| Package | hl7.fhir.cz.hdr |
| Resource Type | StructureDefinition |
| Id | LogAdmissionEvaluationCz |
| FHIR Version | R4 |
| Source | https://hl7.cz/fhir/hdr/https://build.fhir.org/ig/HL7-cz/hdr/StructureDefinition-LogAdmissionEvaluationCz.html |
| URL | https://hl7.cz/fhir/hdr/StructureDefinition/LogAdmissionEvaluationCz |
| Version | 0.0.2 |
| Status | draft |
| Date | 2025-07-18T09:03:32+00:00 |
| Name | LogCzAdmissionEvaluation |
| Title | A.2.4 - Stav při přijetí (cz) |
| Realm | cz |
| Authority | hl7 |
| Description | Nemocniční propouštěcí zpráva - Stav při přijetí - A.2.4 CZ poznámka: Nepovinná sekce uvádět pouze v případě významu pro zajištění kontinuity péče. |
| Type | https://hl7.cz/fhir/hdr/StructureDefinition/LogAdmissionEvaluationCz |
| Kind | logical |
| StructureDefinition | |
| LogHospitalDischargeReportCz | A - Propouštěcí zpráva |
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: StructureDefinition LogAdmissionEvaluationCz
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  LogAdmissionEvaluationCz | 0..* | Base | A.2.4 - Stav při přijetí (cz) | |
  objektivniNalez | 0..1 | BackboneElement | A.2.4.1 - Objektivní nález | |
  datum | 0..1 | dateTime | A.2.4.1.1 - Datum a čas | |
| provedl | 0..1 | BackboneElement | A.2.4.1.2 - Provedl | |
| anthropometrickeUdaje | 0..* | BackboneElement | A.2.4.1.3 - Anthropometrické údaje | |
| text | 0..1 | BackboneElement | A.2.4.1.3.1 - Výsledky měření textem | |
 vysledek | 0..1 | BackboneElement | A.2.4.1.3.2 - Parametrický záznam vyšetření | |
 popisVysetreni | 1..1 | BackboneElement | A.2.4.1.3.2.1 - Popis vyšetření | |
| formalizovany | 1..1 | BackboneElement | A.2.4.1.3.2.2 - Výsledek vyšetření formalizovaný | |
| provedl | 0..* | BackboneElement | A.2.4.1.3.2.3 - Provedl | |
| zakladniZivotniFunkce | 0..* | BackboneElement | A.2.4.1.4 - Základní životní funkce | |
| typVysetreni | 1..1 | string | A.2.4.1.4.1 - Typ Vyšetření | |
| text | 1..1 | BackboneElement | A.2.4.1.4.2 - Výsledek vyšetření textem | |
| vysledek | 1..1 | BackboneElement | A.2.4.1.4.3 - Parametrický záznam vyšetření | |
| popisVysetreni | 1..1 | BackboneElement | A.2.4.1.4.3.1 - Popis vyšetření | |
| formalizovany | 1..1 | BackboneElement | A.2.4.1.4.3.2 - Výsledek vyšetření formalizovaný | |
| provedl | 0..* | BackboneElement | A.2.4.1.4.3.3 - Provedl | |
| somatickeVysetreni | 0..1 | BackboneElement | A.2.4.1.5 - Somatické vyšetření | |
| text | 1..1 | string | A.2.4.1.5.1 - Výsledek vyšetření textem | |
| provedl | 0..* | BackboneElement | A.2.4.1.5.2 - Provedl | |
| funkcniStav | 0..1 | BackboneElement | A.2.4.2 - Funkční stav | |
| datum | 0..1 | dateTime | A.2.4.2.1 - Datum a čas | |
| provedl | 0..* | BackboneElement | A.2.4.2.2 - Provedl | |
| popis | 1..1 | string | A.2.4.2.3 - Popis | |
| hodnoceniFormalizovane | 0..* | BackboneElement | A.2.4.2.4 - Hodnocení formalizované | |
| datumVzniku | 0..1 | dateTime | A.2.4.2.4.1 - Datum vzniku | |
| text | 0..1 | BackboneElement | A.2.4.2.4.2 - Výsledek vyšetření textem | |
| popis | 1..1 | BackboneElement | A.2.4.2.4.3 - Popis vyšetření | |
| formalizovany | 1..1 | BackboneElement | A.2.4.2.4.4 - Výsledek vyšetření formalizovaný | |
| Documentation for this format | ||||
FHIR{
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"id": "LogAdmissionEvaluationCz",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
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"publisher": "HL7 Czech Republic",
"contact": [
{
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"jurisdiction": [
{
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"path": "LogAdmissionEvaluationCz.objektivniNalez.datum",
"short": "A.2.4.1.1 - Datum a čas",
"definition": "Datum a čas vyšetření pacienta lékařem v průběhu jeho přijímání k hospitalizaci",
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"short": "A.2.4.1.2 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
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"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje",
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"short": "A.2.4.1.3 - Anthropometrické údaje",
"definition": "Výsledky antropometrických měření pacienta: Požadované: výška, hmotnost, BMI (automatický výpočet z uvedených hodnot) Volitelné: obvod hlavy, hrudníku, břicha…",
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"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.modifierExtension",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.popisVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.popisVysetreni",
"short": "A.2.4.1.3.2.1 - Popis vyšetření",
"definition": "Popis vyšetření včetně kódu vyšetření, vyšetřované oblasti či vzorku, datum a čas odběru vzorku.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.popisVysetreni",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.formalizovany",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.formalizovany",
"short": "A.2.4.1.3.2.2 - Výsledek vyšetření formalizovaný",
"definition": "Výsledek vyšetření textem a/nebo ve formě číselných a kódovaných výsledků měření. Obsah výsledku vyšetření se bude lišit podle typu vyšetření.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.formalizovany",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.provedl",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.provedl",
