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4.18.5 Resource NutritionOrder - Detailed Descriptions

Detailed Descriptions for the elements in the NutritionOrder resource.

NutritionOrder
Definition

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

Control1..1
Alternate NamesDiet Order; Diet; Nutritional Supplement; Enteral Nutrition
Comments

Referenced by an Order Request (workflow).

InvariantsDefined on this element
nor-1: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class (xpath: exists(f:oralDiet) or exists(f:supplement) or exists(f:enteralFormula))
NutritionOrder.patient
Definition

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

Control1..1
TypeReference(Patient)
Summarytrue
NutritionOrder.orderer
Definition

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

Control0..1
TypeReference(Practitioner)
Summarytrue
NutritionOrder.identifier
Definition

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

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
NutritionOrder.encounter
Definition

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

Control0..1
TypeReference(Encounter)
NutritionOrder.dateTime
Definition

The date and time that this nutrition order was requested.

Control1..1
TypedateTime
Summarytrue
NutritionOrder.status
Definition

The workflow status of the nutrition order/request.

Control0..1
BindingNutritionOrderStatus: Required: http://hl7.org/fhir/nutrition-order-status (Codes specifying the state of the request. Describes the lifecycle of the nutrition order.)
Typecode
Is Modifiertrue
Summarytrue
Comments

Typically the system placing the order sets the status to requested. There after, the order is maintained by the receiver that updates the status as the request is handled.

NutritionOrder.allergyIntolerance
Definition

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

Control0..*
TypeReference(AllergyIntolerance)
Comments

Information on a patient's food allergies and intolerances, inform healthcare personnel about the type of foods that the patient should receive or consume.

NutritionOrder.foodPreferenceModifier
Definition

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.

Control0..*
BindingPatientDiet: Example: See http://hl7.org/fhir/vs/encounter-diet (Medical, cultural or ethical food preferences to help with catering requirements)
TypeCodeableConcept
Comments

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

NutritionOrder.excludeFoodModifier
Definition

This modifier is used to convey order-specific modifiers about the type of food 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. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.

Control0..*
BindingFoodType: Example: See http://hl7.org/fhir/vs/food-type (Codes used to indicate the type of food that should NOT be given to the patient.)
TypeCodeableConcept
Comments

Information on a patient's food allergies and intolerances, and preferences inform healthcare personnel about the type of foods that the patient should receive or consume.

NutritionOrder.oralDiet
Definition

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

Control0..1
InvariantsAffect this element
nor-1: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class (xpath: exists(f:oralDiet) or exists(f:supplement) or exists(f:enteralFormula))
NutritionOrder.oralDiet.type
Definition

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

Control0..*
BindingOralDiet: Example: See http://hl7.org/fhir/vs/diet-type (Codes used to indicate the type of diet being ordered for a patient.)
TypeCodeableConcept
Summarytrue
NutritionOrder.oralDiet.scheduled
Definition

The time period and frequency at which the diet should be given.

Control0..1
TypeTiming
Alternate Namesfrequency
NutritionOrder.oralDiet.nutrient
Definition

Class that defines the quantity and type of nutrient modifications required for the oral diet.

Control0..*
NutritionOrder.oralDiet.nutrient.modifier
Definition

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

Control0..1
BindingNutrientModifier: Example: See http://hl7.org/fhir/vs/nutrient-code (Codes for types of nutrient that is being modified such as carbohydrate or sodium.)
TypeCodeableConcept
NutritionOrder.oralDiet.nutrient.amount
Definition

The quantity of the specified nutrient to include in diet.

Control0..1
TypeQuantity
NutritionOrder.oralDiet.texture
Definition

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

Control0..*
NutritionOrder.oralDiet.texture.modifier
Definition

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

Control0..1
BindingTextureModifier: Example: See http://hl7.org/fhir/vs/texture-code (Codes for food consistency types or texture modifications to apply to foods.)
TypeCodeableConcept
Comments

Coupled with the foodType (Meat).

