A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to a patient/resident.

Referenced by an Order Request (workflow).

Identifiers assigned to this order by the order sender or by the order receiver.

The Identifier.type element can be to indicate filler vs. placer if needed. This is explained in further detail here.

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.

Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

The URL pointing to a protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.

The workflow status of the nutrition order/request.

Typically the system placing the order sets the status to "requested". Thereafter, the order is maintained by the receiver that updates the status as the request is handled. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Indicates the level of authority/intentionality associated with the NutrionOrder and where the request fits into the workflow chain.

Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

When resources map to this element, they are free to define as many codes as necessary to cover their space and will map to "proposal, plan or order". Can have multiple codes that map to one of these. E.g. "original order", "encoded order", "reflex order" would all map to "order". Expectation is that the set of codes is mutually exclusive or a strict all-encompassing hierarchy.

The person (patient) who needs the nutrition order for an oral diet, nutritional supplement and/or enteral or formula feeding.

An encounter that provides additional information about the healthcare context in which this request is made.

The date and time that this nutrition order was requested.

The practitioner that holds legal responsibility for ordering the diet, nutritional supplement, or formula feedings.

A link to a record of allergies or intolerances which should be included in the nutrition order.

Information on a patient's food allergies and intolerances to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.

This modifier is used to convey order-specific modifiers about the type of food that should be given. These can be derived from patient allergies, intolerances, or preferences such as Halal, Vegan or Kosher. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.

Information on a patient's food preferences that inform healthcare personnel about the food that the patient should receive or consume.

This modifier is used to convey Order-specific modifier about the type of oral food or oral fluids that should not be given. These can be derived from patient allergies, intolerances, or preferences such as No Red Meat, No Soy or No Wheat or Gluten-Free. While it should not be necessary to repeat allergy or intolerance information captured in the referenced AllergyIntolerance resource in the excludeFoodModifier, this element may be used to convey additional specificity related to foods that should be eliminated from the patient’s diet for any reason. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.

Information on a patient's food allergies, intolerances and preferences to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.

Diet given orally in contrast to enteral (tube) feeding.

The kind of diet or dietary restriction such as fiber restricted diet or diabetic diet.

The time period and frequency at which the diet should be given. The diet should be given for the combination of all schedules if more than one schedule is present.

Class that defines the quantity and type of nutrient modifications (for example carbohydrate, fiber or sodium) required for the oral diet.

The nutrient that is being modified such as carbohydrate or sodium.

The quantity of the specified nutrient to include in diet.

Class that describes any texture modifications required for the patient to safely consume various types of solid foods.

Any texture modifications (for solid foods) that should be made, e.g. easy to chew, chopped, ground, and pureed.

Coupled with the foodType (Meat).

The food type(s) (e.g. meats, all foods) that the texture modification applies to. This could be all foods types.

Coupled with the texture.modifier; could be (All Foods).

The required consistency (e.g. honey-thick, nectar-thick, thin, thickened.) of liquids or fluids served to the patient.

Free text or additional instructions or information pertaining to the oral diet.

Free text dosage instructions can be used for cases where the instructions are too complex to code.

Oral nutritional products given in order to add further nutritional value to the patient's diet.

The kind of nutritional supplement product required such as a high protein or pediatric clear liquid supplement.

The product or brand name of the nutritional supplement such as "Acme Protein Shake".

The time period and frequency at which the supplement(s) should be given. The supplement should be given for the combination of all schedules if more than one schedule is present.

The amount of the nutritional supplement to be given.

Free text or additional instructions or information pertaining to the oral supplement.

Free text dosage instructions can be used for cases where the instructions are too complex to code.

Feeding provided through the gastrointestinal tract via a tube, catheter, or stoma that delivers nutrition distal to the oral cavity.

The type of enteral or infant formula such as an adult standard formula with fiber or a soy-based infant formula.

The product or brand name of the enteral or infant formula product such as "ACME Adult Standard Formula".

Indicates the type of modular component such as protein, carbohydrate, fat or fiber to be provided in addition to or mixed with the base formula.

The product or brand name of the type of modular component to be added to the formula.

The amount of energy (calories) that the formula should provide per specified volume, typically per mL or fluid oz. For example, an infant may require a formula that provides 24 calories per fluid ounce or an adult may require an enteral formula that provides 1.5 calorie/mL.

The route or physiological path of administration into the patient's gastrointestinal tract for purposes of providing the formula feeding, e.g. nasogastric tube.

Formula administration instructions as structured data. This repeating structure allows for changing the administration rate or volume over time for both bolus and continuous feeding. An example of this would be an instruction to increase the rate of continuous feeding every 2 hours.

See implementation notes below for further discussion on how to order continuous vs bolus enteral feeding using this resource.

The time period and frequency at which the enteral formula should be delivered to the patient.

The volume of formula to provide to the patient per the specified administration schedule.

The rate of administration of formula via a feeding pump, e.g. 60 mL per hour, according to the specified schedule.

Ratio is used when the quantity value in the denominator is not "1", otherwise use Quantity. For example, the Ratio datatype is used for "200 mL/4 hrs" versus the Quantity datatype for "50 mL/hr".

The maximum total quantity of formula that may be administered to a subject over the period of time, e.g. 1440 mL over 24 hours.

Free text formula administration, feeding instructions or additional instructions or information.

Free text dosage instructions can be used for cases where the instructions are too complex to code.

Comments made about the {{title}} by the requester, performer, subject or other participants.

This element SHALL NOT be used to supply free text instructions for the diet which are represented in the .oralDiet.instruction, supplement.instruction, or enteralFormula.administrationInstruction elements.