archetype (adl_version=1.4; uid=02b49d5d-22ee-45eb-be87-80866ecb5dbb)
	openEHR-EHR-EVALUATION.cpr_decision_uk.v0

concept
	[at0000]	-- CPR decision
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"Ian McNicoll">
		["organisation"] = <"freshEHR, UK">
		["email"] = <"ian@freshehr.com">
		["date"] = <"2013-10-11">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record the outcome of a clinical decision as to whether cardio-pulmonary resuscitation should be undertaken or not. This is generally referred to in UK clinical guidance as the CPR (Cardio-pulmonary resuscitation) decision.

This archetype is closely aligned with with the UK Information Standards Board (ISB) standard covering Core Content.">
			use = <"If cardiac or respiratory arrest is an expected part of the dying process and it is the opinion of the senior responsible clinician that attempted cardiopulmonary resuscitation would be unsuccessful or the outcome would be unacceptably burdensome for the person, the making and recording of this clinician’s opinion and recommendation for future management should a cardiopulmonary arrest occur, may be made. These are ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) orders. 

Some patients with capacity to make their own decision may refuse attempted cardio pulmonary resuscitation in advance. These decisions have to be registered as part of an advance decision to refuse treatment (ADRT).">
			keywords = <"DNACPR", "resuscitation", "EoL", "directive", "preference">
			misuse = <"This archetype should not be used to convey the results of other advanced directives, patient preferences or resusciation activity *e.g. suction) which falls short of full cardio-pulminary resuscitation.">
			copyright = <"© Apperta Foundation">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"Appeet Foundation">
		["references"] = <"Information Standards Board ISB Data Dictionary Available at http://www.datadictionary.nhs.uk/

End of Life Care Co-ordination: Core Content Standard Specification Available at http://www.isb.nhs.uk/documents/isb-1580/amd-29-2012/index_html

NHS Scotland Key Information Summary

Leeds ePaccs team">
		["original_namespace"] = <"uk.org.clinicalmodels">
		["original_publisher"] = <"UK Clinical Models">
		["custodian_namespace"] = <"uk.org.apperta">
		["MD5-CAM-1.0.1"] = <"E37E04B211256676D357F175E28E71C6">
		["build_uid"] = <"87ccfa0a-57f8-4345-9da5-f3a7d334939d">
		["ip_acknowledgements"] = <"This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomedct or info@snomed.org.">
		["revision"] = <"0.0.1-alpha">
	>

definition
	EVALUATION[at0000] matches {    -- CPR decision
		data matches {
			ITEM_TREE[at0001] matches {    -- Tree
				items cardinality matches {0..*; unordered} matches {
					ELEMENT[at0003] occurrences matches {0..1} matches {    -- CPR decision
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0004,    -- CPR attempts recommended adult or child
									at0005,    -- CPR attempts not recommended adult or child.
									at0022,    -- CPR decision status unknown
									at0027]    -- For modified CPR child only
								}
							}
						}
					}
					ELEMENT[at0002] occurrences matches {0..1} matches {    -- Date of CPR decision
						value matches {
							DV_DATE_TIME matches {*}
						}
					}
					ELEMENT[at0028] occurrences matches {0..1} matches {    -- Details for Modified CPR child only
						value matches {
							DV_TEXT matches {*}
						}
					}
					ELEMENT[at0006] occurrences matches {0..1} matches {    -- Patient awareness of decision
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0007,    -- Patient not aware of CPR decision
									at0008]    -- Patient aware of CPR decision
								}
							}
						}
					}
					ELEMENT[at0012] occurrences matches {0..1} matches {    -- Informal carer awareness of decision
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0025,    -- Informal carer not aware of CPR decision
									at0026]    -- Informal carer aware of CPR decision
								}
							}
						}
					}
					ELEMENT[at0021] occurrences matches {0..1} matches {    -- Comment
						value matches {
							DV_TEXT matches {*}
						}
					}
				}
			}
		}
		protocol matches {
			ITEM_TREE[at0010] matches {    -- Tree
				items cardinality matches {0..*; unordered} matches {
					ELEMENT[at0017] occurrences matches {0..1} matches {    -- CPR form completed
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0018,    -- CPR form completed
									at0019,    -- CPR form not completed
									at0029]    -- CPR form status unknown
								}
							}
						}
					}
					ELEMENT[at0013] occurrences matches {0..1} matches {    -- Discussion with patient
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0016,    -- Resuscitation discussed with patient
									at0023]    -- Resucitation not discussed with patient
								}
							}
						}
					}
					ELEMENT[at0014] occurrences matches {0..1} matches {    -- Discussion with informal carer
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0015,    -- Resuscitation discussed with informal carer
									at0024]    -- Resuscitation not discussed with informal carer
								}
							}
						}
					}
					ELEMENT[at0011] occurrences matches {0..1} matches {    -- Location of CPR documentation
						value matches {
							DV_TEXT matches {*}
							DV_URI matches {*}
						}
					}
					ELEMENT[at0009] occurrences matches {0..1} matches {    -- Date for review of CPR decision
						value matches {
							DV_DATE_TIME matches {
								value matches {yyyy-mm-ddTHH:MM:SS}
							}
						}
					}
				}
			}
		}
	}