NutritionOrder.oralDiet.texture.foodType
Definition

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

Control0..1
BindingTextureModifiedFoodType: Example: See http://hl7.org/fhir/vs/modified-foodtype (Codes for types of foods that are texture modified.)
TypeCodeableConcept
Comments

Coupled with the textureModifier; could be (All Foods).

NutritionOrder.oralDiet.fluidConsistencyType
Definition

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

Control0..*
BindingFluidConsistencyType: Example: See http://hl7.org/fhir/vs/consistency-type (Codes used to represent the consistency of fluids and liquids provided to the patient.)
TypeCodeableConcept
NutritionOrder.oralDiet.instruction
Definition

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

Control0..1
Typestring
Comments

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

NutritionOrder.supplement
Definition

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

Control0..*
InvariantsAffect this element
nor-1: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class (xpath: exists(f:oralDiet) or exists(f:supplement) or exists(f:enteralFormula))
NutritionOrder.supplement.type
Definition

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

Control0..1
BindingSupplementType: Example: See http://hl7.org/fhir/vs/supplement-type (Codes for nutritional supplements to be provided to the patient)
TypeCodeableConcept
Summarytrue
NutritionOrder.supplement.productName
Definition

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

Control0..1
Typestring
NutritionOrder.supplement.scheduled
Definition

The time period and frequency at which the supplement(s) should be given.

Control0..1
TypeTiming
Alternate Namesfrequency
NutritionOrder.supplement.quantity
Definition

The amount of the nutritional supplement to be given.

Control0..1
TypeQuantity
NutritionOrder.supplement.instruction
Definition

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

Control0..1
Typestring
Comments

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

NutritionOrder.enteralFormula
Definition

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

Control0..1
InvariantsAffect this element
nor-1: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class (xpath: exists(f:oralDiet) or exists(f:supplement) or exists(f:enteralFormula))
NutritionOrder.enteralFormula.administrationInstructions
Definition

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

Control0..1
Typestring
Comments

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

NutritionOrder.enteralFormula.baseFormulaType
Definition

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

Control0..1
BindingEnteralFormulaType: Example: See http://hl7.org/fhir/vs/entformula-type (Codes for type of enteral formula to be administered to patient.)
TypeCodeableConcept
Summarytrue
NutritionOrder.enteralFormula.baseFormulaProductName
Definition

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

Control0..1
Typestring
NutritionOrder.enteralFormula.scheduled
Definition

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

Control0..1
TypeTiming
Alternate Namesfrequency
NutritionOrder.enteralFormula.additiveType
Definition

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.

Control0..1
BindingEnteralFormulaAdditiveType: Example: See http://hl7.org/fhir/vs/entformula-additive (Codes for the type of modular component such as protein, carbohydrate or fiber to be provided in addition to or mixed with the base formula.)
TypeCodeableConcept
NutritionOrder.enteralFormula.additiveProductName
Definition

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

Control0..1
Typestring
NutritionOrder.enteralFormula.caloricDensity
Definition

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 the provides 24 Calories per fluid ounce or an adult may require an enteral formula that provides 1.5 Calorie/mL.

Control0..1
TypeQuantity
NutritionOrder.enteralFormula.routeofAdministration
Definition

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

Control0..1
BindingEnteralRouteOfAdministration: Required: See http://hl7.org/fhir/vs/enteral-route (Codes specifying the route of administration of enteral formula.)
TypeCodeableConcept
NutritionOrder.enteralFormula.quantity
Definition

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

Control0..1
TypeQuantity
NutritionOrder.enteralFormula.rate
Definition

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

Control0..1
TypeRatio
NutritionOrder.enteralFormula.rateAdjustment
Definition

The change in the rate of administration over a given time, e.g. increase by 10 mL/hour every 4 hours.

Control0..1
TypeQuantity
NutritionOrder.enteralFormula.maxVolumeToDeliver
Definition

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.

Control0..1
TypeQuantity