New Zealand Rheumatic Fever FHIR Implementation Guide
1.0.0 - draft

New Zealand Rheumatic Fever FHIR Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Questionnaire: Secondary Prophylaxis Health Assessment Questionnaire

Official URL: https://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/SecondaryProphylaxisHealthAssessmentQuestionnaire Version: 1.0.0
Draft as of 2023-11-10 Computable Name: SecondaryProphylaxisHealthAssessmentQuestionnaire
Other Identifiers: SecondaryProphylaxisHealthAssessmentQuestionnaire (use: official, period: 10/16/23 --> (ongoing))

Gathers information about patient health at a secondary prophylaxis medication appointment

Gathers information about patient health at a secondary prophylaxis medication appointment

Generated Narrative: Questionnaire SecondaryProphylaxisHealthAssessmentQuestionnaire

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. SecondaryProphylaxisHealthAssessmentQuestionnaireGathers information about patient health at a secondary prophylaxis medication appointmentQuestionnairehttps://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/SecondaryProphylaxisHealthAssessmentQuestionnaire#1.0.0
... page1page1. Please complete this questionnaire at the secondary prophylaxis appointment to assess a rheumatic fever patient's health.0..1display
... ReasonsInjectionOverdue2). Reason(s) injection was give late? (multiple choice)1..*choiceOptions: 10 options
... OverdueInjectionOtherDetail3). Other details for late injection (enter text)1..1text
... PainManagementOtherDetails11.1). Details of other pain management (enter text)1..1textEnable When: OtherPainManagementToolsUsed =
... PostInjectionConcern12). Post injection concern or possible reaction identified?1..1booleanInitial Value: boolean = false
... PostInjectionConcernDetails12.1). If Yes, Record Details, Symptoms, Actions Taken and Follow-Up Plan (enter text)1..1textEnable When: PostInjectionConcern =
... AnyOtherConcerns13). Were There Any Other Concerns or Issues Identified During the Visit?1..1booleanInitial Value: boolean = false
... OtherConcernsDetail13.1). If yes, describe details, actions taken, and follow-up planned (enter text)1..1textEnable When: AnyOtherConcerns =
... HealthEducationTopicsDiscussed14). Health education topics discussed? (multiple choice)1..*choiceOptions: 10 options
... HealthEducationOtherDetail14.1). Enter details of other health education topic discussed (enter text)1..1textEnable When: HealthEducationTopicsDiscussed =
... RecentOrUpcomingAppointments15). Any recent or upcoming follow-up appointments?1..1boolean
... RecentOrUpcomingAppointmentsDetails15.1). Enter details and dates of any recent or upcoming follow-up appointments (enter text)1..1textEnable When: RecentOrUpcomingAppointments =
... PlanForNextMedicationAppointment16). Comments for the next appointment (enter text)1..1text

doco Documentation for this format

Options Sets

Answer options for ReasonsInjectionOverdue

  • Previously Care On-Hold
  • Unable to Contact Patient
  • Patient Not Available on the Day
  • Patient Declined Treatment
  • INR Too High
  • Patient Lost to Follow-Up
  • Service Delayed To Follow-Up
  • Service Unavailable on the Day
  • Service Error
  • Other

Answer options for OtherPainManagementToolsUsed

  • Ice pack
  • Buzzy bee
  • Numbing cream (Emla)
  • Numbing spray
  • Distraction
  • Very slow injection
  • Other

Answer options for HealthEducationTopicsDiscussed

  • Secondary prophylaxis
  • Sore Throat Management
  • Skin Infection Management
  • Dental Health
  • Endocarditis Prophylaxis
  • Nutrition
  • Physical Activity
  • Healthy Home Environments
  • Sexual Health
  • Other