<status value="draft"/><description value="Foundational FHIR profiles for the nursing process (ADPIE), including Safety and Equity modules. BETA RELEASE - Feedback Welcome."/><packageId value="onc.ig"/><license value="MIT"/><fhirVersion value="4.0.1"/><definition><resource><reference><reference value="ValueSet/onc-4at-acute-change-vs"/></reference><name value="4AT Acute Change Value Set"/><description value="Scoring for Acute Change or Fluctuating Course"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-4at-alertness-vs"/></reference><name value="4AT Alertness Value Set"/><description value="Scoring options for 4AT Alertness"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-4at-amt4-vs"/></reference><name value="4AT AMT4 Value Set"/><description value="Scoring options for AMT4 (Age, DOB, Place, Year)"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-4at-attention-vs"/></reference><name value="4AT Attention Value Set"/><description value="Scoring for Months Backwards test"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-4at-delirium"/></reference><name value="4AT Delirium Assessment"/><description value="Rapid clinical test for delirium (4AT) comprising Alertness, AMT4, Attention, and Acute Change/Fluctuating Course. A total score of 4 or more suggests possible delirium."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-abbey-pain-scale"/></reference><name value="Abbey Pain Scale"/><description value="Pain assessment for people with dementia or who cannot verbalise. Assesses 6 parameters: Vocalization, Facial Expression, Body Language, Behavioral Change, Physiological Change, Physical Changes. Total score determines pain severity (0-2 No pain, 3-7 Mild, 8-13 Moderate, 14+ Severe)."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-acvpu"/></reference><name value="ACVPU Consciousness Level"/><description value="ACVPU consciousness level assessment for NEWS2 (Alert, Confusion, Voice, Pain, Unresponsive)"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/acvpu-vs"/></reference><name value="ACVPU Value Set"/><description value="ACVPU consciousness level codes"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-barthel-index"/></reference><name value="Barthel Index"/><description value="Barthel Index for measuring independence in activities of daily living (ADL). Score 0-20=total dependency, 91-99=slight dependency, 100=independent. Total range 0-100."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-blood-pressure"/></reference><name value="Blood Pressure"/><description value="Blood pressure observation for NEWS2 (systolic BP used for scoring)"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-body-temperature"/></reference><name value="Body Temperature"/><description value="Body temperature observation for NEWS2"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-braden-scale-assessment"/></reference><name value="Braden Scale Assessment"/><description value="A profile for the Braden Scale pressure ulcer risk assessment"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-bristol-stool-chart"/></reference><name value="Bristol Stool Chart"/><description value="Assessment of stool form using the Bristol Stool Chart (Types 1-7). Gold standard for bowel function assessment."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-clinical-frailty-scale"/></reference><name value="Clinical Frailty Scale (CFS)"/><description value="Assessment of frailty using the Rockwood Clinical Frailty Scale (1-9). Essential for older adults to determine baseline functional status."/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-cfs-vs"/></reference><name value="Clinical Frailty Scale Value Set"/><description value="Codes for Rockwood Clinical Frailty Scale (1-9)"/><exampleBoolean value="false"/></resource><resource><reference><reference value="Observation/example-4at-delirium"/></reference><name value="example-4at-delirium"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-4at-delirium"/></resource><resource><reference><reference value="Observation/example-abbey-pain"/></reference><name value="example-abbey-pain"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-abbey-pain-scale"/></resource><resource><reference><reference value="Observation/example-abc-chart"/></reference><name value="example-abc-chart"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-abc-chart"/></resource><resource><reference><reference value="Observation/example-bristol-stool"/></reference><name value="example-bristol-stool"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-bristol-stool-chart"/></resource><resource><reference><reference value="Observation/example-clinical-frailty"/></reference><name value="example-clinical-frailty"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-clinical-frailty-scale"/></resource><resource><reference><reference value="Observation/example-fluid-balance"/></reference><name value="example-fluid-balance"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-fluid-balance"/></resource><resource><reference><reference value="Observation/example-goal-evaluation"/></reference><name value="example-goal-evaluation"/><exampleCanonical value="https://clinyqai.github.io/open-nursing-core-ig/StructureDefinition/onc-goal-evaluation"/></resource><resource><reference><reference value="Observation/example-mental-capacity"/></reference><name value="example-mental-capacity"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-mental-capacity"/></resource><resource><reference><reference value="Procedure/example-nursing-intervention"/></reference><name value="example-nursing-intervention"/><exampleCanonical value="https://clinyqai.github.io/open-nursing-core-ig/StructureDefinition/onc-nursing-intervention"/></resource><resource><reference><reference value="Condition/example-nursing-problem"/></reference><name