"short": "A.2.4.1.3.2.3 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.provedl",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce",
"short": "A.2.4.1.4 - Základní životní funkce",
"definition": "Výsledky měření základních životních funkcí pacienta: Požadované: Tepová frekvence, dechová frekvence, TK s uvedením strany měření, Volitelné: Saturace 02",
"min": 0,
"max": "*",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.id",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.extension",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.modifierExtension",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.typVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.typVysetreni",
"short": "A.2.4.1.4.1 - Typ Vyšetření",
"definition": "Klasifikace typu vyšetření. Zde fixní hodnota: vital-signs",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.typVysetreni",
"min": 1,
"max": "1"
},
"type": [
{
"code": "string"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.text",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.text",
"short": "A.2.4.1.4.2 - Výsledek vyšetření textem",
"definition": "Textový popis výsledku vyšetření",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.text",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek",
"short": "A.2.4.1.4.3 - Parametrický záznam vyšetření",
"definition": "Parametrický zápis výsledku vyšetření.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.id",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.extension",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.modifierExtension",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.popisVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.popisVysetreni",
"short": "A.2.4.1.4.3.1 - Popis vyšetření",
"definition": "Popis vyšetření včetně kódu vyšetření, vyšetřované oblasti či vzorku, datum a čas odběru vzorku.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.popisVysetreni",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.formalizovany",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.formalizovany",
"short": "A.2.4.1.4.3.2 - Výsledek vyšetření formalizovaný",
"definition": "Výsledek vyšetření textem a/nebo ve formě číselných a kódovaných výsledků měření. Obsah výsledku vyšetření se bude lišit podle typu vyšetření.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.formalizovany",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.provedl",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.provedl",
"short": "A.2.4.1.4.3.3 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.provedl",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni",
"short": "A.2.4.1.5 - Somatické vyšetření",
"definition": "Vyšetření pomocí smyslů vyšetřujícího (pohledem, poslechem, pohmatem a poklepem) a posuzování, zda se takto zjištěné nálezy odchylují od normy. Pokud ano, označujeme tyto odchylky jako objektivní příznaky (angl. signs).",
"min": 0,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni",
"min": 0,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.id",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.extension",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.modifierExtension",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.text",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.text",
"short": "A.2.4.1.5.1 - Výsledek vyšetření textem",
"definition": "Textový popis výsledku vyšetření. Mělo by být strukturováno podle časti těla (e.g. Hlava, krk, ramena, ruce, ...)",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.text",
"min": 1,
"max": "1"
},
"type": [
{
"code": "string"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.provedl",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.provedl",
"short": "A.2.4.1.5.2 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"base": {
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.provedl",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav",
"path": "LogAdmissionEvaluationCz.funkcniStav",
"short": "A.2.4.2 - Funkční stav",
"definition": "Funkční stav lze hodnotit několika různými způsoby, obvykle se zaměřením na schopnosti osoby vykonávat základní aktivity každodenního života (ADL), které zahrnují základní sebeobsluhu, jako je koupání, krmení a toaleta a instrumentální aktivity každodenního života (IADL), které zahrnují činnosti jako vaření, nakupování a řízení vlastních záležitostí.",
"min": 0,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav",
"min": 0,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.id",
"path": "LogAdmissionEvaluationCz.funkcniStav.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.extension",
"path": "LogAdmissionEvaluationCz.funkcniStav.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.modifierExtension",
"path": "LogAdmissionEvaluationCz.funkcniStav.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.datum",
"path": "LogAdmissionEvaluationCz.funkcniStav.datum",
"short": "A.2.4.2.1 - Datum a čas",
"definition": "Datum a čas hodnocení funkčního stavu pacienta.",