ontology
	terminologies_available = <"SNOMED-CT", "RCD99", "READ2">
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"CPR decision">
					description = <"The advance recommendation as to whether cardio-pulmonary resuscitation should be undertaken or not. This is generally referred to in UK clinical guidance as the CPR (Cardio-pulmonary resuscitation) decision.">
				>
				["at0001"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Date of CPR decision">
					description = <"The date at which the CPR decision was originally taken or last reviewed.">
				>
				["at0003"] = <
					text = <"CPR decision">
					description = <"The advance recommendation as to whether cardiopulmonary resuscitation (CPR) should be attempted. In some cases a clear answer may not be available to the recording clinician.">
				>
				["at0004"] = <
					text = <"CPR attempts recommended adult or child">
					description = <"Cardio-pulmonary resuscitation is recommended for adult or child.">
				>
				["at0005"] = <
					text = <"CPR attempts not recommended adult or child.">
					description = <"Cardiopulmonary resuscitation is not recommended for adult or child.">
				>
				["at0006"] = <
					text = <"Patient awareness of decision">
					description = <"Is the patient aware of the CPR decision?">
				>
				["at0007"] = <
					text = <"Patient not aware of CPR decision">
					description = <"The patient is not aware of the cardiopulmonary resuscitation decision.">
				>
				["at0008"] = <
					text = <"Patient aware of CPR decision">
					description = <"The patient is aware of the cardiopulmonary resucitation decision.">
				>
				["at0009"] = <
					text = <"Date for review of CPR decision">
					description = <"The date at which the CPR decision should be reviewed.">
				>
				["at0010"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0011"] = <
					text = <"Location of CPR documentation">
					description = <"The location of the original CPR document, either a text description or an electronic link.">
				>
				["at0012"] = <
					text = <"Informal carer awareness of decision">
					description = <"Is the informal carer, or carers, aware of the CPR decision?">
				>
				["at0013"] = <
					text = <"Discussion with patient">
					description = <"Has resuscitation been discussed with  the patient?">
				>
				["at0014"] = <
					text = <"Discussion with informal carer">
					description = <"Has resuscitation been discussed with  the patient's informal carer or carers?">
				>
				["at0015"] = <
					text = <"Resuscitation discussed with informal carer">
					description = <"Resuscitation has been discussed with the patient's informal carer.">
				>
				["at0016"] = <
					text = <"Resuscitation discussed with patient">
					description = <"Resuscitation has been discussed with the patient.">
				>
				["at0017"] = <
					text = <"CPR form completed">
					description = <"Has the physical CPR form been completed?">
				>
				["at0018"] = <
					text = <"CPR form completed">
					description = <"The physical CPR form has been completed.">
				>
				["at0019"] = <
					text = <"CPR form not completed">
					description = <"The physical CPR form has not been completed.">
				>
				["at0021"] = <
					text = <"Comment">
					description = <"Other narrative comment pertinent to the CPR decision.">
				>
				["at0022"] = <
					text = <"CPR decision status unknown">
					description = <"There is no clear information on the outcome of the CPR decision.">
				>
				["at0023"] = <
					text = <"Resucitation not discussed with patient">
					description = <"Resuscitation has not been discussed with the patient.">
				>
				["at0024"] = <
					text = <"Resuscitation not discussed with informal carer">
					description = <"Resuscitation has not been discussed with the patient's informal carer or carers.">
				>
				["at0025"] = <
					text = <"Informal carer not aware of CPR decision">
					description = <"The informal carer is not aware of the do not attempt cardiopulmonary resuscitation clinical decision.">
				>
				["at0026"] = <
					text = <"Informal carer aware of CPR decision">
					description = <"The informal carer is aware of the do not attempt cardiopulmonary resucitation decision.">
				>
				["at0027"] = <
					text = <"For modified CPR child only">
					description = <"Modified CPR is recommended for child only.">
				>
				["at0028"] = <
					text = <"Details for Modified CPR child only">
					description = <"Narrative description of modification where modified CPR for child only has been selected.">
				>
				["at0029"] = <
					text = <"CPR form status unknown">
					description = <"The completion status of the CPR form is not known.">
				>
			>
		>
	>
	term_bindings = <
		["SNOMED-CT"] = <
			items = <
				["at0004"] = <[SNOMED-CT::450475007]>
				["at0005"] = <[SNOMED-CT::450476008]>
				["at0022"] = <[SNOMED-CT::845151000000104]>
			>
		>
		["RCD99"] = <
			items = <
				["at0004"] = <[RCD99::1R00.]>
				["at0005"] = <[RCD99::1R10.]>
				["at0022"] = <[RCD99::9NgV.]>
			>
		>
		["READ2"] = <
			items = <
				["at0004"] = <[READ2::1R0..]>
				["at0005"] = <[READ2::1R1..]>
				["at0015"] = <[READ2::67P1.]>
				["at0016"] = <[READ2::67P0.]>
				["at0022"] = <[READ2::9NgV.]>
			>
		>
	>