value="example-nursing-problem"/><exampleCanonical value="https://clinyqai.github.io/open-nursing-core-ig/StructureDefinition/onc-nursing-problem"/></resource><resource><reference><reference value="Observation/example-oral-health"/></reference><name value="example-oral-health"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-oral-health"/></resource><resource><reference><reference value="Goal/example-patient-goal"/></reference><name value="example-patient-goal"/><exampleCanonical value="https://clinyqai.github.io/open-nursing-core-ig/StructureDefinition/onc-nursing-goal"/></resource><resource><reference><reference value="Observation/example-patient-story"/></reference><name value="example-patient-story"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-patient-story"/></resource><resource><reference><reference value="Observation/example-reasonable-adjustment"/></reference><name value="example-reasonable-adjustment"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-reasonable-adjustment"/></resource><resource><reference><reference value="Observation/example-seizure-record"/></reference><name value="example-seizure-record"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-seizure-record"/></resource><resource><reference><reference value="Observation/example-urinalysis"/></reference><name value="example-urinalysis"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-urinalysis"/></resource><resource><reference><reference value="Observation/example-what-matters"/></reference><name value="example-what-matters"/><exampleCanonical value="https://fhir.clinyq.ai/StructureDefinition/onc-what-matters"/></resource><resource><reference><reference value="ValueSet/skintone-vs"/></reference><name value="Fitzpatrick Skin Tone Value Set"/><description value="Value set for Fitzpatrick skin type classifications"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-fluid-balance"/></reference><name value="Fluid Balance"/><description value="Assessment of fluid intake, output, and balance. Critical for renal function, hydration status, and heart failure monitoring."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-glasgow-coma-scale"/></reference><name value="Glasgow Coma Scale"/><description value="Glasgow Coma Scale (GCS) for assessing level of consciousness. Total score 3-15 with three required components: Eye (1-4), Verbal (1-5), Motor (1-6)."/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/goal-evaluation-valueset"/></reference><name value="Goal Evaluation Value Set"/><description value="Value set for evaluating patient goal outcomes"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-goal-target-measure-vs"/></reference><name value="Goal Target Measure ValueSet"/><description value="Codes used for goal target measures"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-heart-rate"/></reference><name value="Heart Rate"/><description value="Heart rate (pulse) observation for NEWS2"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/housing-status-vs"/></reference><name value="Housing Status Value Set"/><description value="Value set for patient housing status"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-inspired-oxygen"/></reference><name value="Inspired Oxygen"/><description value="Inspired oxygen observation for NEWS2 (air vs supplemental oxygen)"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/inspired-oxygen-vs"/></reference><name value="Inspired Oxygen Value Set"/><description value="Codes for inspired oxygen status"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/intervention-goal-reference"/></reference><name value="Intervention Goal Reference"/><description value="Extension to link nursing interventions to the patient goals they are intended to achieve."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-mental-capacity"/></reference><name value="Mental Capacity Assessment"/><description value="Records the outcome of a Mental Capacity Assessment for a specific decision. Fundamental legal safeguard in UK nursing practice."/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-mca-vs"/></reference><name value="Mental Capacity Finding Value Set"/><description value="Codes indicating presence or absence of capacity"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-mmse"/></reference><name value="Mini Mental State Examination (MMSE)"/><description value="Mini Mental State Examination for cognitive function screening. Score 24-30=no impairment, 18-23=mild, 0-17=severe. Total range 0-30."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-monk-skintone-observation"/></reference><name value="Monk Skin Tone Observation"/><description value="Observation of patient skin tone using the Monk Skin Tone Scale (10-point scale A-J). Provides more granular skin tone assessment than Fitzpatrick scale, particularly for darker skin tones. Supports equitable care and accurate clinical assessment across diverse populations."/><exampleBoolean value="false"/></resource><resource><reference><reference value="CodeSystem/onc-monk-scale"/></reference><name value="Monk Skin Tone Scale CodeSystem"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-monk-scale-vs"/></reference><name value="Monk Skin Tone Scale ValueSet"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-morse-fall-scale"/></reference><name value="Morse Fall Scale"/><description value="Morse Fall Scale for assessing fall risk. Score 0-24=no risk, 25-50=low risk, ≥51=high risk. Total range 0-125."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-must-score"/></reference><name value="MUST Score (Malnutrition Universal Screening Tool)"/><description value="Malnutrition Universal Screening Tool for identifying adults at risk of malnutrition. Score 0=low risk, 1=medium risk, 2+=high risk. NHS-standard nutritional screening."