"min": 0,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.datum",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.provedl",
"path": "LogAdmissionEvaluationCz.funkcniStav.provedl",
"short": "A.2.4.2.2 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.provedl",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.popis",
"path": "LogAdmissionEvaluationCz.funkcniStav.popis",
"short": "A.2.4.2.3 - Popis",
"definition": "Textový popis funkčního stavu pacienta.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.popis",
"min": 1,
"max": "1"
},
"type": [
{
"code": "string"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane",
"short": "A.2.4.2.4 - Hodnocení formalizované",
"definition": "Formalizované hodnocení funkčního stavu pacienta dle jednotlivých hodnotících kategorií zvoleného systému hodnocení (např. MKF)",
"min": 0,
"max": "*",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.id",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.extension",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.modifierExtension",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.datumVzniku",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.datumVzniku",
"short": "A.2.4.2.4.1 - Datum vzniku",
"definition": "Datum vzniku funkčního omezení",
"min": 0,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.datumVzniku",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.text",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.text",
"short": "A.2.4.2.4.2 - Výsledek vyšetření textem",
"definition": "Výsledek vyšetření volným textem.",
"min": 0,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.popis",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.popis",
"short": "A.2.4.2.4.3 - Popis vyšetření",
"definition": "Popis vyšetření včetně kódu. Jako výchozí systém pro hodnocení funkčního stavu byl zvolen mezinárodní klasifikační systém MKF. Další typy hodnotících škál mohou být doplněny v budoucích verzích standardu na základě potřeby a konsenzu odborné veřejnosti.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.popis",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.formalizovany",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.formalizovany",
"short": "A.2.4.2.4.4 - Výsledek vyšetření formalizovaný",
"definition": "Výsledek hodnocení funkčního stavu v dané kategorii hodnocení.",
"min": 1,
"max": "1",
"base": {
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.formalizovany",
"min": 1,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
]
}
]
},
"differential": {
"element": [
{
"id": "LogAdmissionEvaluationCz",
"path": "LogAdmissionEvaluationCz",
"short": "A.2.4 - Stav při přijetí (cz)",
"definition": "Nemocniční propouštěcí zpráva - Stav při přijetí - A.2.4 CZ poznámka: Nepovinná sekce uvádět pouze v případě významu pro zajištění kontinuity péče. "
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez",
"path": "LogAdmissionEvaluationCz.objektivniNalez",
"short": "A.2.4.1 - Objektivní nález ",
"definition": "Objektivní nález",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.datum",
"path": "LogAdmissionEvaluationCz.objektivniNalez.datum",
"short": "A.2.4.1.1 - Datum a čas",
"definition": "Datum a čas vyšetření pacienta lékařem v průběhu jeho přijímání k hospitalizaci",
"min": 0,
"max": "1",
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.provedl",
"path": "LogAdmissionEvaluationCz.objektivniNalez.provedl",
"short": "A.2.4.1.2 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje",
"short": "A.2.4.1.3 - Anthropometrické údaje",
"definition": "Výsledky antropometrických měření pacienta: Požadované: výška, hmotnost, BMI (automatický výpočet z uvedených hodnot) Volitelné: obvod hlavy, hrudníku, břicha…",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.text",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.text",
"short": "A.2.4.1.3.1 - Výsledky měření textem",
"definition": "Textový popis výsledku vyšetření",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek",
"short": "A.2.4.1.3.2 - Parametrický záznam vyšetření",
"definition": "Parametrický zápis výsledku vyšetření.",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.popisVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.popisVysetreni",
"short": "A.2.4.1.3.2.1 - Popis vyšetření",
"definition": "Popis vyšetření včetně kódu vyšetření, vyšetřované oblasti či vzorku, datum a čas odběru vzorku.",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.formalizovany",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.formalizovany",
"short": "A.2.4.1.3.2.2 - Výsledek vyšetření formalizovaný",
"definition": "Výsledek vyšetření textem a/nebo ve formě číselných a kódovaných výsledků měření. Obsah výsledku vyšetření se bude lišit podle typu vyšetření.",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.provedl",
"path": "LogAdmissionEvaluationCz.objektivniNalez.anthropometrickeUdaje.vysledek.provedl",
"short": "A.2.4.1.3.2.3 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce",
"short": "A.2.4.1.4 - Základní životní funkce",
"definition": "Výsledky měření základních životních funkcí pacienta: Požadované: Tepová frekvence, dechová frekvence, TK s uvedením strany měření, Volitelné: Saturace 02",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.typVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.typVysetreni",
