurement units
  • x wtl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C0392201
x wtl.
vom
Description

blood glucose measurement start date

Data type

date

Alias
UMLS CUI [1,1]
C3173309
UMLS CUI [1,2]
C0392201
bis
Description

blood glucose measurement end date

Data type

date

Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C0392201
Dekubitusbehandlung
Description

pressure ulcer

Data type

boolean

Alias
UMLS CUI [1]
C0011127
Häufigkeit
Description

pressure ulcer daily measurement frequency

Data type

integer

Measurement units
  • x tgl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C0011127
x tgl.
Häufigkeit
Description

pressure ulcer weekly measurement frequency

Data type

integer

Measurement units
  • x wtl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C0011127
x wtl.
vom
Description

pressure ulcer measurement start date

Data type

date

Alias
UMLS CUI [1,1]
C3173309
UMLS CUI [1,2]
C0011127
bis
Description

pressure ulcer measurement end date

Data type

date

Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C0011127
Lokalisation / Grad / Größe:
Description

pressure ulcer

Data type

text

Alias
UMLS CUI [1]
C0558031
Injektionen:
Description

Injection

Data type

boolean

Alias
UMLS CUI [1]
C1533685
Injektionen:
Description

prepare Injection

Data type

boolean

Alias
UMLS CUI [1,1]
C1533685
UMLS CUI [1,2]
C0677212
i.m.
Description

intramuscular Injection

Data type

boolean

Alias
UMLS CUI [1]
C0021492
s.c.
Description

subcutaneous Injection

Data type

boolean

Alias
UMLS CUI [1]
C0021499
Häufigkeit
Description

injection daily frequency

Data type

integer

Measurement units
  • x tgl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C1533685
x tgl.
Häufigkeit
Description

injection weekly frequency

Data type

integer

Measurement units
  • x wtl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C1533685
x wtl.
vom
Description

injection start date

Data type

date

Alias
UMLS CUI [1,1]
C3173309
UMLS CUI [1,2]
C1533685
bis
Description

injection end date

Data type

date

Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C1533685
Medikamentengabe:
Description

Medication

Data type

boolean

Alias
UMLS CUI [1]
C0013227
herrichten
Description

prepare medication

Data type

boolean

Alias
UMLS CUI [1]
C0677212
verabreichen
Description

drug administration

Data type

boolean

Alias
UMLS CUI [1]
C3469597
Häufigkeit
Description

injection daily frequency

Data type

integer

Measurement units
  • x tgl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C1533685
x tgl.
Häufigkeit
Description

injection weekly frequency

Data type

integer

Measurement units
  • x wtl.
Alias
UMLS CUI [1,1]
C0449237
UMLS CUI [1,2]
C1533685
x wtl.
vom
Description

injection start date

Data type

date

Alias
UMLS CUI [1,1]
C3173309
UMLS CUI [1,2]
C1533685
bis
Description

injection end date

Data type

date

Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C1533685
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Similar models