/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/news2-code-vs"/></reference><name value="NEWS2 Code Value Set"/><description value="LOINC and SNOMED codes for NEWS2"/><exampleBoolean value="false"/></resource><resource><reference><reference value="PlanDefinition/news2-escalation-plan"/></reference><name value="NEWS2 Escalation Protocol"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-news2-score"/></reference><name value="NEWS2 Score"/><description value="National Early Warning Score 2 (NEWS2) for detecting clinical deterioration. Fully aligned with NHS CareConnect-NEWS2-Observation-1."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-news2-subscore"/></reference><name value="NEWS2 Sub-Score"/><description value="Individual parameter sub-score for NEWS2 (0-3 for most parameters). References the related vital sign observation."/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/news2-subscore-code-vs"/></reference><name value="NEWS2 Sub-Score Codes"/><description value="SNOMED codes for NEWS2 sub-scores"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/nursing-intervention-valueset"/></reference><name value="Nursing Intervention Value Set"/><description value="Value set for nursing interventions"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-nursing-problem"/></reference><name value="Nursing Problem"/><description value="Nursing diagnosis or problem identified during assessment. Represents clinical judgments about individual, family, or community responses to actual or potential health problems. Part of the ADPIE framework's Diagnosis phase."/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/nursing-problem-valueset"/></reference><name value="Nursing Problem Value Set"/><description value="Value set for nursing problems and diagnoses"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-prognosis-vs"/></reference><name value="Nursing Prognosis ValueSet"/><description value="Prognosis codes for clinical impression"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/observation-goal-reference"/></reference><name value="Observation Goal Reference"/><description value="Extension to link goal evaluation observations to the patient goals being evaluated."/><exampleBoolean value="false"/></resource><resource><reference><reference value="Observation/observation-braden-scale"/></reference><name value="observation-braden-scale"/><exampleCanonical value="https://clinyqai.github.io/open-nursing-core-ig/StructureDefinition/onc-braden-scale-assessment"/></resource><resource><reference><reference value="Observation/observation-skin-tone"/></reference><name value="observation-skin-tone"/><exampleCanonical value="https://clinyqai.github.io/open-nursing-core-ig/StructureDefinition/onc-skintone-observation"/></resource><resource><reference><reference value="StructureDefinition/onc-goal-evaluation"/></reference><name value="ONC Goal Evaluation"/><description value="Explicit evaluation of whether a nursing goal was achieved, closing the ADPIE loop."/><exampleBoolean value="false"/></resource><resource><reference><reference value="Library/onc-news2-cql"/></reference><name value="ONC NEWS2 Auto-Calculation Logic"/><description value="Logic library for calculating National Early Warning Score 2 (NEWS2) from FHIR Observations."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-nhs-patient"/></reference><name value="ONC NHS Patient"/><description value="A patient profile for use in NHS nursing contexts with ethnic category extension."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-nursing-clinical-impression"/></reference><name value="ONC Nursing Clinical Impression"/><description value="Nurse's synthesis of patient progress against care plan, aggregating multiple goal evaluations."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-nursing-goal"/></reference><name value="ONC Nursing Goal"/><description value="Patient-centered goal with mandatory evaluation requirements. Serves as the 'spine' of the CarePlan, linking problems to outcomes."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-nursing-intervention"/></reference><name value="ONC Nursing Intervention"/><description value="Nursing intervention performed to achieve patient goals. Part of ADPIE Implementation phase."/><exampleBoolean value="false"/></resource><resource><reference><reference value="CodeSystem/onc-observation-codes"/></reference><name value="ONC Observation Codes"/><description value="Custom observation codes for Open Nursing Core"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-nursing-assessment"/></reference><name value="Open Nursing Core Assessment"/><description value="Base profile for nursing assessment observations conforming to UK Core standards. Captures structured nursing assessment data as part of the ADPIE (Assessment, Diagnosis, Planning, Implementation, Evaluation) nursing process framework. Used as parent for specialized assessments like NEWS2, Braden Scale, and clinical observations."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-oral-health"/></reference><name value="Oral Health Assessment"/><description value="Assessment of oral cavity health. Critical for prevention of pneumonia in frail elderly and maintaining nutrition/hydration."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-oxygen-saturation"/></reference><name value="Oxygen Saturation"/><description value="Oxygen saturation (SpO2) observation for NEWS2"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-pain-assessment"/></reference><name value="Pain Assessment (NRS 0-10)"/><description value="Pain severity assessment using the Numeric Rating Scale (0-10)"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/pain-assessment-code-vs"/></reference><name value="Pain Assessment Code Value Set"/><description value="LOINC codes for pain severity assessment"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-patient-story"/></reference><name value="Patient Story"/><description value="A narrative summary of the patient's background, biography, preferences, and personhood. Goes beyond clinical history to capture 'who the person is'."