"short": "A.2.4.1.4.1 - Typ Vyšetření",
"definition": "Klasifikace typu vyšetření. Zde fixní hodnota: vital-signs",
"min": 1,
"max": "1",
"type": [
{
"code": "string"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.text",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.text",
"short": "A.2.4.1.4.2 - Výsledek vyšetření textem",
"definition": "Textový popis výsledku vyšetření",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek",
"short": "A.2.4.1.4.3 - Parametrický záznam vyšetření",
"definition": "Parametrický zápis výsledku vyšetření.",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.popisVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.popisVysetreni",
"short": "A.2.4.1.4.3.1 - Popis vyšetření",
"definition": "Popis vyšetření včetně kódu vyšetření, vyšetřované oblasti či vzorku, datum a čas odběru vzorku.",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.formalizovany",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.formalizovany",
"short": "A.2.4.1.4.3.2 - Výsledek vyšetření formalizovaný",
"definition": "Výsledek vyšetření textem a/nebo ve formě číselných a kódovaných výsledků měření. Obsah výsledku vyšetření se bude lišit podle typu vyšetření.",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.provedl",
"path": "LogAdmissionEvaluationCz.objektivniNalez.zakladniZivotniFunkce.vysledek.provedl",
"short": "A.2.4.1.4.3.3 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni",
"short": "A.2.4.1.5 - Somatické vyšetření",
"definition": "Vyšetření pomocí smyslů vyšetřujícího (pohledem, poslechem, pohmatem a poklepem) a posuzování, zda se takto zjištěné nálezy odchylují od normy. Pokud ano, označujeme tyto odchylky jako objektivní příznaky (angl. signs). ",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.text",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.text",
"short": "A.2.4.1.5.1 - Výsledek vyšetření textem",
"definition": "Textový popis výsledku vyšetření. Mělo by být strukturováno podle časti těla (e.g. Hlava, krk, ramena, ruce, ...)",
"min": 1,
"max": "1",
"type": [
{
"code": "string"
}
]
},
{
"id": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.provedl",
"path": "LogAdmissionEvaluationCz.objektivniNalez.somatickeVysetreni.provedl",
"short": "A.2.4.1.5.2 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav",
"path": "LogAdmissionEvaluationCz.funkcniStav",
"short": "A.2.4.2 - Funkční stav",
"definition": "Funkční stav lze hodnotit několika různými způsoby, obvykle se zaměřením na schopnosti osoby vykonávat základní aktivity každodenního života (ADL), které zahrnují základní sebeobsluhu, jako je koupání, krmení a toaleta a instrumentální aktivity každodenního života (IADL), které zahrnují činnosti jako vaření, nakupování a řízení vlastních záležitostí.",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.datum",
"path": "LogAdmissionEvaluationCz.funkcniStav.datum",
"short": "A.2.4.2.1 - Datum a čas",
"definition": "Datum a čas hodnocení funkčního stavu pacienta.",
"min": 0,
"max": "1",
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.provedl",
"path": "LogAdmissionEvaluationCz.funkcniStav.provedl",
"short": "A.2.4.2.2 - Provedl",
"definition": "Identifikuje osobu, která vyšetření provedla nebo je zdrojem informací o výsledku vyšetření. Tato osoba nemusí být totožná s autorem dokumentu.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.popis",
"path": "LogAdmissionEvaluationCz.funkcniStav.popis",
"short": "A.2.4.2.3 - Popis",
"definition": "Textový popis funkčního stavu pacienta.",
"min": 1,
"max": "1",
"type": [
{
"code": "string"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane",
"short": "A.2.4.2.4 - Hodnocení formalizované",
"definition": "Formalizované hodnocení funkčního stavu pacienta dle jednotlivých hodnotících kategorií zvoleného systému hodnocení (např. MKF)",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.datumVzniku",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.datumVzniku",
"short": "A.2.4.2.4.1 - Datum vzniku",
"definition": "Datum vzniku funkčního omezení",
"min": 0,
"max": "1",
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.text",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.text",
"short": "A.2.4.2.4.2 - Výsledek vyšetření textem",
"definition": "Výsledek vyšetření volným textem.",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.popis",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.popis",
"short": "A.2.4.2.4.3 - Popis vyšetření",
"definition": "Popis vyšetření včetně kódu. Jako výchozí systém pro hodnocení funkčního stavu byl zvolen mezinárodní klasifikační systém MKF. Další typy hodnotících škál mohou být doplněny v budoucích verzích standardu na základě potřeby a konsenzu odborné veřejnosti. ",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.formalizovany",
"path": "LogAdmissionEvaluationCz.funkcniStav.hodnoceniFormalizovane.formalizovany",
"short": "A.2.4.2.4.4 - Výsledek vyšetření formalizovaný",
"definition": "Výsledek hodnocení funkčního stavu v dané kategorii hodnocení.",
"min": 1,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
]
}
]
}
}