KBV Prescription of Home Nursing Care Template 12

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Briefkopf
Health Insurance name
Item
Name der Krankenversicherung
text
C0021682 (UMLS CUI [1])
Patient surname
Item
Nachname
text
C0421448 (UMLS CUI [1])
Patient Name
Item
Patientenname
text
C1299487 (UMLS CUI [1])
Patient address
Item
Adresse des Patienten
text
C0421449 (UMLS CUI [1])
Patient Birth Date
Item
Patient Geburtsdatum
date
C0421451 (UMLS CUI [1])
Insurance ID
Item
Kostenträgerkennung
integer
C1547687 (UMLS CUI [1])
Insurance number
Item
Versichertennummer
integer
C1549712 (UMLS CUI [1])
Status
Item
Status
integer
C0449438 (UMLS CUI [1])
Facility number
Item
Betriebsstättennummer
integer
C1549700 (UMLS CUI [1])
Physician ID number
Item
Arzt- Nr.
integer
C1548646 (UMLS CUI [1])
Date
Item
Datum
date
C0011008 (UMLS CUI [1])
Item Group
Verordnung häuslicher Krankenpflege
help by relatives
Item
Die Beurteilung, ob eine im Haushalt lebende Person die verordnete(n) Maßnahme(n) übernehmen kann, ist nicht möglich.
boolean
C0581904 (UMLS CUI [1])
primary prescription
Item
Erstverordnung
boolean
C0033080 (UMLS CUI [1,1])
C0205225 (UMLS CUI [1,2])
subsequent prescription
Item
Folgeverordnung
boolean
C0033080 (UMLS CUI [1,1])
C0332282 (UMLS CUI [1,2])
Home Nursing start date
Item
vom
date
C0019860 (UMLS CUI [1,1])
C3173309 (UMLS CUI [1,2])
Home Nursing end date
Item
bis
date
C0019860 (UMLS CUI [1,1])
C1115730 (UMLS CUI [1,2])
accident
Item
Unfall Unfallfolgen
boolean
C0000924 (UMLS CUI [1])
C0686907 (UMLS CUI [2,1])
C0000924 (UMLS CUI [2,2])
prescription indication
Item
Begründung bei Verordnungsdauer über 14 Tagen:
text
C0033080 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
diagnosis
Item
Verordnungsrelevante Diagnose(n) Besonderheiten lt. Verzeichnis:
text
C0011900 (UMLS CUI [1])
Item
Häusliche Krankenpflege erfolgt:
integer
C0019860 (UMLS CUI [1])
Home Nursing
Code List
Häusliche Krankenpflege erfolgt:
CL Item
statt Krankenhausbehandlung (1)
CL Item
zur Sicherung der ambulanten ärztlichen Behandlung (2)
Item Group
Folgende Maßnahmen sind notwendig
instruction for treatment care
Item
Anleitung zur Behandlungspflege
boolean
C1828372 (UMLS CUI [1])
treatment care
Item
folgende Leistungen
text
C0011017 (UMLS CUI [1])
application count
Item
Anzahl/Einsätze
integer
C0011017 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
blood glucose
Item
Blutzuckermessung
boolean
C0392201 (UMLS CUI [1])
blood glucose daily measurement frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C0392201 (UMLS CUI [1,2])
blood glucose weekly measurement frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C0392201 (UMLS CUI [1,2])
blood glucose measurement start date
Item
vom
date
C3173309 (UMLS CUI [1,1])
C0392201 (UMLS CUI [1,2])
blood glucose measurement end date
Item
bis
date
C0806020 (UMLS CUI [1,1])
C0392201 (UMLS CUI [1,2])
pressure ulcer
Item
Dekubitusbehandlung
boolean
C0011127 (UMLS CUI [1])
pressure ulcer daily measurement frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C0011127 (UMLS CUI [1,2])
pressure ulcer weekly measurement frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C0011127 (UMLS CUI [1,2])
pressure ulcer measurement start date
Item
vom
date
C3173309 (UMLS CUI [1,1])
C0011127 (UMLS CUI [1,2])
pressure ulcer measurement end date
Item
bis
date
C0806020 (UMLS CUI [1,1])
C0011127 (UMLS CUI [1,2])
pressure ulcer
Item
Lokalisation / Grad / Größe:
text
C0558031 (UMLS CUI [1])
Injection
Item
Injektionen:
boolean
C1533685 (UMLS CUI [1])
prepare Injection
Item
Injektionen:
boolean
C1533685 (UMLS CUI [1,1])
C0677212 (UMLS CUI [1,2])
intramuscular Injection
Item
i.m.
boolean
C0021492 (UMLS CUI [1])
subcutaneous Injection
Item
s.c.
boolean
C0021499 (UMLS CUI [1])
injection daily frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
injection weekly frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
injection start date
Item
vom
date
C3173309 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
injection end date
Item
bis
date
C0806020 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
Medication
Item
Medikamentengabe:
boolean
C0013227 (UMLS CUI [1])
prepare medication
Item
herrichten
boolean
C0677212 (UMLS CUI [1])
drug administration
Item
verabreichen
boolean
C3469597 (UMLS CUI [1])
injection daily frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
injection weekly frequency
Item
Häufigkeit
integer
C0449237 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
injection start date
Item
vom
date
C3173309 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
injection end date
Item
bis
date
C0806020 (UMLS CUI [1,1])
C1533685 (UMLS CUI [1,2])
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