/><exampleBoolean value="false"/></resource><resource><reference><reference value="Patient/patient-example-jane"/></reference><name value="patient-example-jane"/><exampleCanonical value="https://clinyqai.github.io/open-nursing-core-ig/StructureDefinition/onc-nhs-patient"/></resource><resource><reference><reference value="StructureDefinition/onc-abc-chart"/></reference><name value="PBS ABC Chart"/><description value="Antecedent-Behaviour-Consequence (ABC) Chart for recording behaviours of concern. Fundamental tool in Positive Behaviour Support (PBS) for Learning Disabilities."/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/onc-pbs-function-vs"/></reference><name value="PBS Behaviour Function ValueSet"/><description value="Common functions of behaviour (SEAT)"/><exampleBoolean value="false"/></resource><resource><reference><reference value="Practitioner/practitioner-example"/></reference><name value="practitioner-example"/><exampleBoolean value="true"/></resource><resource><reference><reference value="ValueSet/problem-category-valueset"/></reference><name value="Problem Category Value Set"/><description value="Value set for categorizing nursing problems"/><exampleBoolean value="false"/></resource><resource><reference><reference value="CodeSystem/onc-problem-type"/></reference><name value="Problem Type CodeSystem"/><description value="Code system for categorizing types of nursing problems"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-qsofa"/></reference><name value="qSOFA (Quick SOFA)"/><description value="Quick Sequential Organ Failure Assessment for sepsis screening. Score ≥2 indicates high risk. Total range 0-3."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-reasonable-adjustment"/></reference><name value="Reasonable Adjustment"/><description value="Captures specific strict requirements for care adjustments under the Equality Act (e.g., 'Needs BSL Interpreter', 'Cannot use stairs', 'Requires large print')."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-relational-observation"/></reference><name value="Relational Engagement Score"/><description value="Assessment of the quality and depth of the nurse-patient relationship or engagement level. Supports the relational aspect of care."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-respiration-rate"/></reference><name value="Respiration Rate"/><description value="Respiration rate observation for NEWS2"/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-seizure-record"/></reference><name value="Seizure Record"/><description value="Record of a specific seizure event, including type, duration, triggers, and recovery phases. Essential for epilepsy management and identifying patterns."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-skintone-observation"/></reference><name value="Skin Tone Observation"/><description value="Observation of patient skin tone using the Fitzpatrick skin type classification. Supports equitable care by enabling skin tone-aware clinical decision making, particularly for conditions that present differently across skin tones (e.g., pressure ulcers, cyanosis)."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-sleep-pattern"/></reference><name value="Sleep Pattern"/><description value="Observation of sleep quality, duration, and disturbances. Sleep pattern disturbance is a key indicator for delirium and general wellbeing."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/UKCore-Extension-EthnicCategory"/></reference><name value="UK Core Ethnic Category"/><description value="An extension to record the ethnic category of a patient, as per UK Core standards."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-urinalysis"/></reference><name value="Urinalysis"/><description value="Point-of-care urine dipstick test results. Used to screen for urinary tract infection (UTI), diabetes (glucose/ketones), and kidney health."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-waterlow-score"/></reference><name value="Waterlow Score"/><description value="Waterlow Pressure Ulcer Risk Assessment - NHS standard tool. Score ≥10 indicates at risk, ≥15 high risk, ≥20 very high risk."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-what-matters"/></reference><name value="What Matters to Me"/><description value="Captures the patient's specific, personal priorities and non-clinical goals (e.g., 'I want to walk my daughter down the aisle'). Fundamental to person-centred care."/><exampleBoolean value="false"/></resource><resource><reference><reference value="StructureDefinition/onc-wound-assessment"/></reference><name value="Wound Assessment"/><description value="Comprehensive wound assessment including staging and dimensions"/><exampleBoolean value="false"/></resource><resource><reference><reference value="ValueSet/wound-stage-vs"/></reference><name value="Wound Stage Value Set"/><exampleBoolean value="false"/></resource><page><extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name"><valueUrl value="toc.html"/></extension><nameUrl value="toc.html"/><title value="Table of Contents"/><generation value="html"/><page><extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name"><valueUrl value="index.html"/></extension><nameUrl value="index.html"/><title value="Home"/><generation value="markdown"/></page></page><parameter><code value="copyrightyear"/><value value="2025+"/></parameter><parameter><code value="releaselabel"/><value value="draft"/></parameter></definition></ImplementationGuide>